*Must be able to work on Thursdays.*
JOB TITLE: Endoscopy Registered Nurse
DEPARTMENT: Nursing
JOB SUMMARY: Has principal responsibility for the nursing care, assessment, monitoring, recovery, and evaluation of assigned endoscopy patients. Provides care before, during, and immediately following endoscopy procedures, including post-anesthesia recovery. Monitors vital signs, anesthesia or sedation side effects, pain, and overall patient stability. Assists patients as they regain consciousness and observes for adverse reactions until the patient is stable for discharge or transfer. Provides discharge teaching and ensures care is delivered in a safe environment according to hospital policy.
OSHA Blood Borne Pathogens Class I.
JOB QUALIFICATIONS:
A. Education: Graduate of an accredited School of Professional Nursing.
B. Personal Job-Related skills: Demonstrated ability in nursing practice. Effective oral and written communication skills. Strong assessment, observation, critical thinking, and patient monitoring skills required.
C. Licensure, Registry or Certification: Registered Nurse currently licensed by the State of Texas. BCLS, ACLS, and PALS certifications. TNCC within one year.
D. Experience:
1. Prior Work Experience: One year of experience as a professional Registered Nurse preferred. Previous endoscopy, perioperative, emergency department, critical care, recovery room, or PACU experience preferred.
2. Technical Training: Current CPR certification. ACLS, PALS, and TNCC within one year of hire. Knowledge of endoscopy procedures, moderate sedation, post-anesthesia recovery, airway monitoring, and discharge criteria preferred.
E. Physical and Mental Requirements: Duties of the position require extended periods of standing and walking. Bending, stooping, twisting, reaching and lifting up to 50 pounds. Occasional heavy lifting when moving or supporting patients who may suddenly become weak, sedated, unstable, or helpless. Must be able to respond quickly and appropriately to emergency situations and changes in patient condition.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
A. Utilizing the nursing process completes a comprehensive physical and psychosocial assessment of patients.
1. Takes nursing histories to provide a basis for developing patient care plans.
2. Completes a thorough nursing assessment and history on admission including review of procedure, allergies, medications, NPO status, prior anesthesia history, and patient risk factors.
3. Identifies teaching/learning/discharge needs at time of admission and throughout the endoscopy encounter.
4. Provides an ongoing assessment which accurately reflects overall physiological and psychosocial needs of patients.
5. Consistently uses input from patient, family, significant other, physician, anesthesia provider, and health care team members.
6. Provides care appropriate for the neonate and the pediatric, adolescent, adult, and geriatric patients served based on demonstrated knowledge of the principle of growth and development over the life span.
7. Assesses and interprets data on neonate and the pediatric, adolescent, adult, and geriatric patient’s status to identify patient’s requirements relative to their age-specific needs and provides care needed as stipulated in departmental policy.
8. Assesses and monitors patients for adverse reactions to anesthesia, sedation, medications, and endoscopy procedures.
B. Using nursing process, plans and provides patient/family care; and evaluates patient’s response to care provided and redirects care as necessary.
1. Formulates appropriate nursing diagnosis and identifies patient problems from admission data base and ongoing assessment.
2. Establishes patient outcome goals that are realistic, specific, measurable, and progressive.
3. Develops and implements nursing orders which are specific and measurable.
4. Initiates interdisciplinary communications and incorporates recommendations.
5. Consults with patient and family and others to formulate care plans that reflect concern for holistic patient needs.
6. Assesses and evaluates patient-response/outcome and makes appropriate modifications on the care plan.
7. Reviews and updates the care plan on a timely basis to reflect patient’s current status throughout the procedure and recovery period.
8. Coordinates patient care before, during, and after endoscopy procedures to promote patient safety, comfort, and continuity of care.
C. Implements and monitors appropriate nursing care to meet patient’s needs and identifies expected outcome for planned nursing intervention and ensures vital information is passed between shifts.
1. Administers medications according to policy including IV’s, IVPB’s, blood and blood components as prescribed by physicians.
2. Knows actions, indications, and contraindications, precautions, adverse reactions, dosage and route of administration on all drugs before administering to patient.
3. Verifies medication administration record for accuracy and performs the required checks on the medication administration record.
4. Monitors all blood transfusions after started by the Registered Nurse and notifies Registered Nurse of any IV push medications to be administered.
5. Gives exchange report to other health care personnel providing accurate and complete information on each patient at the change of shift, when transferring patient to another unit, and at intervals during the shift.
6. Assesses patients at the beginning of shift for acuity of patient needs/problems and based on the assessment, establishes priority in which work activities are consistently completed by the end of shift.
7. Performs basic nursing skills competently to include but not limited to: intake and output, vital signs, urine testing, specimens/cultures, dressing changes, neurological assessments, personal hygiene for patient, skin care, glucose monitoring, airway/suctioning, basic oxygen administration, nasogastric tubes, tube feedings, urinary catheterization, drains, enemas, and intravenous catheterization.
8. Recognizes, evaluates and intervenes appropriately in a life-threatening situation.
9. Recognizes variances of diagnostic tests, vital signs and assessments that should be reported to the physician or anesthesia provider. Notify the physician or anesthesia provider in a time frame appropriate to the variance.
10. Functions proficiently in unit nursing modalities.
11. Consistently checks for new patient orders throughout the shift and implements them in an appropriate time frame.
12. Monitors patients during recovery from anesthesia or sedation, including level of consciousness, airway status, respiratory effort, oxygen saturation, cardiac status, blood pressure, pain level, nausea, bleeding, and overall stability.
13. Assists patients as they regain consciousness and ensures patient safety throughout the recovery period.
14. Identifies and responds promptly to adverse reactions to anesthesia, sedation, medications, or procedure-related complications.
15. Applies appropriate discharge criteria and ensures patients are stable prior to discharge or transfer according to physician order and hospital policy.
D. Participates in the health care educational needs for the client family, and others with regard to patient care needs, disease prevention and health maintenance measures.
1. Develops and implements individualized teaching and discharge plan at admission and throughout the endoscopy encounter.
2. Initiates and documents progressive patient, family, or significant other teaching on admission and throughout recovery.
3. Acts as a liaison between patient, physician, anesthesia provider, family, significant other, and other health disciplines.
4. Provides patient and family education regarding post-procedure care, activity restrictions, diet instructions, medication instructions, anesthesia precautions, warning signs, and follow-up care.
E. Maintains accurate and timely records according to hospital policy and procedures.
1. Documents ongoing assessments, within time frame determined by policy which accurately reflects overall physiological and psychosocial needs of patient.
2. Accurately documents on each shift the patient activities and the patient response to nursing interventions and delegated medical management.
3. Maintains a patient care plan that is current and reflects individual needs and preferences of patients.
4. Documents teaching completed and patient and family response in the patient record.
5. Documents interdisciplinary recommendations for plan of care.
6. Transcribes and/or cosigns physician orders completely and accurately according to hospital policy and practice.
7. Completes all appropriate transfer and discharge forms.
8. Documents pre-procedure assessment, intra-procedure monitoring as applicable, recovery status, discharge criteria, patient condition at discharge, and post-procedure instructions according to hospital policy.
F. OTHER SIGNIFICANT REQUIREMENTS:
A. Maintains HIPAA required and all other confidentiality while working with confidential matters on a daily basis.
B. Provides service direct to patients while maintaining a positive patient relations atmosphere.
C. Interacts with patients, family members, Medical Staff members and other department managers on a continuous basis.
D. Follows aseptic technique for procedures using precautions when involved in direct patient contact or when handling potentially infectious materials.
E. Follows safety and infection control policies and guidelines for JCHD.
F. Meets applicable Medicare standards.
G. Maintains patient safety during all phases of endoscopy care, including pre-procedure preparation, procedure support, recovery, and discharge.
H. Uses strong observational skills to monitor for adverse reactions to anesthesia, sedation, medications, or changes in patient condition.
I. Assists with maintaining endoscopy equipment, supplies, procedure rooms, and recovery areas in a safe, clean, and organized manner according to policy.
J. Performs other duties as assigned within the scope of nursing practice and departmental needs.
Work Location: In person
