Surgery RN

Job Summary:

The RN renders collaborative nursing care via the defined department Method of Practice, to a caseload of patients for an assigned shift in accordance to the medical staff practitioner’s treatment plan, nursing standards of care/practice and professional code of ethics. The RN is committed to promoting the health potential of the patient (body-mind-spirit) through the implementation of the nursing process. Demonstrates ability to delegate appropriately and direct staff in the coordination and delivery of care; assumes responsibility for the appropriate utilization of care resources; demonstrates positive interpersonal relationships with others in problem resolution, is sensitive to the needs of patients, families, and fellow employees.

Job Relationships:

1. Reports directly to Perioperative Manager
2. Reports indirectly to the Perioperative Assistant Manager, DON Outpatient Services, House Supervisor (HS) and other management covering the department. 
3. Collaborates with all members of the Health Care Team in the coordination of patient care.
4. Delegates and directs assigned shift caseload team which may be comprised of RN and ST.
5. In absence of Perioperative Management, takes daily direction from an assigned Shift Charge RN (Board Runner).
6. When working as Surgery RN delegates and directs assigned shift caseload team which may be comprised of RN and ST.

Occupational Hazards:

Works in the general hospital setting. May be exposed to blood, body fluids, or tissues as well as patients in varying stages of infectious states. 

Samples of Duties:

The information listed below is meant to serve as samples of job duties and responsibilities for positions in this classification. This list is neither inclusive nor exclusive, but indicative of several types of duties performed. 

• Performs direct patient care in accordance to performance standards listed on Skills checklist according to the defined patient populations for the intraoperative surgery skills, moderate sedation and GI Laboratory.
  • Demonstrates ability to perform admission, discharge, transfer procedures
  • Utilizes modes of communication to provide continuity of care and to deliver safe care
  • Cares for the patient undergoing an invasive and/or operative procedures
  • Assesses and promotes optimum neurological functioning including pain management
  • Assesses and promotes optimum respiratory and cardiovascular function
  • Demonstrates ability to care for the patient with diabetes and other endocrine challenges
  • Assesses and promotes optimal gastrointestinal functions
  • Assesses fluid electrolyte balance, including blood administration
  • Assesses and promotes optimal musculoskeletal function
  • Assesses and maintains optimal skin integrity including preventative measures
  • Assesses and supports genitourinary function
  • Demonstrates ability to administer medications and has knowledge of actions, route of administration, dosage, and side effects
  • Demonstrates appropriate patient safety practices
  • Provides nursing interventions to assist the patient during the end of life process
• Demonstrates ability to practice as an RN within the Method of Practice for Surgery patient
• Meets the standards of care for: 

• Preoperative patient population
• Intraoperative Patient population

• Gastrointestinal Laboratory patient

• Understands The RN role as part of the Collaborative Practice Model

• Assists in making all necessary preparations for assigned patient’s surgical procedures:
  • Selects needed instruments, supplies, and equipment
  • Checks suctions, cautery, special equipment and ensures all required equipment and supplies are available and in working order. 
• Is able to utilize physician preference card in the planning and set up of the case and room. Reviews procedures and helps revise physician preference cards as needed.
• Assists operative team during procedures:
  • Closely observes surgical procedure and anticipates needs of the surgeons and assistants. 
  • Counts instruments, sponges, and needles with the scrub tech and makes sure the surgeon is informed of any related problems.
• Is responsible for ensuring pathological specimens are correctly identified and bagged the scrub tech. Enters pathology orders and sends specimens to Pathology.
• Cleans, checks, and prepares instruments for sterilization. With scrub tech, ensures correct instrument count on trays
• Assists with cleaning and restocking rooms as needed.
• May perform or assist with:
  • Skin prep
  • Application of monitoring devices
• Provides care based on the approved clinical references and Nursing Policies and procedures

• Assures each patient receives NIHD health excellence via the aims of: safe, effective, patient centered, timely, efficient, and equitable care.
• Understands and models the NIHD Nursing Mission:
  • To be the patient advocate
  • To promote evidence based care
  • To know our patient’s story
  • To protect our patient from harm
  • To educate our patients
  • To actively involve the patient and family in the care
• For shift worked, coordinates case load of patients as assigned:

• Delegates and directs care delivery appropriately
• Coordinates care effectively
• Rounds on the patient SDS preoperative care

• Initiates and revises the nursing process for his/her caseload of patients as evidenced by:
  • Records nursing assessment and care delivery in patient’s medical record.
  • Evaluates data obtained in the Nursing assessment in making knowledgeable interpretation and reliable predictions; generates a nursing problem list
  • From the problem list, develops goals and an individualized plan of care based on the independent realm of nursing practice which addresses teaching, infection control, safety and biopsychosocial needs as appropriate (interventions identified to meet patient care needs). Interdependent and delegated realms of nursing practice are based on the Medical Staff Practitioner plan of care
  • Coordinates, directs, and actively participates in the implementation of the nursing care plan (nursing care provided)
    • Signs off coordination of the case at the end of the shift
• Participates in the development and achievement of department annual goals and objectives (action plans) in accordance with Nursing Services / NIHD goals and overall plan for patient care.
  • Supports the implementation of action plans
  • Adapts to changes
  • Performs other duties as assigned
• Oversees and provides feedback on work performance of the shift staff and other members of the health care team and provides feedback to the Shift Charge or Coordinator, DON, and/or House Supervisor
  • Functions as the RN on assigned case
  • Serves as a preceptor to students, and staff as assigned
  • Follows chain of command to resolve issues and challenges
• Demonstrates leadership skills and completes cross training to:
  • Functions as the Shift Charge (refer to Shift Charge performance standards) if so chooses
  • Cross trains to other positions and/or departments listed:
    • Central Sterile Processing
    • Procedural Sedation/Moderate Sedation
• Complies with departmental staffing practices.
  • Understands the need to verify final schedule on a regular basis in ShiftHound Software
  • Able to use ShiftHound for requesting time off, swapping shifts, picking up open shifts etc.
• Active on selected committees for the purpose of exchanging information and participating in problem solving methods.
  • Attends monthly staff meetings and/or signs off minutes as read
  • Participates on standing committees (Professional Practice Committee, Shared Governance Central Council, OCC, CCC, SIAC, Patient Safe Handling, Resuscitation Committee, Safety Committee)
• Arranges own knowledge base and development by attending formal and informal educational activities.
  • Completes NIHD mandatory competency.
  • Completes annual role specific on-going competency plan.
  • Attends NIHD in-services and/or programs
  • Completes job skills BLS, ACLS, PALS
• Assists in identifying patient care problems for investigation, collecting data and applying current concepts to patient care. Has knowledge of Problem Resolution Methods (FOCUS-PDSA, 5S, Six Sigma, Rapid Improvement Cycle, Project Management) and actively participates in QA/PI activities.
  • Identifies opportunities for improvement.
  • Participates in QA/PI project or team
  • Collects data collection as assigned
  • Participates in survey or data completion as requested 
  • Reviews literature and shares information with peers
• Participates in the development of and/or revision of process standards such as policies and procedures, standards of care and practice etc.
  • Sends request for updates to Shared Governance committee and/or brings current evidence based practice ideas to Partnership Council.
  • Develops, reviews, and/or critiques process standards as assigned.
  • Complies with department process for updates of Policy and Procedures/Protocols, etc.
• Demonstrates knowledge of annual feedback.
  • Complies with job description performance standards.
  • Completes self-review and personal plan for development.
  • Provides feedback into the performance of others.
• Other duties as assigned.

Knowledge, Skills and Abilities:

Knowledge of:

• The Mission, Vision, and Values of Northern Inyo Healthcare District; 
• NIHD policies and procedures, including Compliance Program, Code of Conduct, and Confidentiality standards;
• NIHD safety policies and procedures, including the Rainbow Chart, Employee Health, and Infection Prevention standards;

Skills/Abilities to:

• Communicate effectively both verbally and in writing with NIHD staff and the public;
• Establish and maintain professional working relationships with NIHD staff at all levels as well as the public;
• Develop and maintain a high degree of maturity, integrity, and good judgement.

Minimum Qualifications:

Experience:

1. Possess a minimum of one-year current operating room experience 

Education: 

1. Graduate of School of Nursing
2. Current California State License as a Registered Nurse required

Certification: 

1. BLS upon hire and on-going
2. ACLS and PALS within six months of hire and on-going

Preferred:

Education: 

1. BSN/BA