City/State:
West Nyack, New York
Department:
West Nyack Ambulatory Surgery Center_2
Work Shift:
Day
Work Days:
DAYS VARY, PER DIEM
Scheduled Hours:
7 AM-3:30 PM
Scheduled Daily Hours:
8 HOURS
Scheduled Weekly Hours:
0
Hourly Rate/Range:
Salary: $55+ per hour
For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differential, experience, education or other relevant factors.
Job Summary
Utilizes the nursing process to provide comprehensive nursing care during the intra-operative phase. Coordinates total patient care in coordination with other health team members particularly the Center's anesthesia team, surgical tech and health safety services tech. Functions as a patient advocate utilizing the Patient's Bill of Rights. Demonstrates professional growth and development by accepting responsibility and accountability for one's nursing practice.
Essential Functions
- JOB SPECIFIC COMPETENCIES:
Demonstrates the required job specific technical/professional knowledge, skills and abilities. *
. Assessment
1. Competency to assess the physiological health status of the patient preoperatively and intraoperatively.
a. Verifies the operative procedure using the consent form, the patient’s statement and if needed the surgeon’s verification prior to procedure.
b. Notes the condition of the skin for rashes, bruises, lesions, and previous incisions.
c. Determines mobility of the body using the patient’s statement, range of motion, and the history and physical.
d. Reports deviation of diagnostic studies such as lab or radiology reports.
e. Checks pre-operative vital signs upon admission to surgery: blood pressure, pulse, respirations, and temperature.
f. Notes nutritional status such as patient has been NPO.
g. Verifies allergies to medication, food, or chemicals.
h. Communicates and documents physiological data to other members of the surgical and health care team in verbal or written report, including data which might be relevant to discharge planning.
2. Competency to assess the psychological health status of the patient/family.
a. Elicits patient expectations of care and outcome of surgery.
b. Determines level of knowledge and ability to understand, such as language barrier and seeks assistance as necessary.
c. Identifies philosophical, religious, and cultural beliefs concerning the intraoperative phase, such as blood transfusions, disposition of limbs, and sacraments.
d. Communicates and documents psychological data to other members of the surgical and health care team in verbal and written report, including data which might be relevant to discharge planning.
3. Formulates nursing diagnosis based on health status data.
- Planning
1. Competency to establish realistic and attainable goals based on nursing diagnosis and to develop a plan of care based on nursing actions to achieve patient goals.
a. Provides positioning aids during the intraoperative phase to prevent skin breakdown or impairment of the nervous or vascular system.
b. Provides equipment to insure patient safety in regard to electrosurgery and laser.
c. Coordinates use of supplies and equipment for intraoperative care.
d. Organizes nursing activities in logical sequence, prioritizing nursing actions.
e. Coordinates patient care needs with other members of the surgical and health care team.
f. Assigns activities to appropriate personnel based on their qualifications and patient needs.
g. Maintains required certifications (CPR) and performs effectively in an emergency situation.
h. Communicates and documents patient’s plan of care to other members of the surgical and health care team in verbal and written report, including that which might be relevant to discharge planning.
- Implementation
1. Competency to implement nursing actions in transferring the patient according to the plan of care.
a. Confirms the patient identity using bracelet and patient’s statement.
b. Selects appropriate personnel for transport as determined by patient acuity and number of staff needed.
c. Determines appropriate and safe method of transport.
d. Provides for emotional needs during transport.
e. Communicates and documents method of transport.
f. Participates in pre-operative teaching as needed, such as explanation of surgical routine and environment.
2. Competency to scrub cases, to create and maintain a sterile field.
a. Uses principles of aseptic technique in varying situations, such as infection control practices, skin preps, demonstrated knowledge of clean vs. sterile.
b. Initiates corrective action when breaks in technique occur.
c. Maintains sterility while opening sterile items for procedure, including pouring solutions.
d. Inspects sterile items for integrity of package, sterile indicator and/or outdate prior to delivery to the field.
e. Adheres to dress code policy for peri-operative area(s).
f. Monitors suite to insure that movement around the sterile field is appropriate at all times.
g. The R.N. circulator duties include being in the OR suite during the intra-operative phase.
h. Communicates and documents maintenance of / compromise of sterile field.
3. Competency to provide equipment and supplies based on patient needs.
a. Anticipates needed equipment and supplies, utilizing the surgeon preference card.
b. Selects equipment and supplies in an organized, timely and cost effective manner throughout the peri-operative phase.
c. Assures all equipment is functioning before use.
d. Operates mechanical, electrical, and powered equipment according to manufacturer’s instructions and the Center policy.
e. Removes malfunctioning equipment from service, tags it appropriately and initiates repair and communicates need for service to Clinical Coordinator.
f. Uses supplies judiciously and in a cost-effective manner.
g. Communicates and documents provision of equipment and supplies including charges.
h. If facilitating outside the O.R., performs all ancillary tasks required at the center, up to and including picking soft goods/supplies, facilitating case carts throughout the day, performing specimen check at the end of the day, circulator/scrub lunch reliefs, stocking supplies in the OR and storage areas, communicating low par levels to materials manager and preparing implant carts for the next day’s surgeries.
4. Competency to perform sponge, sharps and instrument counts.
a. Follows policies for sponge, sharps, and instrument counts in the scrub or circulator role.
b. Initiates corrective action when a count is incorrect.
c. Communicates and documents results of counts according to policy.
5. Competency to administer drugs and solutions as prescribed.
a. Administers medications according to policy. Labels medications as a circulator or scrub nurse. Verbally confirms medication and dosage before dispensing onto the field or handing medication to physician as scrub nurse.
b. Communicates and documents administration of medications and solutions according to policy, including medication errors.
6. Competency to physiologically monitor the patient during the peri-operative phase,
a. Assists/monitors physical symptoms, behavioral changes, intake and output, and vital signs.
b. Initiates nursing actions or obtains physician order as appropriate, based on interpretation of physiological data/changes.
c. Communicates and documents patient’s physiological response to other members of the surgical and health care team in verbal or written report, including that which might be relevant to discharge planning.
7. Competency to monitor and control the environment.
a. Controls the environment to provide ultimate patient care, such as temperature of room, sensory stimuli, and traffic and noise level.
b. Adheres to all safety policies and procedures.
c. Maintains appropriate traffic pattern in the peri-operative environment, including monitoring of the sterile field as scrub nurse.
d. Adheres to sanitation policies for infection control including confine and contain and waste disposal.
e. Communicates and documents environmental controls or breaks in technique promptly and appropriately.
f. Assists surgical team in room turnover, communicating laterality and positioning devices for next case to the health safety services tech, wiping down flat surfaces, removing garbage or soiled linen, mopping, etc.
8. Competency to respect patient’s rights.
a. Demonstrates awareness and practices according to the Patient’s Bill of Rights and Center policy.
b. Provides for patient safety and maintains patient confidentiality.
c. Communicates and documents provision for patient’s rights as appropriate.
- Evaluation
1. Competency to perform nursing actions that demonstrate accountability.
a. Exercises safe judgment in decision-making.
b. Demonstrates flexibility and adaptability to changes in nursing practice.
c. Responds in a positive manner to constructive criticism or recommendations for improvement.
d. Demonstrates tact, understanding and good guest relations when dealing with patients, visitors, team members, and other units.
e. Practices within ethical and legal guidelines.
f. Seeks opportunities of continued learning.
g. Communicates and documents nursing actions.
2. Competency to evaluate patients.
a. Develops outcome criteria and measures degree of achievement.
b. Communicates and documents degree of goal achievement to other members of the surgical and health care team in verbal and written report, including that which might be relevant to discharge planning.
3. Competency to evaluate effectiveness of nursing care.
a. Continuously evaluates the patient’s needs, plan of care, and nursing actions, adjusting the plan as required to provide optimum patient outcomes.
b. Assesses the patient post-operatively and determines the effectiveness of care to desired patient goals.
c. Communicates and documents effectiveness of care and results of nursing care to other members of the surgical and health care team in verbal or written report, including that which might be relevant to discharge planning.
d. Participates in the Quality Improvement Program activities including identification of aspects of care, collection and analysis of data, formulation of recommendations, implementation of an improvement plan and evaluation of the process.
4. In keeping with the teamwork philosophy, acts as a resource person to other staff.
5. Adheres to OSHA guidelines for Universal Precautions for exposure to blood and body fluids, using appropriate personal protective equipment (PPE).
6. Participates in the orientation of new employees, students and approved program participants.
7. Attends Center staff and unit meetings, and educational opportunities.
8. Demonstrates flexibility in meeting the needs of the Center.
9. Follows AORN Recommended Practices and the Center’s policy at all times.
10. Assists visitors, staff and physicians, utilizing good guest relations.
- Document on addendum age specific competency.
- Employee Performance Standards
A. CUSTOMER SERVICE:
1. Demonstrates the ability to create a positive interaction with the customer.
2. Demonstrates positive communication with people of different cultures, values and beliefs.
3. Demonstrates the ability to acknowledge customer concerns and
takes corrective action.
4. Demonstrates compliance with identified customer service behaviors.
5. Provides escort to customers when necessary.
B. PERFORMANCE IMPROVEMENT:
1. Participates in Department/Hospital-wide activities which improve
processes and/or outcomes.
2. Utilizes resources to maintain and improve self development and
knowledge.
3. Complies with licensure and/or certification requirements.
4. Participates in annual competency assessment.
C. BUDGET:
1. Demonstrates fiscally prudent use of equipment and supplies.
2. Utilizes charge process for supplies/equipment.
D. PROJECTS/ASSIGNMENTS:
1. Completes projects/assignments within projected time frames and expectations.
Qualifications
- Associate Degree Required or
- Bachelor Degree
- 1-3 years Minimum of 1 years' OR experience Required
- Proficient in circulating and scrubbing in orthopedic cases or ability to learn the latter. (High proficiency)
- Registered Nurse New York - New York State Board of Nursing Required
- BLS Basic Life Support - American Heart Association Required
- ACLS - Advanced Cardiac Life Support - American Heart Association Required
Montefiore Nyack Hospital is an equal employment opportunity employer. Montefiore Nyack Hospital will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law.
