RN – North Runnels Hospital

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RN – North Runnels Hospital

Department: Nursing

Reports To: CNO

FLSA Status: Non-Exempt

Position Summary:

Performs the primary functions in assessing, planning, implementing, directing and evaluating patient care in the rural hospital setting. Plans, provides and documents discharge planning and teaching to patients, families and caregivers in order to obtain optimal health and wellness after discharge.
OSHA Bloodborne Pathogens Class I

Job Qualifications:

• Education: Graduate of an accredited School of Professional Nursing.

• Personal Job Related Skills: Knowledge of nursing theories and practices. Effective oral and written communication skills.

• Licensure, Registry or Certification: Registered Nurse currently licensed in the state of Texas. TNCC, ACLS, BLS and PALS required.

• Experience / Prior Work Experience: One year experience as a professional Registered nurse in a clinical setting preferred.

• Physical and Mental Requirements: Duties of this position require extended periods of standing, walking, bending, stooping, twisting, reaching, and lifting up to 50+ pounds. Occasional lifting and supporting patients that may suddenly become weak or helpless.

Essential Duties and Responsibilities:

A. Utilizes the nursing process, completes comprehensive physical and psychological assessment of hospital patients.

1. Takes patient histories to provide a basis for developing patient care plans.

2. Completes a through nursing assessment and history on patient admissions.

3. Identifies teaching, learning and discharge needs throughout patient’s hospital stay.

4. Provides an ongoing assessment which accurately reflects physiological and psychosocial needs of the patients.

5. Consistently uses input from the patient, family, significant other, caregiver, physician and health care team members.

6. Provides appropriate care for all ages of patients based on demonstrated knowledge of the principles of growth and development over the life span.

7. Assesses and interprets data for all ages of patients to identify requirements relative to the patient’s age-specific needs and provides care needed as stipulated in departmental policy.

B. Uses the nursing process, plans and provides patient/family care, evaluates patient’s response to care and redirects care as necessary.

1. Formulates appropriate nursing diagnosis and identifies patient problems form admission data and ongoing assessments.

2. Establishes patient outcome goals that are realistic, specific, measurable and progressive.

3. Develops and implements nursing orders that are specific and measurable.

4. Initiates interdisciplinary communications and incorporates recommendations.

5. Consults with patients, families and care team to formulate care plans that reflect concern for holistic needs.

6. Assesses and evaluates patient response and makes appropriate modifications to the care plan.

7. Reviews and updates care plans on a timely basis to reflect patient’s current status throughout their hospital stay.

C. Implements and monitors appropriate nursing care to meet patient’s needs.

1. Identifies expected outcomes for planned nursing intervention and insures vital information is passed between shifts.

2. Administers medications according to policy, including IVs, blood and blood components as prescribed by physicians.

3. Knows actions, indications, contradictions, precautions, adverse reactions, dosage and route of administration on all drugs before administering to the patient.

4. Verifies medication accuracy and performs the required checks on the medication administration record.

5. Gives exchange report to other health care personnel providing accurate and complete information on each patient at the change of shift, when transferring patient to another facility, and at intervals during the shift.

6. Assesses patients at the beginning of shift for acuity of patient needs, problems or concerns and establishes that priority of work activities are completed by the end of the shift.

7. Performs basic nursing skills competently to include: intake and output, vital sign monitoring, physical, mental and neurological assessment, lab specimen collection, dressing changes, patient personal hygiene and skin care, glucose monitoring, airway/suctioning, supplemental oxygen administration, nasogastric tubes, tube feedings, urinary catheterization, drains, enemas, and intravenous catheterization.

8. Recognizes and evaluates life-threatening situations.

9. Recognizes variance of diagnostic tests, vital signs and assessments that require reporting to the medical practitioner in an appropriate time frame.

10. Functions proficiently in unit nursing modalities.

D. Participates in the health care educational for the patient, family, caregiver or significant other concerning needs, disease prevention and health promotion.

1. Develops and implements an individualized teaching and discharge plan on admission and throughout hospitalization.

2. Initiates and documents progressive patient, family, caregiver and significant other teaching on admission and throughout hospitalization.

3. Act as a liaison between patient, family, caregivers, significant other, physician or other healthcare professionals.

E. Maintains accurate and timely records according to hospital policies and procedures.

1. Documents ongoing assessments in a timely manner determined by current policy which accurately reflects patient’s physiological and psychosocial needs.

2. Accurately documents patient care activities and patient’s response to interventions and delegated medical staff.

3. Maintains a patient care plan that is accurate and current which reflects patient’s individual needs or preferences.

4. Documents teaching completed and patient, family, caregiver or significant others response.

5. Documents interdisciplinary recommendations for plan of care.

6. Transcribes and/or cosigns physician’s orders completely and accurately according to hospital policy and practice.

7. Completes all appropriate transfer and discharge forms or paperwork.

Other Significant Requirements

Maintains HIPAA and all other confidentiality at all times.

Maintains continuous working relationships with physicians, co-workers, patients and family members.

Greet, assists and acknowledges all visitors.

Follows aseptic procedures and precautions when involved in direct patient care or handling potentially infectious materials.

Follows safety guidelines and policies set forth by the hospital.