A staff nurse is a professional Registered Nurse who provides quality nursing care to patients in accordance with recognized nursing techniques, procedures established standards, and administrative policies of Clearfield Hospital and Nursing Division. He/She is responsible for the administration of direct and indirect patient centered nursing care using nursing judgments based on the nursing process, scientific principles and nurse practice act. Responsible for planning, directing, controlling, observing and performing of nursing care to meet patient care needs and provide physicians with optimal service. Confers and completes daily patient rounds with attending and/or consulting physician.
*Complies with PENN HIGHLANDS CLEARFIELD policies and procedures, accreditation agency requirements, and federal, state or local law and regulations
1. Plans, directs, monitors and evaluates patient care.
a. Performs assessments in an ongoing and systematic manner, focusing on physiologic, psychological and cognitive status.
b. Formulates a goal directed plan of care, which is prioritized and based on determined nursing diagnosis and patient outcomes.
c. Implements care in a knowledgeable, skillful, consistent and continuous manner by utilization of/adherence to pre-determined standards, which define the structure, process, and desired patient outcomes of nursing process.
d. Evaluates effectiveness of self, care given by all health care team members in progressing patients toward desired outcomes.
e. Demonstrates ability to practice nursing as described by the following definition: “The nurse does for others what they would do for themselves if they had the strength, the will, and the knowledge”.
f. Identifies pt/so learning needs and implements teaching as needed.
2. Demonstrates advanced level problem solving skills and decision-making abilities.
a. Exercises judgment consistent with commonly accepted, current nursing practice.
b. Communicates with physicians routinely about patient care.
c. Appropriately notifies physicians, supervisor/nurse manager about patient problems.
d. Remains flexible in staffing patterns and resolution of staffing conflicts.
e. Seeks validation of knowledge base, skill level and decision making as necessary and assertively seeks guidance in areas of question.
3. Must be able to demonstrate competency to provide appropriate care to the age of the patients served in his/her assigned area. The skills and knowledge needed to provide such care must be gained through education, training or experience.
a. Identifies and demonstrates application of growth and development principles.
b. Demonstrates age-appropriate communication skills.
c. Assesses and interprets age-specific clinical data.
d. Provides patient care and performs treatments with age-specific considerations (i.e., equipment, medication administration.)
e. Involves family/significant other in plan of care.
f. Consults with multidisciplinary health care team regarding nursing assessment findings and plan of care
g. Evaluates patient’s response to medical, nursing, and other disciplines; intervention
h. Revises the plan of care with input from the patient, significant other, and other health care providers
i. Utilizes clinical resources
j. Administers medications according to policy/procedure/protocol and within scope of practice (Example: patient ID, read backs, etc.)
k. Maintains proficiency in starting and maintaining IV lines utilizing standard precautions
l. Responds appropriately to changes in patient condition
m. Reviews medical record for diagnostic test results on an ongoing basis
n. Conducts clinical rounds on patient assignment after receiving report
o. Implements the plan of care according to physician’s, nursing orders, clinical pathways, and nursing care standards.
4. Coordinates and implements patient teaching and discharge planning sessions for assigned patients and significant others as evidenced by:
a. Identifies patient learning needs on admission and throughout a patient’s stay
b. Initiates discharge planning and collaborates with other health care team members to achieve goals
c. Develops and implements a teaching plan for discharge
d. Evaluates the results of patient teaching and discharge planning
e. Reviews written instruction provided to patients/significant others regarding medications, activities, diet, treatment, and follow-up plan of care with patients and/or significant others and documents accordingly
5. Provides leadership and direction of patient care as seen by
a. Plans patient care based on the priority of needs and available resources
b. Delegates and supervises assignment to other staff members (i.e. LPN, CNA, Unit Secretary) according to patient needs and abilities of personnel
c. Reports changes in patient’s condition to medical and nursing personnel and follows-up
d. Responsible for gathering pertinent shift summary information from LPN or CNA. Conducts a shift summary by reporting on assigned patients to charge nurse and oncoming staff.
e. Performs responsibilities for patient care/unit operation
f. Monitors patient’s response to interventions performed by other staff members
g. Utilizes cost effective measures in delivering patient care
h. Monitors the health care environment and implements measures to maintain safety of staff, patients, and visitors
i. Supports and demonstrates understanding of mission and goals of the unit
6. Participates in the orientation and preceptorship of new staff on the clinical unit as evidenced by
a. Orients and/or preceptors new staff
b. Demonstrates welcoming behavior to new employees
c. Introduces new staff to all health care team members
d. Assures socialization of new staff (i.e. take along to lunch, breaks, and educational programs)
e. Serves as resource person for new staff
f. Participates in the development of an individualized orientation plan that is based on the new staff member’s education, experience, competence, and unit priorities
g Utilizes educational resources as indicated
h. Follows unit-based performance standards as criteria for evaluation of new staff
i. Participates in the evaluation process of new staff members on a regular basis
j. When functioning as preceptor/mentor submits a written progress report on new staff members to the Charge Nurse routinely
7. Assumes responsibility as a professional as evidenced by
a. Complies with departmental and hospital policies regarding attendance, work schedule and call system (where applicable)
b. Participates in the development and revision of competency based standards of care and unit based goals and objectives
c. Attends inservice programs on new products/equipment and procedures
d. Presents information obtained at education conferences to staff members
e. Participates in the improvement of department through individual or work team contributions
f. Provides feedback to enhance coworker performance
g. Participates in unit staff meetings as scheduled
h. Complies with departmental and unit policies regarding dress code
8. Utilizes effective interpersonal skills relating to the patient, significant other; and members of the health care team as evidenced by
a. Develops and promotes professional relationships
b. Utilizes appropriate resources for problem resolution
c. Solves those problems that are within their scope of responsibility and practice
d. Informs Manager and oncoming Charge Nurses of unusual or difficult patient care problems
e. Appropriately communicates evaluation of patient response to intervention to the interdisciplinary team
9. Unit Specific Duties
a. Demonstrates competency in the care of medical/telemetry/surgical/orthopedic/trauma patients according to established standards
b. Completes basic arrhythmia course annually/ACLS, if specialty unit
c. Completes Preceptor Certification Course and demonstrates competency annually, if applicable
d. Develops and completes personal leadership plan annually, to include educational enhancement opportunities
IF ASSIGNED TO THE CARDIAC CATHETERIZATION LAB
(letters e-l apply below):
e. Identifies, initiates and coordinates appropriate nursing care of the patient within the Cardiac Cath Lab
f. Initiates patient education as needed
g. Maintains patient comfort, safety and homeostasis
h. Functions in varying job assignments to include scrub nurse, circulating nurse and outpatient nurse
i. Participates in unit quality assurance activities
j. Adheres to radiation safety program
k. Possesses detailed knowledge of cardiovascular anatomy and physiology
l. Assists in the selection and preparation of specialized
equipment utilized in interventional therapies
10. CH Required Competencies – Actively participates or becomes aware of department Quality Improvement initiatives
a. Participates in the identification of quality issues requiring improvement
b. Participates in data collection, development and/or implementation of action plans for the unit
c. Demonstrates effective and safe use of equipment necessary in performing his/her job
d. Demonstrates compliance with patient safety policies and procedures to maintain a safe environment
-- Promptly reports environmental concerns that may jeopardize safety
-- Promptly reports actual or potential events that compromise patient safety
e. Demonstrates assertiveness when situations pose a threat to patient safety
f. Demonstrates compliance with Infection control policies and procedures and implements infection control measures
g. Maintains a continuing education log of all training/education initiatives
h. Responds promptly to patient/client/customer/coworker requests for service within the scope of the employee’s responsibility. If not in the scope of responsibility, employee refers the request to the appropriate resource.
i. Demonstrates competency in skills pertaining to specific unit/job area. (See attached annual competency assessment tool.)
General duties as directed.
Graduate of an accredited school of nursing and current licensure by Pennsylvania State Board required.
Appropriate nursing practice/experience (in past three years).
Certification in CPR required. ACLS required in specialty units. Ability to take and willingness to accept responsibility and make sound decisions required. Ability to work with patients, doctors, nursing staff and families to provide optimal levels of patient care required. Ability to exercise independent judgment required.