Registered Nurse Critical Care - ED

Covenant Health • $76K — $105K *

Nashua, NH 03060In-Person

Hospitals & Medical Centers

Less than 5 years of experience

Today

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Job Overview by Ladders

Qualifications

Current New Hampshire RN license required
Graduate of an approved Nursing program strongly preferred
3-5 years of Critical Care Experience preferred for the Cardiac Cath/Angiography Lab
ASN required, BSN preferred
BLS required, ACLS preferred for all critical care RN roles
PALS required for specific departments prior to completion of orientation
Membership in a professional organization preferred

Responsibilities

Provide professional nursing care to patients in a hospital unit
Complete unit-specific competencies for critically ill patients during onboarding and annually
Engage in quality improvement processes within the practice area
Document patient care comprehensively and timely in the EHR
Respond quickly to patient monitoring alarms and provide emotional support
Participate in unit committees and councils for collaborative improvement
Implement safety protocols and maintain a secure environment for patients and staff

Benefits

Opportunities for continuous learning and professional development
Participation in shared governance and unit-based initiatives
Supportive work environment fostering teamwork and collaboration
Access to mentorship programs for new nurses
Flexible scheduling with on-call assignments as needed
Commitment to maintaining a safe and compliant workplace

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Full Job Description

Job Summary:

Essential Duties and Responsibilities

Renders professional nursing care to patients within an assigned unit of the hospital, in support of medical care as directed by medical staff and pursuant to objectives and policies of the hospital
Compliant in completion of all unit specific competencies and requirements required to care for critically ill patients within the department during orientation period onboarding and annually as assigned.
Involved in quality improvement planning and processes for the area of practice
Clinical documentation and care plans completed comprehensively for all patients assigned in a timely manner within the electronic health record (EHR), including Vital Signs, assessments, care plans, and information related to any change in condition.
Knowledge and understanding of responsibilities during down-time
Responds quickly to all patient monitoring alarms
Provides emotional support for patients and families during difficult situations
Collect specimens as ordered and in the order required per policy, labeling and sending to the lab in a timely manner
Engages and participates in unit or organizational committees and councils.
Ability to analyze patient assessments and data, communicate findings, document and implement actions timely and accurately
Pursues personal growth and development through continuous learning opportunities within and outside of the organization.
Seeks feedback and accepts constructive criticism regarding practice and takes actions as appropriate.
Practice reflects knowledge of current practice standards (ANA, NH Nurse Practice Act, Specialty standards).
Communicates patient information appropriate for continuity and safe care through hand offs, walking rounds, and physician/provider interaction.
Provides a safe and secure environment for patients, visitors, and staff by following established procedures and protocols
Implements resources and initiatives that are in place or in process to improve patient safety.
Works within guidelines of Just Culture Environment to promote error reporting and adoption of safe practices.
Assures issues are addressed through appropriate use of the chain of command
Completes hourly rounding in collaboration with LNAs (Licensed Nursing Assistant) on all assigned patients
Identifies and assists in correction of patient care safety issues.
Builds respectful relationships through early and pro-active identification of concerns, compliments, or suggestions
Collaborates unit to unit and shift to shift for resolution of conflicts and issues in a timely manner
Consults with nurses in other department/units to draw upon expertise in other clinical areas/specialties.
Works collaboratively with Providers to complete assessments and perform bedside procedures.
Displays professional, positive perspective, including when faced with difficult circumstances
Seeks opportunities to assist all team members
Actively participates in unit-based shared governance and with the philosophy of the unit and the organization.
Appropriately delegates aspects of care and unit activities to other nursing personnel
Provides support and mentors new nurses and other disciplines withing the department through preceptorship and other methods as requested by the department leadership.
Participates in Peer Review maintaining confidentiality.
Participates in DNV survey readiness.
Demonstrates characteristics of the SPIRIT of St. Joseph Hospital with a commitment to my co-workers and holds peers accountable for the same.
Follows organizational HIPAA compliance policy.
Demonstrates fiscal responsibility through complete and accurate timekeeping, as well as patient supply utilization.
Avoiding unauthorized use of overtime and managing ETO per policy.
Participates in annual evaluation 360 process as requested.
Provides quality care by remaining up-to-date on Nurse Sensitive Indicators.
Responds to emergency situations per department/role requirements such as Code Blue and rapid response team.
Other duties as consistent with this role.

Emergency Department, additional responsibilities include:

Triages patients and determines priority of care (ESI level) based on physical, psychological, and social needs including factors influencing patient flow through the system.
Implement protocol orders associated with approved chief complaints.
Performs focused assessment related to chief complaints in a timely manner according to established triage guidelines
Reassess arrived patients after initial triage to ensure no change in condition.
Provides quality care for patients presenting with acute illness and/or trauma requiring emergent/urgent attention and able to recognize potential life-threatening conditions for early intervention
Initiates corrective action as appropriate when information from monitoring equipment shows adverse symptomology or patients demonstrate adverse clinical symptoms
For admitted/boarding patients, complete required documentation per policy
Engages in initiatives aimed at improving patient throughput

Cardiac Cath and Angiography Lab additional responsibilities include:

Ability to learn complex technologies effectively
Experience with complex/critical care medication infusions, including titration management
Enhanced knowledge of anatomy and physiology, especially cardiac
Experience with emergency cardiac interventions
Provide in-depth history and medication review (pre-admission testing) of all patients scheduled for procedures to ensure patient safety peri-procedure. Demonstrates the ability to correctly identify periprocedural safety issues, and report to physician accordingly.
Demonstrates clinical expertise in creating and maintaining a sterile field.
Plans and provides equipment and supplies based on procedure and physician needs.
Participates in on-call assignments and demonstrates flexibility to cover staffing as needed.
Ability to be within 30-minute radius when on call.
Ability to safely administer procedural sedation. Pass annual sedation examination. Documents sedation according to policies and procedures.
Maintains safe working environment to include radiation safety/appropriate personal protection attire.
Demonstrates criteria for arterial and venous sheath removal. RN has working understanding of guidelines provided in physician orders for safe sheath removal when patient has been given blood thinners prior to sheath removal.
Demonstrates the ability to identify criteria for equipment including Intra-Aortic Balloon Pump (IABP), IMPELLA etc. Assist MD with set up, insertion and maintenance of equipment as needed.
Assist with insertion of Flow wire, Opsens and IVUS. RN must demonstrate contraindications and reversal for IV adenosine infusion.
Demonstrates a working knowledge of hemodynamic waveforms. Obtains the ability to monitor arterial waveform during left heart catheterization. Able to identify damping and ventriculization of arterial waveforms. Able to correctly identify different hemodynamic waveforms during right heart catheterizations.

Job Requirements

Job Knowledge and Skills

Basic Dysrhythmia preferred or obtained prior to completion of orientation.
NIHSS certification preferred or obtained prior to completion of orientation
Certification in Specialty preferred
Call shifts required for Cath Lab and Stress Lab.
CPI training preferred or obtained within 6 months of hire.
CPI advanced training for the ED and ICU within 6 months of hire.

Education and Experience

Current New Hampshire RN license required
Graduate of an approved Nursing program strongly preferred
3-5 Years Critical Care Experience preferred for the Cardiac Cath/Angiography Lab
ASN required, BSN preferred
BLS required
ACLS Preferred for all critical care RN roles (excluding the Operating Room and Pre-Admission testing and is required prior to completion of orientation)
PALS Preferred -
- Required prior to completion of orientation for Urgent Care, and PACU
- Required prior to assuming care for critically ill pediatric patient for Emergency Department (may have ENPC in place of PALs)
TNCC - Preferred - required within 18 months of hire for the Emergency Department
TCAR - Preferred - required within 1 year of hire for the ICU and PACU.
Crisis Prevention Institute (CPI) training preferred or obtained prior to completion of orientation
Membership in a professional organization preferred.

Comp Range:
$36.86 - $50.76
Rate of pay displayed reflects the beginning of the pay scale. At the time of an offer, determination of your offer will reflect your skills and experience as it relates to the position.

Our people make the difference. See firsthand what makes our employees and culture shine!

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About Covenant Health

Covenant Health is a not-for-profit healthcare system providing comprehensive, community-wide health services in East Tennessee. It is the largest employer in the region with more than 10,000 dedicated employees working to improve the health of the communities they serve. Covenant Health operates nine acute-care hospitals, numerous outpatient facilities, and physician clinics serving communities throughout East Tennessee. The health system also includes specialty providers of behavioral, oncology, and rehabilitation services, along with home care, physician practices, and community outreach programs. Covenant Health is committed to providing excellent care to every patient, every time, and to making its communities healthier places to live.

Learn more about Covenant Health

Size

10,000 employees

Industry

Healthcare

Net Income

$100 million

Founded

1996

5 Year Trend

-2%

Revenue

$2 billion

* Ladders Estimates

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