Careers at PSI

JOB SUMMARY

Provides planned, skilled nursing care for patients in the critical preoperative and postoperative periods. Provides continuous patient surveillance for early recognition and immediate emergency treatment of medical or surgical complications that may arise in any postoperative patient.

RELATIONSHIPS

Reports to:         Team/Director of Nursing

Supervises:        Licensed Practical Nurses; ancillary personnel assigned to pre/postoperative area

QUALIFICATIONS

Graduate of accredited school of nursing required

Current state licensure required

Experience in postoperative or critical care area preferred

CPR/ACLS certification required

ACLS required, BLS Required. Minimum 2 years experience in critical care. OH RN license required

MENTAL DEMANDS

Require constant and frequent judgment and response; occasionally in response to disasters or emergencies, actual events or drills. Require language skills adequate for high-level written and interpersonal communication in American English.

PHYSICAL DEMANDS

Require high-level visual and auditory acuity for timely response and patient care assessment activities. Ability to move quickly in response to physician and patient needs, to stand for long periods, occasional overhead and low reaching, and to exert force of up to 50 lbs. occasionally, up to 20 lbs. frequently and/or up to 10 lbs. constantly. Patient care activities may require the ability to exert force of up to 30 lbs. constantly, up to 40 lbs. occasionally and up to 100 lbs. rarely.

OCCUPATIONAL EXPOSURE

Category I exposure to bloodborne pathogens; frequent exposure to chemical hazards; may encounter radiation hazards.

ESSENTIAL FUNCTIONS AND OBJECTIVES

1.   Supports the philosophy, goals, and objectives of the Organization.

1.1.   Supports, and performs according to, approved policies and procedures.

1.2    Participates as a team member in support of the total peri-operative process

1.3    Considers patient rights in performance of job duties and responsibilities.

1.4    Participates as a functional team member in admitting and discharging patients in a safe and timely manner.

2.   Contributes to the progress and development of the approved QAPI Program.

2.1.   Supports risk management and participates in programs directed to patient and staff safety.

2.2.   Contributes to the QAPI process; identifies role and contributions to functional teams; participates in data collecting; collaborates with team to identify opportunities to improve patient safety.

2.3.   Objectively evaluates suggestions, grievances, and processes to identify opportunities to improve performance and quality of care.  Accepts constructive criticism with a positive attitude. 

2.4   Places the best interest of the Team ahead of self interests.

2.5   Accepts changes in patient care assignments with a positive attitude and response.

2.6   Readily accepts changes in work schedule.  Is accepting of changes necessary to meet unanticipated scheduling needs.

3.   Communicates effectively with patients, visitors, physicians, and co‑workers.

3.1    Interactions are respectful and courteous.

3.2.   Communicates effectively on the patient’s level, keeping in mind age, mental ability and education.  Uses a translator when necessary and treats the translator with the same courtesy as the patient.

3.3.   Documents pertinent patient information on the chart and other appropriate places (e.g. bed eye sheet; bilateral hearing aides, monocular, claustrophobic, etc.) and gives report to appropriate staff. (i.e. informs the CRNA of Accucheck results and/or patients home test  if appropriate.) 

3.4  Communicates effectively and educates the patient regarding the admission and discharge processes as they occur. 

3.5    Recognizes when there is a need for patient’s caregiver and/or family member to assist in the admission process to obtain accurate information to assure a safe and satisfactory surgical experience.    

4.   Maintains and promotes professional competence through continuing education and other learning experiences.

4.1.   Attends and actively participates in team meetings, committees, conferences, and quality management activities.

4.2.   Researches and submits pertinent articles and information for review at staff meetings.

4.3.   Seeks new learning experiences by accepting challenging opportunities and responsibilities. Actively participates in problem solving for assigned team.

4.4.   Objectively evaluates suggestions and constructive criticism presented by administration, team leader or team member and attempts to improve performance or seeks further guidance, as needed.  Uses “team protocol” when approaching another team member to offer suggestions, constructive criticism or resolve conflicts. 

4.5.   Maintains current R.N. license and fulfills obligation for required continuing education for license and facility. Maintains membership in relevant professional organizations.

4.6. Attends mandatory and voluntary meetings, in-services, workshops, seminars and   conferences according to job responsibilities and Facility requirements.  Seek to broaden knowledge of peri-operative surgery.

4.7.   Assists with orientation and training of new personnel and acts as a resource person for patient care problems.

4.8.   Completes “team” assignments within the required guidelines. 

5.   Adheres to safety policies and procedures in performing job duties and responsibilities.

5.1.   Reports observed or suspected violations, hazards, and noncompliance according to Facility policy.  Corrects, immediately and responsibly, safety issues or problems which staff is qualified to address (wet floor, side rail down).

5.2.   Observes safety measures in performance of job duties and responsibilities; enforces compliance with safety and security policies and procedures. Uses proper body mechanics when assisting a patient. 

5.3.   Responds to emergency situations with competence and composure, is familiar with alarm sounds and can differentiate call bells, monitor alarms and code alarm.  Is familiar with crash cart, its contents and where to obtain necessary supplies.  Is knowledgeable regarding locations of eye wash stations and spill kits. 

6.   Interacts appropriately with various age groups.

6.1.   Accurately assesses and interprets age-specific patient data.  Interacts with patient & family appropriately during the pre/post operative experience.

6.2.   Accuratelyinterprets age-specific responses frompatient and family members and   communicates questions and instructions accordingly.

6.3.   Involves the patient’s family/significant other in decision-making about the patient’s care.

6.4.   Provides care appropriate to the patient’s age group and mental abilities during pre and post-op care, assessments and instructions.

6.5    Assesses the patient’s mental and physical capabilities accurately and knows when it is imperative to include family members or caregivers in care to assure a satisfactory  outcome for the patient.

6.6    Assesses problems appropriately. Resolves problems independently when possible; knows when to seek assistance.

6.7.   Accurately applies knowledge of growth and development.

6.8.   Considers age-specific patient requirements when responding to emergency situations.

6.9    Knowledgeable in age-specific disease processes and treats patients accordingly.

7.   Effectively organizes time, equipment, supplies, and personnel.

7.1.   Organizes nursing activities efficiently; considers staff abilities when delegating activities.

7.2.   Prioritizes patient care with efficient use of available time to prepare for the next work day.

7.3.   Uses equipment effectively by anticipating patient needs and providing appropriate care. Demonstrates proficiency in operating all equipment in the pre-post area.

7.4.   Assists with inventory of supplies, drugs, and equipment to maintain availability and stock levels in pre/postoperative areas.  Has knowledge of supply locations, par levels, and ordering procedures.

7.5.   Is familiar with the Pharmacy; where medications are stored and is knowledgeable of medications used in the Facility. 

7.6.   Considers cost-effectiveness in the provision of care.     

7.7.   Maintains order and cleanliness of pre/postoperative area.

8.   Performs thorough preoperative patient assessment required by the outpatient setting.

8.1.   Assists in assessing the physical, emotional and developmental status of the patient upon admission according to Facility policy.

8.2.   Develops a plan for patient care based on assessment data. Considers present and past disease processes, medications, allergies, and personalizes a plan of care according to the patient. 

8.3.   Educates patient & family about routine pre/post care and updates when necessary.

8.4.   Provides comfort and reassurance to the patient and supports the patient’s right to privacy, dignity, and confidentiality.

9.   Implements and documents preoperative care according to Facility policy (e.g. evaluates charts, administers medications, and prepares operative site).

9.1.   Identifies the patient with another qualified staff member, involving the patient in the process according to the facility policy.  Identification process is documented on the patient’s chart.

9.2.   Identifies and marks the correct operative site with another qualified staff member involving the patient in the process according to the facility policy.  Identification process is documented on the patient’s chart. 

9.3.   Verifies patient compliance with pertinent pre-operative instructions and obtains  full  set of vital signs  prior to instilling dilating medication. (e.g. NPO status, use of pre-op antibiotic eye drops)

9.4.   Confirms that proper techniques and procedures are used according to accepted standards of practice. Uses aseptic technique and is proficient in instilling medications to operative eyes and initiating intravenous lines.

9.5.   Communicates “Need to Know” report to CRNA during the admission process and to the circulating RN upon transport to OR. 

9.6.   Reviews and co-signs pre-op assessments completed by Licensed Practical  Nurses as required by Ohio Law.

10. Performs safe and individualized nursing care for the patient in the immediate postoperative period.

10.1. Organizes nursing activities efficiently; understands greeting the patient and circulating RN upon arrival to post-op is priority. 

10.2. Receives report from the circulating R.N.; communicates need for clarification or questions when appropriate to assure accurate and complete information for transfer of patient care. 

10.3. Assesses and documents the patient’s physical and emotional status upon arrival in the post-operative area.  Compares post-op assessment with pre-op assessment for any pertinent changes. 

10.4. Documents postoperative care and identity of second person in the postoperative area during the patient’s recovery from anesthesia/sedation according to Facility policy.

10.5. Provides nursing care to meet patient needs related to surgical condition and type of anesthesia administered.

10.6. Observes safety measures in patient care activities.

10.7. Assures that discharge instructions are given and understood by patient and or caregiver.

10.8. Assures patient has met facility discharge criteria prior to release from facility.

 10.9.    Reviews and co-signs post-op assessments completed by Licensed Practical 

The OR Nurse will provide nursing care to the patient during the intra–operative course of treatment.  The RN will perform nursing activities in multiple areas of the ASC to promote safe, efficient, and exceptional patient care and to serve as the patient advocate.  The RN will work in conjunction with the Surgeons and Anesthesia team to prepare patients for surgery and/or monitor them post-operatively for progress/complications. 

Required: 

• Critical thinking skills 

• Ability to document appropriately 

• Computer skills with basic EMR experience 

Preferred: 

• 2 years operating room experience 

ESSENTIAL FUNCTIONS AND OBJECTIVES 

1. Supports the philosophy, goals, and objectives of the Organization.

1.1. Supports, and performs according to, approved policies and procedures. 

1.2. Participates as a team member in support of the total peri-operative process. 

1.3. Considers patient rights in performance of job duties and responsibilities. 

2. Contributes to the progress and development of the approved QAPI Program.

2.1. Supports risk management by participation in programs directed to patient and staff safety. 

2.2. Contributes to the QAPI process; identifies role and contributions to functional teams; participates in data collection; collaborates with team to identify opportunities to improve patient safety and quality of care. 

2.3. Objectively evaluates suggestions, grievances, and processes to identify opportunities to improve performance and quality of care.  

2.4 Places the best interest of the Team ahead of self interests. 

2.5. Supports efforts to identify staffing patterns and problems. 

2.6. Accepts changes necessary to meet unanticipated facility scheduling needs.    

2.7. Performs according to established quality improvement policies and procedures. 

2.8. Attends team meetings.  

3. Communicates effectively with patients, visitors, physicians, and coworkers.

3.1. Interactions are respectful and courteous. 

3.2. Communicates effectively and professionally on a patient’s level, keeping in mind age, mental 

           ability and education, using a translator when necessary for patients with language barriers. 

3.3. Documents that information received from the patient is disseminated to the appropriate people or departments. 

4. Maintains and promotes professional competence through continuing education and other learning experiences.

4.1. Attends and actively participates in team meetings, committees, conferences, and QAPI  

           activities. 

4.2. Researches and submits pertinent articles for review at staff meetings. 

4.3. Seeks new learning experiences by accepting challenging opportunities and responsibilities  

       4.4      Actively participates in problem solving for assigned team. 

4.5. Objectively evaluates suggestions or grievances and attempts to improve performance or seeks further guidance, as needed.  Accepts constructive criticism with a positive attitude. 

4.6. Maintains current R.N license and fulfills obligation for required continuing education for license and facility. Maintains membership in relevant professional organizations. 

4.7. Seeks to broaden knowledge of peri-operative nursing. 

4.8. Organizes and participates in orientation and staff development programs to meet identified learning needs. 

4.9. Assists with orientation and training of new personnel and acts as a resource person for patient care problems.  

4.10. Completes team assignments within the required guidelines. 

5. Adheres to safety policies and procedures in performing job duties and responsibilities.

5.1. Reports observed or suspected violations, hazards, and noncompliance according to Facility policy and procedure to the Safety Officer or other designated person. 

5.2. Observes safety measures in performance of job duties and responsibilities; Corrects immediately and responsibly, safety issues or problems which staff is qualified to address (wet floors, side rail down) 

5.3. Uses proper body mechanics while transporting patients to the OR via stretcher and while positioning patient for surgery. 

5.4 Responds to emergency situations with competence and composure. Is familiar with alarm sounds and can differentiate alarm tones.  Is familiar with the crash cart, its contents, and where to obtain necessary supplies and is knowledgeable of location of eye wash stations and spill kits. 

6. Interacts appropriately with various age groups.

6.1. Accurately assesses and interprets age-specific patient data. 

6.2. Accurately interprets age-specific patient responses to questions and instructions. Takes into consideration age related variables e.g., hearing, visual and motor deficits. 

6.3. Involves the patient’s family/significant other in decision-making about the patient’s care. 

6.4. Provides care appropriate to the patient’s age group. 

6.5. Accurately applies knowledge of growth and development. 

6.6. Considers age-specific patient requirements when responding to emergency situations. 

6.7.     Provides interpreter or employee for language barrier patients 

7. Organizes time, equipment, supplies, and staff to provide effective case management.

7.1. Arrives promptly to designated work area and begins work related activities. 

7.2. Supervises and directs patient care in a single operating room.  

7.3. Assures OR surfaces are dusted with disinfectant prior to bringing supplies into OR. 

7.4. Assures equipment settings are correct for planned case and surgeon. 

7.5. Verifies proper functioning of equipment and assures clock time on monitor correlates with 

           time on atomic clock. 

7.6. Verifies correct lot numbers are documented on board for the day.  

7.7. Prepares fluids for the case using sterile technique. 

7.8. Assures correct medications, solutions and implants are in the OR.  

7.9. Assures correct supplies are available for scheduled procedure. 

7.10. Assures correct equipment is in the OR for scheduled procedure 

7.11. Organizes nursing activities efficiently and effectively delegating activities appropriate to the 

           abilities of available staff members.   

7.12   Utilizes down time effectively by assisting other team members with their preparations for day,  

           assisting pre/post team, and performing tasks that would otherwise wait until the end of the  

           day. 

7.12. Considers cost-containment by using supplies economically and in effective turnover time. 

7.13. Assists with supply, drug, and equipment inventories to maintain stock level and availability. 

8. Addresses patient needs during admission to the operating room with attention to requirements specific to the outpatient setting.

8.1. Verifies correct patient, correct surgery correct site with informed consent on the patient’s 

                  chart prior to transfer to OR.. 

8.2. Confirms allergies and NPO status prior to transfer to OR. 

8.3. Checks lab values if appropriate prior to transfer to OR and reports to physician. 

8.4. Verifies planned anesthesia is properly consented and anesthesia, e.g. topical or blocks, 

                  have been completed prior to start of case. 

8.5. Obtains record of pre-op vital signs. 

8.6. Transports patients to the operating room according to Facility policy, safety requirements, and patient needs. 

8.7. Verifies vital signs appropriate to initiate surgery. 

8.8. Identifies the patient and correct surgical intervention according to Facility policy and communicates with all surgical team members. 

8.9. Informs surgical team of pertinent patient information may affect plan of care, e.g. allergies, disease processes, positioning difficulties, claustrophobia, hard of hearing, latex allergy, etc. 

8.10. Provides comfort and reassurance to the patient; maintains patient’s privacy and dignity.  Discourages inappropriate conversations in OR; monitors volume of conversations in the OR to 

           promote safety and professionalism and assure patients can hear safety instructions. 

8.11. Explains intra-operative phase routine procedures and care to the patient. 

9. Performs the circulating nurse’s functions adhering to approved operating room procedures for the scheduled procedure.

9.1. Prepares operating room according to the procedure to be performed and patient needs. 

           Reviews surgical schedule at beginning of day to prepare for any unusual cases scheduled. 

9.2. Assembles and provides properly functioning equipment, supplies, and instruments before start of procedure; positions and adjusts equipment as required during the procedure. 

9.3. Anticipates needs of the surgical team; assists anesthesia staff by supporting the patient during administration of anesthesia. 

9.4. Assists with the proper and safe positioning of the patient and prepares the operative site as directed by established procedure. 

9.5. Is proficient with operation of autoclaves and the removal of sterilized instruments from autoclave. 

9.6. Monitors compliance with principles of aseptic technique according to accepted standards. 

9.7. Assists with identification and confirmation of operative site.  Assures time-out is observed. 

9.8. Assures all measures are taken to assure correct surgical site and order prior to draping of patient. 

9.9. Verifies correct procedure(s) to be performed. 

9.10. Verifies correct implant to be used when appropriate. 

9.11. Provides for comfort in the physical environment by monitoring designated parameters.  

9.12. Has knowledge of EKG interpretation and reports any changes in heart rhythm, heart rate, blood 

           pressure or O2 saturation to anesthesia and/or surgeon when appropriate.  

9.13   Supports and assists anesthesia as requested 

9.14. Provides continuity of patient care by communicating with other perioperative care personnel and documenting records appropriately.   

9.15. Provides a report to the post-op nurse to include procedure, any changes in vital signs, medications given, or additional new post-op orders that may vary from the normal discharge instructions.   

9.16  Helps expedite transfer of patient by helping with patient transfer as needed.  Assists patient and initiates first vital signs until post-op nurse is available to receive report. 

9.17. Returns to OR to expedite room turn over when appropriate or transfers next patient to OR safely and efficiently per Facility policy. 

10. Responds in a timely manner to meet the needs of the patient and physician.

10.1. Accurately comprehends and interprets verbal orders and direction. 

10.2. Documents patient care records and other forms accurately according to Facility policy. 

10.3. Accurately advises others responsible for patient care about the patient’s status. 

10.4. Documents in OR log, tissue logs and/or implant log books according to Facility policy   

11. Performs end of day functions.

11.1. Assures OR is restocked for next surgical day. 

11.2. Assures OR is cleaned and closed according to Facility Policy and Procedure. 

11.3. Assures all unused equipment and supplies are removed from OR / sub-sterile area and put 

                  away in their appropriate areas. 

11.4. Assist in pulling cases for next surgical day as needed; asks when unsure. 

11.5. Assure medications needed for next surgical day are available. 

11.6. Assure daily/weekly duties on checklist have been completed and documented. 

11.7. Assists with PM narcotic count as needed. 

11.8. Assists other teams as needed to complete all end of day functions. 

Job Summary: Responsible for the delivery of safe, effective, and quality patient-family centered care in the OR and other areas of perioperative services for all patient populations.

Primary Responsibilities:

1. Promotes the mission, vision, and values of the organization
2. Follows the Policies and Procedures of the Employee Handbook
3. Assesses patients at intervals as stated in Policies and Procedures.
4. Provides culturally and age-appropriate, ethical care within legal standards of practice.
5. Assist in the development of the perioperative patient plan of care by:

a) Serving as a liaison between physician offices and the surgery center

b) Gathering pertinent patient information related to the scheduled case.

c) Arranging collected data into the appropriate patient record

d) Responsible for contacting all patients scheduled for surgery to assess their biophysical, psychosocial, spiritual, cultural, and educational status.

e) Utilizing critical thinking in the assessment of patients.

f) Communicating in a collaborative and efficient manner with the interdisciplinary team.

g) Ensuring that documentation is completed in a timely and thorough manner, which is able to be read and understood by clinical staff.

h) Contributing to the provision of quality nursing care through excellence in customer service and performance improvement techniques that demonstrate positive outcomes in patient care.

1. Delegates tasks as appropriate according to the state Nurse Practice Act and job description
2. Participates in performance appraisal process.
3. Uses problem solving and conflict resolution skills to foster effective work relationships with team members.
4. Maintains required competencies.
5. Pursues professional growth and participates in a professional organization.
6. Acts as a patient advocate and maintains privacy and confidentiality of all appropriate information.