Ascension Health Registered Nurse - PRCU in Grand Blanc, Michigan
Job ID: 269784
Registered Nurse - PRCU
Grand Blanc, Michigan
Additional Job Information
Title: Registered Nurse
City, State: Grand Blanc, MI
Location: Health Park
Department: Respiratory Intermdte Care 001
Additional Job Details: Full-Time Nights, 7pm - 7:30am Monday thru Friday and QOWE
As the leading healthcare provider in mid-Michigan, Genesys has been improving our community's health for more than 95 years, and part of Ascension since 1999. As a group of affiliated medical campuses, outpatient centers, primary care locations including a network of 160 primary care physicians and ancillary healthcare organizations, we share a philosophy of providing personalized care to every person we serve.
Uses independent professional judgment, analytical skills, and the nursing process to provide a full range of delegated, interdependent, and independent nursing services to patients. Within the framework of the Seven Dimensions of Patient Care and Benner's Domains of Nursing Practice, demonstrates clinical competence; compassion and customer service orientation; focus on process and outcomes; and cost-consciousness when assessing, planning, implementing, and evaluating nursing care provided to patients.
Seven Dimensions of Patient Care: Coordinates development of a multi-disciplinary plan of care in accordance with Nursing Problem Care Sets (Core Outcomes and Core Intervention Sets) and/or clinical practice guidelines, age-specific requirements and professional and regulatory requirements to ensure appropriate length of stay, use of resources, and achievement of quality outcomes.
Provides patient care that reflects a respect for patient's rights, dignity, values, culture, preferences, and expressed needs. Assesses patient/family needs for information and education across the continuum, plans and implements patient teaching using a variety of techniques and methods, and evaluates effectiveness of educational interventions.
Helps to alleviate patient fears and anxiety through skillfull application of professional and interpersonal communication.
Utilizes a variety of pharmacologic and non-pharmacologic approaches to ensure patient comfort and relief of pain. Involves patient, family, significant others in development of plan of care. Collaborates with patient/family, hospital staff, and community agencies to develop discharge plans that prepare patients for continued care needs.
Orientation Self-Evaluation: (C) Competent (NT) Needs Training or Review
STANDARDS OF PERFORMANCE:
Seven Domains of Nursing Practice
Helping/Teaching & Coaching:
- Incorporates all elements of Signature Care in Daily interactions with patient:
__ Introduces self and writes name on whiteboard
__ Discusses plan of care with patient/family
__ Explains meds and treatments, provide teaching as appropriate
__ Asks if patient needs anything else before leaving room
- Assesses health status and determines care needs of the patient. Performs ongoing reassessment as required.
__ Completes Admission Assessment and shift assessment as required.
__ Completes assessment for Risk Factors; including fall, skin breakdown, VTE, and aspiration. Initiates appropriate initiatives as indicated – SKINN Bundle, Fall Prevention Plan, SCD, etc.
__ Completes Medication Reconciliation upon admission and change in level of care.
- Establishes, directs, coordinates and documents plan of nursing care in conjunction with patient/family.
__ Initiates Problems and Outcomes list (plan-of-care) based on medical diagnosis and patient needs.
__ 4. Monitors, documents, and reports patient response to interventions and progress toward outcomes.
__ Documents nursing interventions (NIC) and progress toward outcomes (NOC); patient education; and evaluation every shift, as required.
__ 5. Educates patient regarding treatment plan, safety measures, medications, and self-care as indicated. Documents education activities on shift assessment flowsheet and plan of care (POC).
__ 6. Works with Case Manager to ensure appropriate referrals initiated prior to discharge.
__ 7. Reviews discharge plans/instructions with patient prior to discharge, including signs/symptoms to watch for after leaving the hospital. Ensures appropriate follow-up arranged.
__ 8. Ensures that “core measures” Discharge Instructions are given to all CHF patients.
__ 9. Documents patient care according to established documentation guidelines.
Administration of Therapeutic Regimens:
__ 1. Demonstrates knowledge and skill application of basic nursing procedures - dressing change, catheterization, NG tube insertion, suctioning.
__ 2. Implements/completes medical interventions as ordered.
__ 3. Initiates standing orders appropriately.
__ 4. Initiates and/or assists with all patient care activities including activities of daily living and provides other services as required for patient comfort, safety, and well-being.
__ 5. Assesses and initiates interventions to prevent/minimize patient skin breakdown.
__ 6. Follows clinical practice guidelines and procedures as written.
__ 7. Establishes and maintains peripheral IV therapy.
__ 8. Obtains body fluid specimens, per procedure. Obtains blood specimens if no phlebotomist assigned to area.
__ 9. Performs blood capillary glucose monitoring.
__ 10. Administers the following according to established policies and procedures:
__ a. Medications
__ b. IVs
__ c. Blood products
__ 11. Prepares patients for surgery or other invasive procedures according to established guidelines.
__ 12. Performs or assists with procedures according to established standards of care and nursing practice.
__ 13. Utilizes equipment based on manufacturers instructions and established nursing procedure. Correctly operates and trouble shoots IV pumps, PCA pumps, epidural pumps, feeding pumps, patient beds, as applicable.
Monitoring Patient Responses/Responding to Changing Patient Situations:
__ 1. Regularly reviews work in progress to ensure that treatments, medications, and tests ordered are expeditiously carried out and documented.
__ 2. Reviews patient medical record/reports and confers with physician regarding treatment plans. Routinely checks chart for new orders.
__ 3. Monitors patient physiologic parameters including vital signs, lab work, I&O, blood glucose; recognizes and reports meaningful changes and intervenes appropriately. Documents interventions accordingly.
__ 4. Monitors presence and intensity of patient’s pain on admission, after pain producing events, with each new report of pain, and routinely at regular intervals. Informs patient about pain relief and pain relief measures; administers pain medication or alternative interventions as indicated; includes pain management resources in the discharge plan/instructions.
__ 5. Recognizes acute changes in respiratory status - dyspnea, cyanosis, tachypnea, respiratory depression, airway obstruction and responds appropriately with direct intervention and physician/SWAT notification.
__ 6. Recognizes acute changes in neurologic status/decreased LOC and responds appropriately with direct intervention and physician/SWAT notification.
__ 7. Recognizes acute changes in cardiac status - tachycardia, chest pain and responds appropriately with direct intervention and physician/SWAT notification.
__ 8. Recognizes acute changes in urinary output and responds appropriately with direct action and physician notification.
__ 9. Utilizes SBAR tool or other standardized approach to data collection and information sharing when notifying physician of patient changes/concerns.
__ 10. Responds appropriately to life-threatening emergencies through initiation of CPR, assembly of emergency equipment, and immediate interventions (as allowable and indicated).
__ 11. Performs emergency equipment checks.
__ 12. Provides appropriate support/summons appropriate resources for families in crisis/grieving process.
Ensuring Quality of Health Care Practices:
__ 1. Communicates with other professionals/departments and physician staff to ensure appropriate progress of patients through the system.
__ 2. Monitors individual patient length of stay (LOS); notifies case manager and nurse manager of potential LOS/discharge issues.
_ 3. Identifies ethical issues related to patient care (including issues related to advanced directives) and initiates steps for resolution.
__ 4. Demonstrates adherence to patient confidentiality requirements.
__ 5. Communicates with patients and families cordially, diplomatically and respectfully.
__ 6. Acts to resolve customer concerns/complaints immediately; reports complaints that cannot be immediately resolved to Patient Care Director, Clinical Manager, or House Supervisor.
__ 7. Promotes a physically safe environment for the patient including use and documentation of restraints according to policy.
__ 8. Utilizes universal precautions for all patients.
__ 9. Makes cost effective use of supplies and resources.
__ 10. Assists in evaluating new products, procedures, nursing practices.
__ 11. Supports organizational, nursing department, and unit strategic goals and activities; participates in department and unit based council/staff activities meetings.
__ 12. Supports and actively participates in Nursing Department and unit specific quality monitoring and quality improvement activities.
__ 13. Participates in teaching/mentoring of student nurses and orientates.
__ 14. Evaluates own performance utilizing input from peers, co-workers, managers, physicians, customers, and develops a plan for continual improvement. (Does not include formal peer review.)
__ 15. Completes yearly safety and unit specific education requirements (GLI).
My BLS is current: _ Yes _ No
Organizational and Work Role:
_ 1. Provides input on appropriate patient care assignments; taking into consideration patient condition and knowledge/experience/work load of staff.
_ 2. Provides direction and leadership to other staff by:
__ a. Clearly communicating expectations/responsibilities to team members.
__ b. Observing patients and work in progress periodically throughout the shift.
__ c. Communicating with team members about work to be completed/problems encountered.
__ d. Assisting team members with patient care activities as needed.
__ e. Assisting other "teams" as situation requires.
__ 3. Uses the 4 Ps (patient, pertinent issues, picture, plan) to give appropriate and pertinent information at change-of-shift and/or transfer.
__ 4. Participates in the creation and maintenance of a healthy work environment by:
__ a. Treating co-workers with respect.
__ b. Communicating to co-workers with respect; resolving conflicts and/or negative feelings promptly, privately, and appropriately.
__ c. Taking responsibility for personal actions, behaviors, and attitudes and not displacing anger or frustration onto co-workers, patients, or families.
__ d. Communicating appropriate patient care issues/concerns to nurse manager.
__ 5. Responds appropriately to changes in unit workloads, patient census, and/or staffing levels.
- Graduate of an approved professional (RN) nursing program; must possess current Michigan licensure to practice as a registered nurse (RN).
- Interpersonal skills necessary in order to interact with patients/families, other nursing staff members, physicians, and other hospital personnel.
- Ability to concentrate and pay close attention to detail when planning and performing professional nursing care, resolving patient care problems, and dealing with patients and families; often during stressful situations.
- Ability to walk or stand continuously and frequently lift and position patients.
Working Conditions: 1. Normal patient care environment with moderate exposure to excessive noise, dust, temperature, etc. Frequent exposure to communicable diseases, hazardous substances, and moderately adverse Working Conditions due to performance of patient care activities.
Orientation Requirements: This position, aside from the above requirements, will require approximately three (3) to nine (9) months on-the-job experience in order to acquire and effectively apply knowledge of unit and departmental policies, procedures, and standards for patient care and professional nursing practice.
The above is intended to describe the general nature and level of work performed by people assigned to this classification. It is not to be construed as an exhaustive statement of duties, responsibilities or qualifications for the people so classified, nor is it intended to limit or modify in any way, the right of any supervisor to assign, direct, and control the work of employees under their supervision. The most recently dated job description on file in the Human Resources Department will be considered the official job description.
Licensed Registered Nurse credentialed from the Michigan Board of Nursing obtained within 2 Months (60 days) of hire date or job transfer date.
One or more of the following:
Certified BLS Provider specializing in Basic Life Support credentialed from the American Heart Association (AHA) obtained within 3 Months (90 days) of hire date or job transfer date. Or Certified Instructor.
Requires a graduate of an approved professional (RN) nursing program.
Equal Employment Opportunity
Genesys Health System will provide equal employment opportunities (EEO) to all associates and applicants for employment regardless of race, color, religion, national origin, gender, sexual orientation, gender identification or expression, age, disability, marital status, amnesty, genetic information, carrier status or any other legally protected status or status as a covered veteran in accordance with applicable federal, state and local laws.
Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.