Job Description

Overview

The Operating Room Registered Nurse is responsible for the management and delivery of patient care utilizing the nursing process to assess, plan, implement and evaluate care of patients undergoing a surgical procedure. The OR Registered Nurse directs and guides the delivery of patient care, patient education, and all care related activities, while maintaining standards of professional nursing. Exceptional skills and knowlege to assess, diagnose, plan, intervene and evaluate the outcomes of interventions. He/She is familiar with all instruments, supplies, and equipment used during specific surgical procedures. The Operating Room Registered Nurse addresses the physiological, psychological, socio cultural and spiritual responses of surgical patients.

The Perioperative Services Float RN will become competent in two of the three areas of Perioperative Services: Operating Room Circulating Nurse, Pre/Post Nurse, or Endoscopy Nurse.

The main position will be the one located on the nurse\xe2\x80\x99s P5 and the nurse will only be scheduled call in the main position area (e.g. Perioperative Services Float \xe2\x80\x93 Pre/PACU will only be scheduld Pre/PACU call).

The Periop Services Float RN will become completely oriented to their main position and will also learn basic skills of one of the other areas of Periop. The skill set of each additional area will follow the position specific contributions. All nurses of Periop Services will be competent in the basic skills of one other area within six (6) months of completion of the main area of orientation.

Special Criteria Details On-call as scheduled. Will float between Periop and PACU. *WAIVER REQUIRED

Responsibilities * Practices within the boundaries of the NYS Practice Act for Registered Professional Nurses and provides care according to CVPH (generic & unit-specific) Standards of Care and Practice and the AORN standard.

• Assesses patient by performing a functional health pattern/physical assessment on all patients as indicated throughout perioperative phases and when a significant change in condition occurs, upon transfer to/receiving from another unit, and as defined by CVPH generic, unit-specific Patient Care Standards, and AORN standards.
• Verifies and/or transcribes and implements physician orders.
• Utilizes computer technology as applicable, (e.g, Order Entry for orders, retrieving of lab data, etc)
• Provides leadership and measures effectiveness of nursing care by providing supervision, delegation, monitoring/reassessment of all patient care as required.
• Assess, reassesses, plans implements and evaluates nursing care (including DC plan) to include nursing actions to achieve age-specific outcome goals for the patient(s) with various diagnosis.
• Performs in crisis/emergency (e.g. code 99, 66, malignant hyperthermia, external temporary cardiac pacemaker) while maintaining a positive/ calm approach.
• Communicates patient care needs effectively (e.g. shift to shift, unit to unit, physician).
• Documents/communicates nursing care, physiological responses to other health care providers through verbal reports and patient record(s) as dictated by policy/guidelines; Reports to physician changes/deviations from expected norm.
• Provides prioritized patient/family education.
• Provides nursing care for the patient requiring pain management (surgical, chronic and terminal) according to organization and unit standards.
• Provides nursing care to the patient requiring various respiratory therapy modalities such as oxygen therapy, airway management, including artificial airways, suctioning, mechanical ventilation.
• Provides nursing care for the patient requiring blood/blood product therapy.
• Provides nursing care to the patient requiring medication administration by applicable routes to include controlled substances; Utilizes the pyxis system as required.
• Provides nursing care to the patient requiring restraints/ protective/ supportive devices, wandering/elopement, seizure and suicide precautions, and the patient on fall protocol.
• Provides nursing care to the patient requiring IV therapy to include initiation and maintenance by various routes (e.g., peripheral, central), methods (e.g., continuous, intermittent, IVPB, IVP), and solutions/medications (e.g., TPN, PPN, lipid infusions, medicated drips).
• Provides nursing care to the patient requiring monitoring/intervention with \xe2\x80\x9cPoint of Care Testing\xe2\x80\x9d (e.g., fingersticks, stool/gastric testing), patient care devices (e.g., PCA, Gemini, suction apparatus), input/output tubes/devices (e.g., NG tubes, urinary drains, surgical drains, enteral feeding tubes), and other such devices/treatments.
• Provides nursing care for the patient requiring special procedures/interventions to include conscious sedation, lumbar puncture, chest tube insertion, thoracentesis, liver biopsy, bone marrow, etc.
• Provides care using infection control practices as outlined in hospital policies/procedures (e.g. Universal Standard Precautions and Isolation Techniques).
• Advocates patient rights and demonstrates a working knowledge of Advance Directive practices, organ donation and procurement as evidenced by completion of documentation as outlined by CVPH policy/procedures.
• Manages conflict/identifies ethical dilemmas and assists patients and families in resolving.
• Supports fluctuation in patient care needs by floating/overtime when required, willing to take any reasonable assignments to assure meeting targeted goals such as room turnover, patient satisfaction, etc. and follows defined O.R. attire and traffic policies.
• Provides nursing care for the patient requiring preventive skin care, wound management, pressure ulcer prevention/treatment and stoma care
• Provides nursing care for the patient with a tracheostomy and/or requiring suctioning (nasopharyngeal, oropharyngeal, or tracheal).
• Provides nursing care for the patient requiring specimens.
• Demonstrates respect for the diversity of patient population providing comprehensive holistic care for the dying patient, including post mortem care and support for the patient\'s spirituality.
• Provides equipment and supplies based on patient needs.
• Provides nursing care for the patient requiring cardiac or invasive monitoring.
• Assists during endotracheal intubations by maintaining cricoid pressure and providing nursing care.
• Provides physiological monitoring during a procedure for the infant, child, adolescent, adult and geriatric patient
• Provides cardiovascular/respiratory/neuro assessment as patient condition or unit standards dictate.
• Maintains principles of sterile/aseptic techniques through identifying/utilizing appropriate methods of sterilization/disinfection.
• Provides nursing care to the patient requiring applied devices.
• Functions as a scrubbed member of the surgical team.
• Reads posted communication in a timely manner.
• The circulating RN will maintain the leadership role, monitoring the assigned licensed and unlicensed caregivers and maintaining continuous surveillance so as to detect and prevent potential adverse clinical events.
• Other duties as assigned.

ADDENDUM: REGISTERED NURSE (CHARGE) (ACU/PACU/OR)

The PACU/ACU/OR charge nurse is responsible for the direction of nursing personnel and overall coordination of efficient, effective, and safe nursing care in the PACU, ACU, or OR. The PACU/ACU/OR charge nurse directs and guides the overall delivery of nursing care, patient safety and all care related activities, while maintaining standards of professional nursing. He/she collaborates with other disciplines and units, as appropriate, and utilizes the nursing process to assess, plan, implement and evaluate patient outcomes. The charge nurse is competent in all aspects of peri-anesthesia nursing care and communicates and coordinates with the other perioperative charge nurses and clinical coordinator to orchestrate the perioperative team for optimal care delivery. * Demonstrates the ability to assess patient needs and acuity, skills/expertise of staff and other available resources to coordinate and adjust assignments to meet unit needs. Assigns patient care, breaks, on duty inservices, meetings and project time.

• Facilitates ongoing, interactive and positive communication with other perioperative charge nurses, surgeons, anesthesia providers, perioperative management, and staff. Serves as a liaison to the Patient/Family Waiting room, providing timely updates on patient condition.
• Serves as a resource person and role model for the perioperative team: assuring compliance with hospital and perioperative standards and policies, helping to identify and solve unit related issues and serving as a mentor to provide learning experiences for staff and nursing students.
• Provides calm and professional leadership in crisis and emergency situations, maintaining good communication with the other perioperative charge nurses to coordinate effective use of available resources.
• Participates in the development of standards for clinical practice and performance improvement initiatives, assists in the follow up of incident reports and safety issues.
• Assures that all signatures and required narcotic administration documentation is completed on the NAR before staff are released at the end of the shift.

Qualifications * Graduate from an accredited School of Nursing.

• Currently licensed as a Registered Professional Nurse in New York State.
• BLS or ACLS required with ACLS certification within 18 months of hire.
• Meets requirements of physical/pre-placement screening.
• Must pass Periop 101 course within 3 months of hire required.
• Must be able to take call as scheduled.
• Must have a demonstrated record as a team member.
• Previous experience in Periop Services will be considered first.

As applicable, the individual has training/competency in attending to the special needs and/or behaviors appropriate to the age of the patients for which care is being provided.

University of Vermont Health Network