Description

Job Objective:

A Registered Nurse who is responsible for the nursing care of patients in the Critical Care setting guided by policies and procedures of the Critical Care Unit and hospital.

Duties and Responsibilities:

A. Nursing Process:

1. Applies nursing process in direct patient care
   • Assessment of physiological, psycho social, educational, cultural, and spiritual needs of patient as evidenced by written assessment within one hour of admission and visual assessment within fifteen minutes of arrival
   • Documents physical assessment every four hours on in the electronic medical record and vital signs/I&O Q2 or more frequently as required by diagnosis/disease process/physician orders.
   • Reassesses patient's needs every four hours and more often when necessary and documents in the electronic medical record and patient care plan. Provides further interventions as necessary and re-evaluates outcomes.
2. Care of acutely ill patient
   • Monitors vital sign, i.e. EKG, Sa02, etc. and intervenes as necessary
   • Initiate and monitor vasoactive drips, ie Dopamine, Dobutamine, Nipride, Norepinephrine etc.
   • Monitor invasive lines, i.e. central lines, arterial lines, etc.
   • Monitor ventilator patients and intervene when necessary
   • Operate various pain management equipment, i.e. PCA, Epidural, etc.
   • Assess patient for respiratory depressions and/or arrest and intervene immediately if necessary, i.e. CPR, use ambu bag, chin lift maneuvers airways, etc.
   • Responds to codes in unit and responds to codes in other units in the hospital.
   • Monitor, assess and intervenes with extremely unstable patients, ie post cardiac surgery, trauma, organ donation, etc.
   • Insures that patients have a safe post-operative/post-procedural period from general, regional or local anesthesia, including Moderate Sedation .
   • Provide age specific and disease specific care and education to patients/families relating to post-procedural care.

B. Technical Equipment Operation:

1. Operates technical equipment safely, efficiently and accurately as per unit competency level.

• Pressure line set up and maintenance
• Cardiac monitors
• Insertion, maintenance, withdrawal of blood form arterial line, and removal of arterial line
• Cardiac output
• Insertion, maintenance and removal of PA lines
• ICP and/or Camino set up, insertion and maintenance
• Crash cart/defibrillator/cardioverison
• Ventilator management
• Peripheral Nerve Stimulator
• Ventricular Assist Device
• Transvenous pacemaker/non-invasive pacing
• Femostop/C-clamp for line removal

Non-Essential Duties:

• Participates on unit or hospital based committees
• Other duties as assigned, within compliance with Title 22, The Joint Commission, and CMS.

Knowledge, Skills and Abilities:

Knowledge

• Demonstrates knowledge of criteria for 1:1 patient
• Demonstrates knowledge of patient classification system
• Demonstrates knowledge of staffing guidelines for Critical Care Unit
• Demonstrates knowledge of Moderate Sedation
• Demonstrates knowledge of Critical Care security policies and procedures.
• Demonstrates knowledge of Critical Care visitation policy.
• Supports and adheres to the values and mission statement established by the AVH Board of Directors
• Conforms to required accreditation standards.
• Conforms with and supports hospital quality management and performance improvement guidelines

Skills

• Meets skills and abilities of a Registered Nurse
• Skill and ability to follow telephone etiquette/standards
• Displays a willingness to work as a team player
• Safely and effectively uses all equipment necessary to carry out duties

Abilities

• Ability to adhere to all established AVH policies and procedures and to interpret and function under these.
• Ability to organize work and establish priorities
• Ability to expand on own initiative in performance of duties
• Ability to function effectively under pressure and meet time parameters
• Ability to relieve clerical staff at desk, or to adopt any function commonly assigned to unlicensed assistive personnel, or as allowed within scope of nursing practice, as needed

Education and Experience:

Education

• Maintains current licensure, certifications, education, and physical health standards
• Participates in mandatory and/or optional educational activities/offerings. Attends staff meetings regularly and as required by assigned unit
• Demonstrates knowledge and competency on hospital information technologies used in the designated patient care area.
• Successfully completes written and practical competencies annually or otherwise as assigned.
• CCRN preferred.
  Experience

• Two years acute care nursing preferred, new grad training provided as appropriate.

Required Licensure and/or Certifications:

• Meets all required licensure and/or certifications necessary for Registered Nurse.
• ACLS certification required on file in Department of Education.

Physical Requirements and Working Conditions:

• Work often performed under stressful, emotional, and physical conditions
• Accepts additional workload during times of unexpected circumstances, e.g., high activity, high census, and sudden emergencies.
• May be exposed to contaminated instruments that may cause infections, burns, or cuts.
• May also be exposed to wet and/or humid conditions, fumes or airborne particles, toxic or caustic chemicals, risk of electrical shock, and risk of radiation.

A detailed description of the physical requirements of this job is maintained in the Employee Health Department.

Requirements

Education and Experience:

Education
• Adheres to required educational standards
• Maintains current licensure, certifications, education, and physical health standards Participates in mandatory and/or optional educational activities/offerings. Attend staff meetings regularly and as required by assigned unit
• Demonstrates knowledge and competency on hospital information technologies used in the designated patient care area.
• Successfully completes written and practical competencies annually or otherwise as assigned.

Experience
• Two years' acute care nursing preferred; new grad training provided as appropriate

Required Licensure and/or Certifications:
• Current California Registered Nursing license
• BCLS Certification
• ACLS, PALS, and/or other additional Certifications required for some specialty areas

*Resuscitation credentials such as (BLS, ACLS, PALS, etc.) are required before completion of orientation period.

Education and Experience:

Education
• Maintains current licensure, certifications, education, and physical health standards
• Participates in mandatory and/or optional educational activities/offerings. Attends staff meetings regularly and as required by assigned unit
• Demonstrates knowledge and competency on hospital information technologies used in the designated patient care area.
• Successfully completes written and practical competencies annually or otherwise as assigned.
• CCRN preferred.

Experience
• Two years of acute care nursing preferred, new grad training provided as appropriate.

Required Licensure and/or Certifications:
• Meets all required licensure and/or certifications necessary for Registered Nurse.
• ACLS certification required on file in the Department of Education.