Registered Nurse, Full time Nights - Critical Care Unit

Expectations :

Responsible for coordination of care to meet identified needs of the patient / family. Supervises the management of patient care utilizing critical thinking and nursing process, discharge planning, resource identification, linking and scheduling patients with required services, monitoring care delivery, advocating for the patient, care planning and evaluating outcomes.

Coordinates patient care across the health care continuum, and assists other team members with meeting individual patient needs.

This position may require flexibility of hours.

EDUCATION :

Bachelor’s degree (BSN) required. Associate Degree in Nursing (ADN) will be considered if enrolled in a BSN program with degree completion within 2 years of date of hire or date of transfer to an RN position.

Diploma or transcripts on highest degree earned required.

EXPERIENCE / TRAINING :

Minimum 2 years of current experience in a critical care unit, in an acute mixed unit preferred and 3 years' experience preferred.

Surgical, Neuro, Cardiac and Trauma nursing experience also strong preferred. Must challenge and successfully pass the Basic Dysrhythmia course curriculum within 21 days of hire.

Basic computer skills / experience with computerized documentation systems required, EPIC experience preferred.

LICENSES / CERTIFICATIONS :

Required :

Current unrestricted Registered Nurse (RN) license issued by California Board of Registered Nursing (BRN)

Current Basic Life Support Provider (BLS), and Advanced Cardiovascular Life Support Provider (ACLS) issued by American Heart Association

Current National Institutes of Health Stroke Scale (NIHSS) within 30 days of hire / transfer

SKILLS :

Care of the patient receiving Sedation / Analgesia

Care of the patient with Hemodynamic monitoring and / or support

Care of the patient with Neurological monitoring

Care of the patient with Pulmonary monitoring and / or support, including ventilators

Care of the Trauma patient

Must be willing and able to work in a face paced, frequently changing environment.

Must be willing and able to multi-task effectively to accomplish work assignments.

1. Demonstrates competent knowledge base in pathophysiology of the cardio vascular patient; through appropriate assessment, critical thinking skills, and plan of care, which is measured by addressing :

a. Organ perfusion and cardiac output.

b. Patient activity, and

c. Dysrhythmias.

2. Demonstrates competent knowledge base in the pathophysiology of the neuro patient; through appropriate assessment and critical thinking skills.

Formulates and implements an ongoing patient specific plan of care, which is measured by addressing :

a. Adequate cerebral perfusion pressures.

b. Patient safety.

c. The appropriate levels of stimulation for the patient are monitored / documented and maintained by the RN.

3. Demonstrates competent knowledge base in the pathophysiology of the respiratory patient, through the appropriate assessment and critical thinking skills.

Formulates and implements an ongoing patient specific plan of care, which is measured by addressing :

a. Maintenance of normal or appropriate O2 / CO2 levels.

b. The ability to identify and appropriately intervene in emergent situations related to (a).

c. Weaning assessment with appropriate sedation and daily rapid shallow breathing index, (RSBI), as indicated on the mechanically ventilated patient.

4. Demonstrates competent knowledge base in the pathophysiology of the metabolic patient; through appropriate assessment and critical thinking skills.

Formulates and implements an ongoing patient specific plan of care, which is measured by addressing :

a. The nurse's ability to monitor and interpret acid-base balance and lab values as they relate to the patient.

b. Patient's nutritional status.

c. Optimal glucose control (80-110).

5. Demonstrates competent knowledge base for all current and future unit and hospital specific core measures implemented to improve patient outcomes through appropriate assessment and critical thinking skills.

Formulates and implements an ongoing patient specific plan of care, which is measured by adherence to :

a. Incorporating Ventilator Bundle on all mechanically ventilated patients for the purpose of reducing the risk of ventilator acquired pneumonia.

b. Incorporating blood stream infection prevention standards for the purpose of reducing the risk of central line catheter BSI in all patients that have a central line inserted.

• Support use of central line cart.
• Adhere to appropriate Hand Hygiene.
• Support complete / full barrier precautions.

c. Incorporating Sepsis bundle using "Trigger Tool" to identify suspected / identified critically ill patients for the purpose of initiating early goal directed therapy.

d. Incorporating appropriate sedation management and use of approved Sedation-Agitation Scale

e. Incorporating optimal pain management set to the patients functional pain goal per policy and procedure.

f. Patient-centered care philosophy.

Allowing patients' loved ones to have access to them, as long as access does not impair delivery of quality medical care.

g. Palliative care bundle, supportive care and communication.

6. Demonstrates technical skills to safely operate and troubleshoot problems with critical care equipment and diagnostic devices for which they have been trained.

7. Demonstrates proficiency in delivering age specific care to the assigned patient populations : adolescent, adult and geriatric in the critical care setting.

8. Ensures environment safety by maintaining hallways clear, fire doors closed, medication room / supply doors are locked, discarding of outdated nourishment, ensuring documentation of refrigerator temperatures on designated logs, reporting needed equipment repairs to Facilities / Engineering and follows-up on completion of reported need for repair.

9. Provides clerical support by demonstrating proficiency in use of information systems (Meditech, PCS, Acuity, KRONOS and e-mail), consistently makes accurate entries on each system, performing chart assembly and breakdown, ensuring accurate and complete information is recorded in appropriate interventions in PCS and CCU Flow-sheet and maintaining all medical records in the chart stamped with patient identification.

10. Attends Annual Skills Day, and all mandatory classes per hospital policy or unit needs.

11. Is knowledgeable about patient safety, core measures, TJC requirements and Patient Safety Goals, as it pertains to their job.

12. Approves timecard on time, prior to close of payroll, and maintains timecard, completes all required logs, (missed meal / break).

13. Actively participates in unit cleanliness.