Registered Nurse - Operating Room - Full Time

Job Summary:

Responsible for delivery of patient care through the nursing process of assessment, planning, implementation, and evaluation. Directs and guides patient teaching and the activities of ancillary personnel while maintaining standards of professional nursing. Understands and adheres to GCMC’s Compliance Standards as they appear in GCMC’s Corporate Compliance Policy, Code of Conduct and Conflict of Interest Policy.   Keeps abreast of all pertinent federal, state and GCMC regulations, laws, and policies as they presently exist and as they change or are modified.

Experience:       

• Entry level-graduate per Education requirements
• Specialty Units-At least 1 year of medical-surgical nursing preferred.  (i.e. ICU, Maternity, Psych)

Skills:

• See core competencies and unit specific competencies

Licensure/Certificates/Certification:

• Current NYS license to perform as a registered professional nurse
• Current BLS-CPR certification required (or within first 30 days of employment)
• Specialty Unit - Maternity – Neonatal Resuscitation Certification within 6 months of employment
• Specialty Unit –ICU- ACLS within 6 months of hire

 Essential Job Functions:    

Accordingly, employees may be asked to perform duties that are outside the specific functions that are listed.                         

Assessment-Performs patient assessment and documents accurately in a timely manner per nursing and department policy.

• Performs nursing admission assessment thoroughly and within timeframe.  Documents the admission assessment accurately and completely.
• Performs skin risk assessment accurately and reassessment per policy and protocol.
• Performs pain assessment and reassessment per policy and utilizes hospital approved pain scale and documents appropriately.

 Patient Monitoring-Monitors patient as appropriate for condition, status and safety according to nursing department policy.

• Monitors patient’s vital signs and systems per protocol and documents on appropriate forms.
• Recognizes change in patient’s condition or status and reports to charge nurse or physician as appropriate.
• Calls CAT team for patients who meet criteria.
• Works to ensure patient safety is maintained in all aspects of patient care, by following all policies related to National Patient Safety Goals, etc.
• Raises concern about patient care and utilizes the Chain of Command as needed to prevent patient harm.

Medication Administration-Performs safe administration and complete documentation of medications, IV fluids, and blood products in accordance with nursing policy.

• Follows medication administration policy using e-Mar, bar coding and scanning of medications and has at least an 85% scan rate.
• Insertion of IVs under aseptic technique and follows IV policy by changing site, tubing and dressing and documents accordingly.
• Always follows hospital policy when administering blood products.
• Maintains security of electronic signature with Omnicell and accounts for all narcotics removed from automated dispensing system through proper waste/return administration documentation. 

Patient and Family Education

• Assesses and addresses educational needs of patients and families to include disease state, care and treatment.
• Documents educational needs.
• Distributes appropriate teaching sheets.
• Includes evaluation of learner’s understanding post-teaching.

Safe Discharge/Discharge Planning  

• Contributes to or initiates discharge plan upon day of admission and participates in interdisciplinary planning.
• Completes all pre-discharge checklist items.
• Always gives patient correct forms and discharge instructions by using 2 patient identifiers.
• Provides patient a safe discharge and appropriate follow-up information and community resources are in place.

Assist Providers-Assist providers in performing procedures and treatments per unit, department specific and hospital policy.

• Assist physicians/providers with beside procedures and remains competent with unit-specific procedures.
• Performs read back of critical values and telephone orders when interacting with physicians as warranted.
• Uses SBAR when giving physicians report on change in patient condition.

Equipment Use

• Demonstrates knowledge and ability to use equipment safely and effectively.
• Utilizes hospital equipment per policy (i.e., guardrails for IV pumps, alarm settings).
• Uses patient lift equipment per policy at all times.

Nursing Clinical Skills- Demonstrates the abilit