The St. David's HealthCare Registered Nurse (SDHRN) fulfills an important role as a central patient care provider responsible for the coordination and delivery of patient centered nursing care. As a full partner of the healthcare team, the SDHRN collaborates with all other healthcare disciplines to achieve successful execution of the patient's plan of care. The SDHRN utilizes physical assessment skills and advanced diagnostic technology to aid in the assessment of the patient's nursing care needs. Data collected is analyzed, synthesized and disseminated to other healthcare providers. The SDHRN continues to monitor and assess the patient's physical condition, emotional and social needs, continually refining the plan of care to ensure achievement of the desired goals of the patient and facility outcomes. Participates in providing patient specific care standards as directed, and follows service excellence standards to ensure high levels of patient satisfaction.
Reviews patient's history prior to beginning physical assessment and incorporates findings into the exam.
Performs physical patient assessments/reassessments on a regular basis in accordance department standards. Pertinent data is collected using appropriate assessment techniques.
Incorporates available technology to aid in physical assessment.
Prioritizes data collection by assessing the patient's immediate condition or needs.
Is able to discern critical findings and timely communicates changes in the patient's condition to the appropriate patient care providers.
Data collection is inclusive of the patient, significant others and health care providers when appropriate.
The data collection process is systematic and ongoing.
SDHRN (IMC) demonstrates advanced patient monitoring and assessment skills including:
Arterial Blood Gases: Analysis
Cardiac Monitoring: 12 Lead EKG
Cardiac Monitoring: Bedside Cardiac Monitor
Cardiac Monitoring: Arrhythmia Interpretation
Chest Tube Drainage System
Endotracheal Tube: Position Assessment and Repositioning
Glasgow Coma Scal Hemodynamic Monitoring: Arterial Pressure
Hemodynamic Monitoring: Central Venous Pressure
Considers the developmental goals for infant, toddler, preschool, school age, adolescent, adult and geriatric patients during the assessment of patients.
Assesses patient/family learning needs, including any tasks that the patient can or cannot accomplish as related to his or her current health problem. Consideration of age, cultural values, religious beliefs, emotional barriers, desire and motivation to learn, physical and/or cognitive limitation, and language barriers, as indicated.
Assesses for signs of abuse and neglect. Documents findings and reports as appropriate when required.
Develops patient centered nursing diagnoses.
Nursing diagnoses are derived from the assessment data.
Assists in the completion of diagnostic testing as ordered by the medical team and other health care providers.
In collaboration with interdisciplinary members of the team, formulates a plan of care including expected outcomes for each patient based on diagnoses derived from patient assessments.
Prescribes appropriate nursing care to meet the goals, as well as the physical, psychological, psychosocial, emotional, and social needs of the patient.
Applies knowledge of the principles of growth and development over the life span to identify patient and family requirements relative to age specific needs
Demonstrates the ability to organize and set priorities.
The plan is individualized to the patient's condition, age or needs.
The plan incorporates the discharge planning process at time of development.
The plan is developed with the patient, significant others, and health care providers, when appropriate.
The plan reflects current nursing practice.
The plan is documented.
The plan provides for continuity of care.
The plan is appropriate to the patient's age, developmental age, educational needs, and family/guardian expectations as related to the diagnosis.
Coordinates and participates in providing direct patient care.
Performs skills proficiently and in accordance with the standards of nursing care.
Utilizes all equipment in the unit appropriate to patient with maximum efficiency and effectiveness based on knowledge and education.
Interventions are implemented in a safe and appropriate manner and documented.
Performs nursing care in an organized and systematic manner.
Can organize work and utilize time efficiently based on knowledge of nursing theories and procedures.
Can interpret reports, data and medical information to determine the needs of the patient and family.
Can interpret an extensive variety of technical instructions and manage several abstract and concrete variables.
Addresses patient's nutritional needs as appropriate.
Ensures execution of appropriate evidence based order sets to address patient care preventative needs, such as DVT prophylaxis, falls prevention and other potential hospital acquired conditions.
Is aware of patient's condition and how it relates to our core measure outcomes.
Addresses patient's nutritional needs as appropriate and demonstrates knowledge of TPN and enteral feeding of patients.
Is able to execute ICU specific skills to carry out the patient's plan of care including:
Arterial Blood Gases: Arterial Puncture, Arterial Line Blood Draw
Arterial Sheath Removal
Blood Products Administration
Central Line Care
Pacemaker: Transvenous Pacing
Verifies accuracy of medication administration by following all safety measures.
Ensures medications are kept secure and stored appropriately.
Educates patients on potential side effects of prescribed medications.
Explains the purpose of all prescribed medications and teaches patient's the appropriate self administration of medications as part of discharge planning process.
Evaluates the patient's progress toward attainment of goals defined in the plan of care.
Evaluation is systematic and ongoing.
The patient, significant others, and health care providers are involved in the evaluation process when appropriate.
Is able to articulate the organization mission, vision and values and how it relates to the SDHRN role.
Advocates on behalf of our patients and their family.
Continuously pursues patient safety.
Teaches, supervises, and serves as a resource person and delegates in accordance with the competency level of all staff members.
Serves as a preceptor and completes the appropriate documentation of training and competency.
Performs unit specific technical skills.
Can manage multiple priorities.
Has advanced time management skills.
Adapts to a rapidly changing work environment.
Demonstrates the ability to work with people from diverse socio economic backgrounds.
Is an engaged member of the unit and seeks opportunities to participate on various hospital committees.
Is an active participant in achieving facility patient throughput goals of the organization.
Increases the value of the care provided by ensuring efficient and appropriate use of supplies.
Ensures patient charges are correctly assigned by utilizing point of use accounting systems in supply rooms and other areas.
Manages incremental overtime by minimizing occurrence through proactive transition of care planning.
Manages time and attendance by arriving on time for work assignment, facilitating coverage when absent from work, clocking in and out accurately.
Is highly engaged on all service excellence quality initiatives such as: hourly rounding, patient discharge phone calls, narration of care provided and golden hour.
Knowledge, Skills & Abilities
The SDHRN ensures all nursing care provided meets the standard of care. The SDHRN demonstrates knowledge of national patient safety goals, hospital core measures, performance improvement processes and service excellence quality initiatives. The SDHRN is knowledgeable of all policies and practices relative to the role and duty performed. The SDHRN demonstrates at minimum, basic computer skills related to the role and care of the patient.
Must be able to demonstrate understanding of national patient safety initiatives by strict compliance to all safety protocols and procedures as required by both HCA and St. David's North Austin Medical Center.
Education & Experience
Required: Graduate from an accredited nursing program or current enrollment in an Alternative Entry MSN program
Preferred: Bachelor's or higher level Degree; Previous experience in an adult intensive care unit (ICU) or adult intermediate care unit (IMC)
Licenses & Certifications
Required: Texas RN License or a Compact RN license from a NCLA Compact State; BCLS Certification; ACLS Certification within one year of hire
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