GRADUATE NURSE - Clarion Hospital

A Graduate an approved program by the State Board of Nursing, who has not completed examination for licensure is responsible for the complete nursing care of a group of patients under the direct supervision of a Registered Nurse. The graduate nurse is responsible to the Nurse Manager and accountable to the patient. The Graduate Nurse will be enrolled into the Nurse Residency Program, a twelve-month program that progresses through three phases: orientation; interactive classroom education; and independent self-directed learning. Gradate Nurses are given the opportunity to be paired with a nurse mentor for continued one-on-one support. This program is designed as a series of learning and clinical practice experiences to assist newly licensed nurses as they transition from the student role to clinical practitioner.

Actively promotes a Lean work culture by performing team member duties to encourage consistent use of LEAN principles and processes, including continually seeking work process improvements. Recognizes the necessity of taking ownership of one's own motivation, morale, performance and professional development. Strives for behavior consistent with being committed to Excela Health's missions, vision and values.

1. Regular, consistent, on-site, and timely attendance.
2. Ensures that assessment of the patient and the direct and indirect patient care delivered is in accordance with the PA Nurse Practice Act, hospital policies, procedures and protocols and other professional standards of care.

a. Collects pertinent health assessment data on admission and in an ongoing systematic manner, focusing on the physical, psychosocial, age, cultural and spiritual needs of the patient. b. Documents the initial nursing assessment on appropriate medical records within the established time frames. c. Implements the individualized plan of treatment, evaluates and revises the established plan of care for each patient on an as-needed basis. d. Reassesses the patients condition and takes appropriate action as indicated or by unit-specific policy including, but not limited to, pain management. e. Involves the patient/family and other healthcare providers when appropriate. f. Complies with completeness, accuracy and timeliness of documentation.

3. Develops an educational process for the provision and coordination of patient care activities that promote and maintain health, fosters self-care and improves outcomes.

a. Participates in the interdisciplinary education to assess the patients readiness to learn, identify the patients educational barriers and tailor the educational processes to meet the needs of the patient/family. b. Ensures the process includes education about safely and effectively using medication, pain and managing pain, available resources, how to obtain further care, and information about their responsibilities in their care. c. Acquires and distributes educational resources tailored to patient needs. d. Provides and reviews written discharge instructions that demonstrate an inter-relationship between education, discharge planning and continuity of care.

4. Maintains a collaborative relationship with physicians and other health care providers to achieve desired patient outcomes and assure a continuous flow of patient care.

a. Communicates pertinent information for interdisciplinary patient care conferences, shift reports and internal and external transfers (when eligible). b. Takes action to proactively identify and resolve patient needs.

5. Participates in unit performance improvement activities designed to enhance the quality of patient care and customer service.

a. Assists in data collection process as requested. b. Recommends modifications for performance improvement.

6. Demonstrates leadership by utilizing the concepts inherent to the practice of the professional nurse.

a. Demonstrates an ability to solve problems independently utilizing critical thinking skills and seeking assistance from immediate supervisor when appropriate. b. Delegates patient care appropriately. c. Maintains accountability for actions taken. d. Acts as a patient advocate. e. Assists in maintaining organizational/departmental goals.

7. Assists in the departments compliance with state, The Joint Commission (TJC), OSHA and other regulatory agencies.

a. Participates in continuous survey readiness for inspections and surveys. b. Participates in the non-punitive medication reporting system. c. Ensures accountability for narcotics per regulatory/organizational policies. d. Adheres to the infection control processes, including standard precautions, to reduce the risk of acquiring or transmitting infections.

8. Provides for patient safety in compliance with hospital and nursing department policies.

a. Utilizes two forms of patient identification before implementing any form of patient care. b. Involves the patient and/or family in patient safety standards and processes. c. Minimizes the use of patient restraints and, if the patients condition warrants, monitors per individual assessed need and documents per policy. d. Assumes appropriate team role during code situations or mock codes. e. Responds effectively during emergency situations, including internal and external disasters. f. Assists in maintaining a safe and clean environment for patients, visitors and staff.

Limitations of Practice

a. Always under the direct supervision of an RN. b. May not accept verbal or phone orders from a physician. c. All physician orders must be checked by an RN. d. Must have approval by Nurse Manager/Preceptor before giving shift report. e. After successful completion of the IV skills lab and competency validation, the Graduate Nurse may administer IV push medications, IV fluids and blood.

Ability to perform the Essential Functions listed on the Physical Conditions and ability to perform the Essential Functions on the Working Condition chart (see attached chart).