RN Registered Nurse Attending RN IMCU Nights

Job Description Summary

The attending nurse will facilitate the new delivery of patient care with the interdiciplanary healthcare team. The attending nurse is the consistent patient/family and healthcare team contact supporting the staff nurse. These coordinated efforts remain continuous throughout the patient's care. In collaboration with the Nurse Manger, the Attending Nurse will continually look to improve and redefine the delivery of care model to best provide the highest level of safe patient outcomes. When providing direct care the Attending nurse will follow all task, responsibilities, provisions of care as the Registered Nurse

Job Description

ESSENTIAL FUNCTIONS

The Attending RN must follow the RN essential functions when providing direct care as follows:
1: Medication Administration
a. *Demonstrates knowledge of and follows SSH policies and procedures for administering, transcribing, and recording medications.
b. *Completes medication reconciliation process following SSH policy and procedure.
c. *Demonstrates proper procedure for the documentation of narcotic withdrawal, administration, verifies count, wastes per policy and resolves narcotic discrepancy.

2. Plan of care/Documentation/Patient Family Centered Care/Patient Experience
Develops, discusses, and communicates a prioritized problem list/plan of care for each patient.
a. Develop, evaluate and update individualized plan of care for patient and documents outcomes.
b. Initiating admission assessment within 8 hours of admissions, identifies and documents patient/family/significant other teaching needs upon admission and throughout hospitalization.
c. Continues assessment/reassessment and identifies care needs within established nursing practice.
d. Documents all patient care following the department of nursing policy, unit based standards, disease processes (CHF, PNA vaccines) and nurse sensitive indicators (falls, skin, CAUTI)
e. Assess/reassesses and documents patient's level of comfort utilizing the appropriate pain scale and the patient's response to each intervention both pharmacological and non-pharmacological per South Shore Hospital policy.
f. Works on behalf of patient /family. Seeks help to represent patient/family when they are unable to represent themselves.
g. Raises ethical questions and concerns with clinical team. Seeks available resources to help formulate and understand ethical decisions.
h. Actively communicates plan of day via white board updating every shift.
i. Facilitates discharge/transfer and communicates barriers utilizing chain of command.

3. Safety/Quality - Foster's a "Culture of Safety" through personal ownership and commitment to a safe environment.
a. Verifies patient identification with two identifiers prior to the start of any invasive procedure, including "time out", administration of care, medications, labeled specimen's an documents confirming the correct patient, procedure, site, equipment and consent.
b. *Complies with the current CDC hand hygiene guidelines through proper handwashing. Adheres to universal precautions, makes appropriate use of personal protective equipment at all times and appropriately disposes of hazardous materials. Maintains awareness of MSDS sheets and how to access.
c. Ensures environment meets regulatory requirements at all times.
d. Understands and is able to demonstrate individual roles and responsibilities in the event of hospital codes/emergency preparedness.

4. Professional Development: Assumes overall responsibility for own professional development by incorporating evidenced-based practice, research, and performance improvement initiatives as a part of ongoing nursing practice.
a. Obtains at least 5 contact hours per year in area of practice.
b. Practices within the legal boundaries of MA Nurse Practice Act. Directs other licenses and non-licensed personnel as assigned.
c. Displays the ability to accept and respond appropriately to feedback and recommendations for change.
d. Demonstrates professional working relationships with colleagues from all disciplines to promote a positive/encouraging workplace.
e. Critical Thinking: analyzes causes of problems, identifies and evaluates alternative solutions, and selects appropriate solution, and communicates appropriately and effectively utilizing chain of command.
f. Accountable for being informed about changes in hospital policy and procedure.
g. Works collaboratively with the Nurse Manager and CPDS to monitor and develop existing roles on the unit.
h. Assess need for personal growth and development and takes the initiative in seeking opportunities to meet this need.

5. Technology: Utilizes technological solutions to work processes and practices.
a. Access Lotus Notes to review email, learning management and other resources as applicable to RN role.
b. Utilizes software applications required by department and unit standards.
c. Accountable to understand how to operate in downtime.

6. UNIT COMPLIANCE/EMERGENCY PREPAREDNESS/INFECTION CONTROL
a. Monitors/maintains unit compliance with regulatory, accrediting and hospital policy for patient services and environmental and personnel safety.
b. Under the direction of the Nurse Manager, reports unit compliance with regulatory agency standards (i.e., OSHA, JCAHO, DPH, FDA).
c. Monitors the staff's understanding of established emergency, infection control and/or Universal Precautions, procedures as evidenced by CQI reports, incident report follow-ups, and staff meeting minutes.

7. CONTINUOUS QUALITY IMPROVEMENT - Attains all agreed to goals and objectives within specified time frames, as part of the organization's overall mission.
a. Works in conjunction with the nurse manager to oversee unit KPI programs which monitors and evaluates critical aspects of care and quality metrics.
b. Partners with CPDS to identify potential for problems within existing system by direct observation or analysis of data.
c. Submits reports as requested by the Nurse Manager.
d. Serves as a role model for interdisciplinary problem solving, using a standard Lean A3 approach and PDCA model
e. Dissemination of unit's KPI results if requested.
f. Participates in the development of KPII unit based score card as evidenced by divisional meeting minutes.
g. Completes incident report investigation in a timely and comprehensive manner.
h. Involves front line staff in the development and execution of quality plan and quality improvement projects.
i. Participates in consistent patient rounding and engages in service recovery efforts.
j. Actively participates in all Culture of Service Excellence activities.

8. SHARED GOVERNANCE
a. Fosters a service which is consistent with the patient care beliefs and shared management philosophy of the department.
b. May provide for opportunity to discuss and update staff on progress of shared governance model, project team, etc., as evidenced by staff meeting minutes.
c. Supports staff involvement in project teams/committees as evidenced by discussion in minutes.
d. Projects are completed with consideration for quality, practice and educational components.
e. Participates in or chairs projects or committees as volunteered or assigned.

9. FINANCE
a. Recommendations regarding changes of products/par levels reflect cost, quality and standardization.
b. Recommends staffing plan and personnel mix to service the unit.
c. Recommends capital equipment needs for the unit.

10. COLLABORATION
a. Collaborates with other organizational departments to improve and enhance patient care services.
b. Utilizes appropriate resources within the institution to provide consultation, education, technical or informational services as needed, for self, staff and patients.
c. Initiates interdepartmental communication to ensure problems are resolved and special needs are met.
d. Works with other organization/departments to advocate for, develop and implement service enhancement for patients and families.
e. Utilizes Shared Governance model on unit in collaboration with the Nurse Manager to resolve real and potential problems and to implement improvements and change.
f. Collaborates with the team to resolve barriers to promote hand-offs interdisciplinary rounds, and efficient throughput of patients.
g. Ensures, with geographic provider and Department of Care Progression that the patient care needs are met.
h. Attends and coordinates meetings with clinicians for timely decision of predictions and discharges.
i. Communicates all key information to on coming charge nurse/covering nurse in an efficient, comprehensive manner when hand-offs are required.

11. COMPLIANCE
a. Works with legal, regulatory and ethical practice standards relevant to the position.
b. Complies with applicable policies and procedures.
c. Safeguards the privacy and security of patient information. The employee complies with policies and procedures relating to SSH's privacy and security programs.
d. Brings potential compliance issues to manager, supervisor, director or Vice President.
e. Complies with the mandatory education requirements of the compliance, privacy and security programs.

12. CUSTOMER SERVICE-PATIENT & FAMILY EXPERIENCE
a. Consults with patients/families as evidenced by rounds, family conferences, case conference.
b. Follows-up on patient survey responses in accordance with hospital policy and procedure following receipt of survey. Any identified trends will be addressed following hospital policy and procedures, as evidenced by communication with the Nurse Manager.
c. Accurately identifies real/potential problems affecting service and implements solutions with follow-through communication.
d. Responds to reported problems/complaints based on urgency.

13. PATIENT AND FAMILY CENTERED CARE
a. Conveys respect for values, preference, and expressed needs of the patient and family.
b. Recognizes the patient and family in accordance to patient preferences, as important members of the health care team.
c. Collaborates with the patient, and family according to patient preferences, in planning, implementing, and evaluating care.
d. Welcomes the presence and participation of family members at all times according to patient preferences, regardless of rounds, change of shift, or other events on the unit.
e. Ensures the patient care assessment and patient care plan using Patient and Family centered care principles developed in collaboration with the interdisciplinary care team.
f. Identifies and uses best practices to promote patient/family focused care.
g. Communicates with the patient and family discussing the daily plan of the day, care progress, predicted discharge, and answers questions/teaches/coaches.
h. Updates the plan of care utilizing the patient "white boards", and ensures the plan is understood by all care members while communicates with the patient/family.
i. Meets with family or care partner in collaboration with the RN to discuss plan of care, disposition, goals of treatment, palliative care, and end of life issues.
j. Care delivery should always be: patient and family centered, evidence-based accountable coordinated and continuously reassessed.

14. LANGUAGE & CULTURE - Considers the individual needs of each person with whom they interact.
a. Possesses age and cultural knowledge and awareness.
b. Interacts with sensitivity in the delivery of care/services to a diverse population as needed.
c. Effectively utilizes resources to provide care/services - such as, interpreter services and on-line sources.

15. Technology and Learning
a. Data collection and the ability to interpret/synthesize that key clinical information (e.g., medication reconciliation, advance directive, discharge data) will be a critical component of the role.
b. Works collaboratively to establish support services standards (e.g., bed turn around, phlebotomy timing), to facilitate early discharge before noon.
c. Implements and continually reassess a standard that promotes a synergistic staff assignment.
d. Functions as a super user when organizational initiatives are implemented.

JOB REQUIREMENTS
Minimum Education - Preferred

Graduate of an accredited school of nursing

BSN or health care related BS required within 3 years

Minimum Work Experience
Minimum of 2 years acute care experience

Required Licenses / Registrations

RN - Registered Nurse – Board of Registration in Nursing (Massachusetts)

Required Classes/Certifications

ACLS - Advanced Cardiac Life Support