The Emergency Department Registered Nurse is responsible for identifying patient needs and priorities for care through assessment, planning for and delegating care based on patient needs, executing therapeutic physician or nurse-initiated interventions, and evaluating the patient's response to care and progress towards outcomes. Whenever possible, the family or those significant to the family are considered as part of the assessment, planning, intervention, and evaluation efforts of the Registered Nurse. When care is not provided directly by the Registered Nurse, the RN assigns/delegates care to other qualified members of the health care team. The RN coordinates care between other professional disciplines as needed. Through documentation and verbal communication, essential information is shared with health care team members. Unit-based activities which contribute to a positive work and professional environment are performed.
Accountabilities/Essential Job Functions:
1. Clinical Practice
1. Initiates assessment based on the patient's presenting problems or needs, the physician's medical diagnosis and Gordon's Functional Health framework within 15 minutes of admission:
i. collects key information from patient, family, laboratory, and other medical reports
ii.determines nursing diagnosis and priorities for care with special consideration given to patient teaching, discharge planning, and the growth and development needs of the patient
iii. determines which standards of care and practice apply to the patient
iv. documents assessment, including nursing diagnoses or other clinical judgments
2. Completes ongoing assessments according to nursing division policy and/or as determined by patient condition:
v.re-prioritizes care based on new information
vi. continues to update nursing diagnoses
vii. involves family and/or other significant individuals in assessment activities
3. Performs therapeutic nursing interventions:
viii. as ordered by the Physician and/or the Nurse
ix. consistent with primary and population-specific standards of care and practice
x.with consideration given to knowledge gained from the initial and ongoing assessment of the patient
xi. consistent with Nursing Division policies and procedures, demonstrated competencies, and with consideration given to risk management and infection control practices
xii. consistent with the nature of the unit:
4. ACLS protocol
xiii. arrhythmia detection and treatment
xiv. airway management
xv. wound care
xvi. pain management measures
xvii. crisis intervention
xviii. discharge planning
5. Determines the impact of nursing interventions on the patient's condition and recognizes the patient's progress towards meeting desired outcomes.
6. Documents care based on standards of care and practice and/or clinical priorities for documentation including:
xix. assessment and ongoing assessment findings
xx. updated clinical priorities for documentation
xxi. therapeutic nursing interventions with special attention to patient education and discharge planning interventions
xxii. patient's response to interventions and progress towards outcomes are noted
7. Demonstrates ability to manage the care of patients with conditions common to the unit, including:
xxiii. management of the patient with cardiovascular emergencies
xxiv. management of the patient with respiratory emergencies
xxv. management of the patient with ent emergencies
xxvi. management of the patient with gyn emergencies
xxvii. management of the patient with wound and orthopedic emergencies
xxviii.management of the patient with neurological emergencies
8. Serves as a role model and mentor to students in the health professions.
9. Serves as preceptor, Charge Nurse or Triage Nurse at the discretion of the manager.
2. Professional Communication
10. Maintains confidentiality in matters relating to patient/family.
11. Interacts with patients/families with a variety of developmental and sociocultural backgrounds.
Provides information to patients and families which reduces anxiety and conveys an attitude of acceptance, sensitivity, and caring.
Maintains professional relationships and conveys relevant information to other members of the health care team.
Initiates communication with peers about clinical priorities for care.
Relays information appropriately over telephone, pagers, and other communication devices.
12. Provides direct care to one to three patients. May manage the care of additional patients.
13. Accepts a patient care assignment based on patient census, acuity, needs, and the qualifications and competencies of self and of other staff members.
14. Works closely with LPNs and other care providers to complete the initial and ongoing assessments of patients and to provide clinical assistance as needed.
15. Delegates work to other staff members as needed.
16. Initiates problem-solving and conflict resolution skills to foster effective work relationships with peers.
4. Professional Development
17. Attends at least 75% of staff meetings and all mandatory inservice.
18. Contributes to the annual review of unit-based scope statement and determination of important aspects of care for clinical review.
19. Assists in the development of indicators, thresholds, study methods, and data collection as assigned.
20. Responds to problems/opportunities to improve care.
21. Supports and is involved in the hospital's Total Quality Improvement initiative.
22. Participates in and maintains competencies required for the position.
Education/Training: Graduation from an accredited School of Nursing with current Registered Nurse licensure from the State.
Experience: At least one year of medical-surgical or critical care is preferred.
License/Certification: Current Registered Nurse licensure from the State. CPR/ACLS certification
Skills: An ability and willingness to demonstrate and maintain clinical competency as required for the unit of assignment. Annual skill competency verification Excellent verbal and written skills. An ability and willingness to work with patients growth and development needs, particularly related to patients who are: all ages; experiencing healthcare crisis; or dying. An ability to manage a sometimes chaotic work environment related to changing patient needs, including work with patients with acute, chronic, and complex disease processes, and those who are dying. A positive attitude towards health care team members and diverse patient populations.
Environmental and Job Hazards: Regular exposure to blood/body fluids. Occasional interaction with potentially combative or disruptive patients. Normal Emergency Department environment.
Physical and Mental Demands: Position requires exertion of 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects.