Registered Nurse - Observation Unit - Full-Time, 7pm -7:30am Monday thru Friday & every 3rd weekend

NEW PREMIUMS 5

% Market Pay Differential Increased Night Shift Premium

• 10% $2

Weekend Differential Sign On Bonus:

$10,000

Department:

Observation Schedule:

Full-time 7pm

• 7:30am Monday thru Friday & every 3rdweekend

Hospital:

Henry Ford Health Genesys Location:

Grand Blanc, Michigan

GENERAL SUMMARY

Use independent professional judgment, analytical skills, and the nursing process to provide a full range of delegated, interdependent, and independent nursing services to patients. Within the framework of the Seven Dimensions of Patient Care and Benner's Domains of Nursing Practice, demonstrates clinical competence; compassion and customer service orientation; focus on process and outcomes; and cost-consciousness when assessing, planning, implementing, and evaluating nursing care provided to patients.•

Seven Dimensions of Patient Care:

Coordinate development of a multi-disciplinary plan of care in accordance with Nursing Problem Care Sets (Core Outcomes and Core Intervention Sets) and/or clinical practice guidelines, age-specific requirements and professional and regulatory requirements to ensure appropriate length of stay, use of resources, and achievement of quality outcomes. Provide patient care that reflects a respect for patient's rights, dignity, values, culture, preferences, and expressed needs. Assesses patient/family needs for information and education across the continuum, plans and implements patient teaching using a variety of techniques and methods, and evaluates effectiveness of educational interventions.

• Help to alleviate patient fears and anxiety through skilflul application of professional and interpersonal communication.
• Utilize a variety of pharmacologic and non-pharmacologic approaches to ensure patient comfort and relief of pain.

Involves patient, family, significant others in development of plan of care. Collaborate with patient/family, hospital staff, and community agencies to develop discharge plans that prepare patients for continued care needs.

Orientation Self-Evaluation:

(C) Competent (NT) Needs Training or Review.

• Standards of Performance:

• Seven Domains of Nursing Practice.

• Helping/Teaching &Coaching:

• Incorporate all elements of Signature Care in Daily interactions with patient:
• Introduce self and writes name on whiteboard.
• Discuss plan of care with patient/family.
• Explain meds and treatments, provide teaching as appropriate.
• Ask if patient needs anything else before leaving room.
• Assess health status and determines care needs of the patient. Performs ongoing reassessment as required.
• Complete Admission Assessment and shift assessment as required. Complete assessment for Risk Factors; including fall, skin breakdown, VTE, and aspiration. Initiate appropriate initiatives as indicated SKINN Bundle, Fall Prevention Plan, SCD, etc.
• Complete Medication Reconciliation upon admission and change in level of care.
• Establish, direct, coordinate and document plan of nursing care in conjunction with patient/family.

Initiate Problems and Outcomes list (plan-of-care) based on medical diagnosis and patient needs. Monitor, document, and report patient response to interventions and progress toward outcomes. Document nursing interventions (NIC) and progress toward outcomes (NOC); patient education; and evaluation every shift, as required. Educate patient regarding treatment plan, safety measures, medications, and self-care as indicated. Document education activities on shift assessment flowsheet and plan of care (POC).

• Work with Case Manager to ensure appropriate referrals initiated prior to discharge.

Review discharge plans/instructions with patient prior to discharge, including signs/symptoms to watch for after leaving the hospital. Ensures appropriate follow-up arranged. Ensure that core measures Discharge Instructions are given to all CHF patients. Document patient care according to established documentation guidelines.

Administration of Therapeutic Regimens:

Demonstrate knowledge and skill application of basic nursing procedures

• dressing change, catheterization, NG tube insertion, suctioning.

Implement/complete medical interventions as ordered. Initiate standing orders appropriately. Initiate and/or assists with all patient care activities including activities of daily living and provides other services as required for patient comfort, safety, and well-being. Assess and initiate interventions to prevent/minimize patient skin breakdown. Follow clinical practice guidelines and procedures as written. Establish and maintain peripheral IV therapy. Obtain body fluid specimens, per procedure. Obtains blood specimens if no phlebotomist assigned to area. Perform blood capillary glucose monitoring. Administer the following according to established policies and procedures:

• Medications.
• IVs.
• Blood products.

Prepare patients for surgery or other invasive procedures according to established guidelines. Perform or assist with procedures according to established standards of care and nursing practice. Utilize equipment based on manufacturers instructions and established nursing procedure. Correctly operates and trouble shoots IV pumps, PCA pumps, epidural pumps, feeding pumps, patient beds, as applicable. Monitoring Patient Responses/Responding to Changing Patient Situations. Regularly reviews work in progress to ensure that treatments, medications, and tests ordered are expeditiously carried out and documented. Review patient medical record/reports and confers with physician regarding treatment plans. Routinely checks chart for new orders. Monitor patient physiologic parameters including vital signs, lab work, I&O, blood glucose; recognizes and reports meaningful changes and intervenes appropriately. Documents interventions accordingly. Monitor presence and intensity of patient s pain on admission, after pain producing events, with each new report of pain, and routinely at regular intervals. Informs patient about pain relief and pain relief measures; administers pain medication or alternative interventions as indicated; includes pain management resources in the discharge plan/instructions. Recognize acute changes in respiratory status

• dyspnea, cyanosis, tachypnea, respiratory depression, airway obstruction and responds
• appropriately with direct intervention and physician/SWAT notification. Recognize acute changes in neurologic status/decreased LOC and responds appropriately with direct intervention and physician/SWAT notification. Recognize acute changes in cardiac status
• tachycardia, chest pain and responds appropriately with direct intervention and physician/SWAT notification. Recognize acute changes in urinary output and responds appropriately with direct action and physician notification.
• Utilize SBAR tool or other standardized approach to data collection and information sharing when notifying physician of patient changes/concerns.

Respond appropriately to life-threatening emergencies through initiation of CPR, assembly of emergency equipment, and immediate interventions (as allowable and indicated). Perform emergency equipment checks. Provide appropriate support/summons appropriate resources for families in crisis/grieving process. Ensuring Quality of Health Care Practices. Communicate with other professionals/departments and physician staff to ensure appropriate progress of patients through the system. Monitor individual patient length of stay (LOS); notifies case manager and nurse manager of potential LOS/discharge issues. Identify ethical issues related to patient care (including issues related to advanced directives) and initiates steps for resolution.

• Demonstrate adherence to patient confidentiality requirements.