Registered Nurse-Emergency Services

General Statement of Job This position provides safe and effective nursing care and treatment to patients in the Emergency Services Department.

Employees are part of a managed care team and works collaboratively with ancillary personnel in the provision of proper medical services and treatment. This position is responsible for assessing the patient, planning the care and evaluating the effectiveness of nursing interventions in accordance with established regulations, policies, nursing standards and medical instructions.

Specific Duties and Responsibilities Essential Functions:

• Provides nursing care to meet the needs of the patient population served as qualified, i.e., neonatal, infant, child, adolescent, adult, and geriatric patients.
• Delivers age appropriate patient care within defined hospital and emergency care standards for assessment, care planning, interventions, and reassessment, and delegates care appropriately to other team members and support staff.
• Performs duties with a clear understanding of the Joint Commission Safety Goals and delivers care with patient safety as a goal. Follows hospital policies guiding compliance with National Patient Safety Goals.
• Demonstrates understanding and commitment to hospitals mission, philosophy, standards, policies and procedures. Recognizes all staff, physicians and visitors, as well as, patients as customers and provides courteous and respectful service.
• Participates in the orientation and mentoring of new staff members recognizing importance of bringing new staff into a friendly and supportive work environment.
• Maintains competencies and participates in required training and in-services for unit.
• Ensures completion of continuing education requirements in subjects pertinent to emergency nursing or position related information.
• Delegates and supervises care appropriately to CNAs, Paramedics and Unit Clerks with follow up and feedback procedures to ensure quality of care. Initiates appropriate actions as needed.
• Assists manager and other staff members to maintain competence and skills for procedures assigned and assists in validation of skills and competence of new staff members prior to delegation of patient care.
• Demonstrates an understanding of responsibility of emergency plans and is available for patient care as needed or scheduled when hospital emergency preparedness plans are activated.
• Works cooperatively with ancillary departments in ensuring the patients care is safe, following protocols as applicable.
• Participates with team members and manager to identify opportunities for improvement in patient care processes.
• Utilizes and ensures staff uses supplies efficiently, following infection control procedures, avoiding waste and follows patient charging procedures.
• Serves as an example for team members in cost saving practices.
• Ensures the placement of identifying arm-band on patient upon patients arrival in the Emergency Services Department.
• Follows the Universal Protocol for prevention of wrong site, wrong procedure and wrong person surgery.
• Provides informed consent for procedures and aspects of care in accordance with policies, procedures and regulatory guidelines.
• Utilizes patient care equipment safely, following hospital policy and procedure. Reports any identified equipment breakdown or malfunction by hospital policy. Maintains cleanliness of equipment after use.
• Serves as a leader for change, positively promoting new systems and changes implemented which improves the hospital and the service provided to its patients.
• Participates in hospital community activities and helps portray a positive image of the hospital in the community.
• Documents and reports any complaints from patients, physicians and visitors to supervisor as guided by hospital policies and procedures.
• Checks code cart and performs monitor/defibrillator checks each shift.
• Verifies medication discrepancies are not present at the end of the shift.
• Follows and adheres to EMTALA guidelines in arranging for transfer of a patient to another healthcare facility.
• Screens all patients for the appropriate acuity and priority level in a timely manner.
• Assesses each patient for potential abuse, suicidal or exploitation. Reports to proper authority any concerns of abuse, neglect, suicide or exploitation.
• Evaluates emotional needs of the patients with appropriate referrals.
• Explains all procedures and care plans to patients, and as appropriate to family. Ensures patient and/or family are educated for appropriate health maintenance.
• Performs home medication reconciliation with the appropriate documentation.
• Orders initial lab tests and x-rays by established protocols or per physician orders.
• Ensures patients are appropriately prepared for tests.
• Obtains and transcribes physicians orders in a timely and accurate manner ensuring all tests are ordered appropriately and efficiently.
• Completes assessments and documentation of all patients.
• Evaluates clinical/diagnostic reports and reports variances to the Physician and documents same.
• Assess patients care status frequently and charts patients vital signs and notifies physician of abnormal ranges as well as any significant changes.
• Develops plan of care and patient focused goals with the patient and family as appropriate, ensuring patient understanding and involvement in their care.
• Verifies any patient allergies prior to administration of medications.
• Communicates effectively with other patient care providers and team members for efficiencies and safety of care through appropriate ordering procedures, preparing patients for surgery and other procedures, communicating fall potential and other risk identifiers.
• Utilizes patient restraints appropriately following the hospitals policies and procedures.
• Assesses lung sound in patients to evaluate pulmonary status by auscultation.
• Observes cardiac rhythm and initiates ACLS protocol defibrillates patients safely in accordance with regulations, policy and accepted procedure.
• Assesses each patients pain and documents utilizing the approved pain scale. Documents reassessment of pain post-treatment and at time of discharge.
• Reviews with the Physician all critical lab values and documents patients plan of care.
• Documents and maintains all patient care records and related required documentation.
• Maintains records and communications with respect to patients privacy.
• Follows policies for administration of high-risk drugs, patient identification, documentation and taking telephone orders with read back and communication of critical values/diagnostic results.
• Documents the administration of medicines including dosage, medicine route, medicine site, and patients response as required in the documentation system.
• Arranges for patient interviews with Surgeon and Anesthesiologist in preparation for surgery, and remains available to answer any questions the patient may have or arrange for more information from the Surgeon.
• Performs time out procedures on all invasive procedures at the bedside as needed.
• Communicates and completes documentation for effective handoff of patients care (SBAR) for admission or transfer of patient to another health care facility.
• Utilizes good communication skills, critical thinking and checkpoints for teamwork. Provides patient information timely and effectively during shift report and with patients hand-offs.
• Discharges patients including the plan of care for follow up requirements.
• Completes discharge instructions with information regarding food and drug interaction.
• Provides nursing care to patients with either hard or soft splinting devices; assesses circulation, mobility, and neurological status of patients. Applies splints and bandages per physicians orders.
• Performs waived testing per policy and completes associated documentation.
• Follows proper aseptic techniques in all medication preparation and administration.
• Utilizes needle-less system in providing patient care as appropriate in accordance with policies, procedures and regulatory standards.
• Starts IVs and delivers IV medications to patients as needed. Runs and calculates IV drips.
• Documents the date and time all IV tubing on initiation of IV infusions.
• Completes control tests on Accu Check machine daily.
• Performs bedside blood glucose monitoring per physician order and/or hospital policy.
• Performs NG tube insertion and performs gastric suction per hospital policy and procedures.
• Performs port flushes, injections and blood transfusions as needed.
• Dresses patient wounds as needed utilizing appropriate method of care.
• Collects specimens following hospital policy and procedure.
• Utilizes personal protective equipment in performing duties where actual or potential exposure to hazardous conditions may be present.
• Reports variances in care and/or medication administration for quality improvement.
• Performs duties in accordance with pathogen transmission practices; i.e., follows hand washing procedures and utilizes protective equipment effectively.
• Participates in the cleanliness of the work environment.
• Follows the cleaning and disposal policies and procedures for all hazardous waste.
• Participates in the hospital Utilization Management Program by assisting with discharge planning, reporting to case managers and keeping patient, family, physician and other personnel informed.
• Delivers patient care in accordance with established infection control standards for patient placement, IV therapy, medication administration and the performance of all patient procedures; demonstrating adherence to hand washing policy.
• Follows guidelines for performance improvement and demonstrates understanding of participation in the Core Measures for Lakeside Medical Center and for documentation review and restraint review process.
• Participates in departments QI activities on a daily basis.
• Ensures availability of age appropriate supplies and equipment.
• Completes pre-operation checklist.
• Witnesses consents for surgery, anesthesia and special procedures as per hospital policy.
• Transports patients to appropriate care locations utilizing monitoring if indicated.
• Floats to other units as required.
• Emergency duty may be required of the incumbent that includes working in special needs or Red Cross shelters or to perform other emergency duties including, but not limited to, responses to threats or actual disasters, man-made or natural.

Additional Duties: May be required to act in a Charge Nurse capacity during which, the additional duties would be required:

• Supervises RNs, LPNs, Paramedics, CNAs and Unit Clerks and the provision of care to patients in accordance with policies, procedures and regulations.
• Assists the Nursing Manager - Emergency Services with order transcription and overall operation of the unit.

This job description reflects the general duties considered necessary to describe the principal functions of the job as identified and shall not be considered as a complete description of all the work requirements and expectations that may be inherent in the position. The omission of specific statements of duties does not exclude them from the position. Management of the Health Care District of Palm Beach County reserves the right to assign duties not listed herein as necessary to accomplish the goals of the organization.

The Health Care District of Palm Beach County is an independent special taxing district that has served as a healthcare safety net for more than 36 years to fill in gaps in access to healthcare services. This unique healthcare system covers the entire county and provides a wide range of services such as nine community health centers (Federally Qualified Health Centers) which serve everyone regardless of ability to pay; school health teams in 172 public schools; a lifesaving Trauma Hawk aeromedical helicopter program; a rural, public teaching hospital, Lakeside Medical Center; an award-winning skilled nursing center; a ground ambulance program for Health Care District patients needing a higher level of care and the countys Trauma Agency, which ensures quality outcomes within the countys trauma system and leads initiatives to prevent traumatic injury.

We are committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of race, color, creed, religion, military or veteran status, age, sex, pregnancy status, genetic information, national origin or ancestry, citizenship, physical or mental disability, marital status, sexual orientation or identification status, or any other legally recognized category protected by jurisdictional, state or federal law. The information collected by this application is solely to determine suitability for employment, verify identity and maintain employment statistics on applicants.

We are also committed to maintaining a safe, healthy, and productive work environment for all employees. As such, we are a Drug-Free Workplace.

This role may require Agency of Health Care Administration (AHCA) background screening and clearance. As required under House Bill 531, applicants may review AHCAs education and awareness information at the following link: https://info.flclearinghouse.com

Position Qualifications Education:

• Nursing degree from an accredited nursing school required.

Experience:

• One (1) year of acute care nursing experience as an RN required.

Certification:

• Current CPR certification required, ACLS and PALS required upon hire. Advanced certification such as CEN preferred. Cardiac Proficiency Certification preferred.

Licensure:

• State of Florida, Registered Nurse license required.

Registrations:

• N/A

Training:

• N/A