Registered Nurse Surgery

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Location

BMH Bronson Methodist Hospital

Title

Registered Nurse Surgery - L3 - 72 hr/pp - Bronson Methodist

Under general supervision and in accordance with the policies, procedures and guidelines established within the organization, the unit, and the Michigan Public Health Code, the registered nurse manages the care delivery for patients in the organization throughout the length of stay to achieve quality outcomes and timely discharge by the following: utilizing the nursing process of assessment, planning, diagnosing, implementation and evaluation; coordinating the care provided by other professionals; delegating selected acts, tasks or functions that fall within the scope of professional nursing practice and the abilities of patient care assistants and universal service assistants; providing selected aspects of physical care within the scope of professional nursing practice as appropriate given the patient's level of acuity and complexity of care required; and documenting and communicating during each tour of duty the patient's response to care provided, consumption of resources and anticipated needs. Employees providing direct patient care must demonstrate competencies specific to the population served.

BMH 5700 Surgery Only

Associate's degree in Nursing required

Bachelor's degree in Nursing preferred, must obtain within 8 years of hire

Licensed Registered Nurse in good standing for the state of Michigan

As of December 29, 2013, any nurse hired by Bronson who does not hold a BSN (or higher nursing degree) will be given 8 years from date of hire date to obtain. If, after 8 years, the nurse has not met this requirement, employment will be terminated.

BLS certification required by completion of core orientation

Critical care or ALS as well as other certifications may be required for some RNs, unit specific

Career Ladder RN Level 3

• Must maintain all steps in level one, level two and complete the following to obtain level 3

• Five years’ experience in BMH OR following completion of orientation

• AORN member or committee

• Ability to scrub and circulate cases OR circulate 3 services proficiently.

• Completion of 4 professional development hour per year and present learned knowledge from each session in one of the following forms

  • Staff meeting,

  • committee meeting

  •  hallway in-service

  • Power point

  • Poster presentation

• Choose one option from the list below:

  • CNOR certification

  • Minimum of 102 hours of call per month (employees must bid on and be accepted into these positions)

  • Team Lead (employees must bid on and be accepted into these positions)

  • Relief Charge positions (employees must bid on and be accepted into these positions)

Profession Development options – Documented in Workday and present learned knowledge

• BOLD Class (virtual, in-person or on-demand)

• Crucial Conversations

• Preceptor (includes yearly maintenance class)

• Conference attendance

• Professional webinars, other learnings, and book reviews

• Other (must be approved by leader)

Committee Attendance and participation must be at 80% ---- Virtual participation is approved, and attendance must be documented by committee leader champion

Committees in Surgery include:

• Staffing Committee

• Education Committee

• Shared Governance

• Professional Practice

• Team Development and Engagement

• Safety and Care in the OR

• Surgery Policy and Procedure

• Safety Champion

Committees outside of Surgery include but are not limited to:

• Divisional and/or sub committees

• Nursing Informatics

• CISM

Standards of Practice:

• The registered nurse collects comprehensive data pertinent to the patients’ health or the situation.

o Assesses the patient’s physical and developmental needs

o Analyzes assessment data to identify appropriate patient needs

o Documents nursing history and age appropriate physical/emotional needs/strengths for assigned patients

o Reviews vital signs to assess condition of patient and detect deviations from normal.

• The registered nurse analyzes the assessment data to determine patient problems or issues

o Uses the assessment data to identify patient problems

o Confirms problems with patient and family when appropriate

o Documents the expected outcomes and plan of care related to the problems through use of the clinical pathway and outcome teaching record

• The registered nurse identified expected outcomes for a plan individualized to the patient

o Utilizes the patient/family input when defining outcomes. Incorporates the patient values, ethical and cultural considerations.

o Coordinates discharge planning for outcomes not achieved utilizing the continuum of care available.

• The registered nurse develops a plan that prescribes interventions to attain expected outcomes.

o Incorporates clinical pathways into the plan when appropriate

o Develops individualized interventions with patient input when appropriate

o Considers data from other members of the healthcare team when developing the plan of care

• The registered nurse implements the identified plan.

o Implements appropriate interventions.

o Administers prescribed medication and treatment in accordance with approved nursing techniques and polices.

o Utilizes evidence-based interventions specific to the patients plan

o Maintains awareness of comfort and safety needs of the patient.

o Initiates a patient education plan according to the individualized needs of the patient, and coordinates the implementation of the plan.

o Manages the care plan for patients by organizing and delegation patient care interventions to be implemented. Evaluates the effectiveness of care given by self and others.

• The registered nurse evaluates progress toward attainment of the expected outcomes

o Evaluates the effectiveness of the planned interventions and the patient response toward achievement of the expected outcomes.

o Documents the patient response toward the expected outcomes.

Standards of Professional Performance:

• The registered nurse systematically evaluates the quality and effectiveness of nursing practice.

o Participates in quality improvement activities

o Uses the results of quality improvement activities to initiate changes in nursing practice.

• The registered nurse attains knowledge and competency that reflects current nursing practice.

o Participates in ongoing educational activities related to appropriate knowledge and professional issues.

o Maintains professional records that provide evidence of competency and continued ongoing educational activities.

• The registered nurse evaluates one’s own nursing practice in relation to professional practice standards and guidelines, relevant statues, rules and regulations.

o Provides age appropriate care in a culturally and ethnically sensitive manner.

o Participates in self-evaluation, identifying areas of strengths as well as areas benefiting from professional development.

o Participates in systematic peer review as appropriate.

• The registered nurse interacts with and contributes to the professional development of peers and colleagues.

o Shares knowledge and skills with peers and colleagues

o Maintains compassionate and caring relationships with peers and colleagues

o Contributes to a supportive and healthy work environment.

• The registered nurse collaborates with patient, family, and others in the conduct of nursing practice.

o Partners with the multiple health disciplines to effect change and generate positive outcomes for the patient and family, based on the plan of care.

• The registered nurse integrates ethical provisions in all areas of practice.

o Delivers care in a manner that preserves and protects patient autonomy, dignity, confidentiality and rights.

o Demonstrates a commitment to connecting with self and others through relationship centered care giving.

o Serves as a patient advocate

• The registered nurse integrates research finding into practice.

o Uses research to improve the health of patients and the practice environment.

o Participates in the various levels of research based on their level of education. Such activities may include: identifying clinical problems, participating in data collection, participating in the research committee, sharing research activities/finding with others, conducting research, analyzing data and trends of nursing practice to develop changes in nursing practice and utilizes evidence based practice in the development of policies, procedures and standards of practice in patient care.

• The registered nurse considers factors related to safety, effectiveness, cost and impact on practice in the planning and delivery of nursing services.

o Assigns or delegates tasks based on the needs and condition of the patient, potential for harm, complexity of the nursing activity, required problem solving and innovation, predictability of outcome, extent of patient interaction

o Assists the patient and family in becoming informed consumers about the options, costs, risks and benefits of treatments and care.

• The registered nurse provides leadership in the professional practice setting and the profession.

o Participated in nursing councils, hospital and unit based committees as appropriate.

o Attends at least 50% of unit staff meetings

o Works to create and maintain professional, healthy work environment when representing Bronson in all settings (local, regional or nationally)

Responsibilities related to the Scrub RN

o Interprets procedure card, assesses case cart for supplies prior to the scheduled procedure time.  Identifies missing equipment and/or supplies and makes arrangements to acquire those supplies.

o Applies knowledge of operative procedure and physician preferences by anticipating physicians' needs.

o Observant of overt changes in patient's condition that indicates a problem has emerged.

o Evaluates and updates case information, i.e., preference cards, broken or misplaced equipment, back-ordered supplies, and recommended changes in procedure.

o Remains aware of the proper use of equipment and instruments, and discourages improper use and handling by co-workers & physicians.

o Is observant of the changing needs of the operative field and the surgical team, anticipates potential needs, and takes appropriate actions.

o Acts as the specialist and resource for circulators who may be unfamiliar with positioning devices, specialty equipment, and/or implants needed.

o Assigned and responsible for after-hour call on a rotational basis.

o Ability to perform scrub duties in multiple services; ie: neuro and ortho STII able to perform spinal fusions in bother services.

Shift

Variable

Time Type

Full time

Scheduled Weekly Hours

36

Cost Center

5700 Surgery (BMH)

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