Registered Nurse

Description

Summary:

A Registered Nurse (RN) is a professional caregiver responsible for providing primary care to patients, including assessment, treatment, care planning, patient education, and medical care evaluation. The RN works to promote good health, prevent disease and help patients cope with their disease by providing advice and emotional support.

Responsibilities and Duties:

• Must demonstrate a sound knowledge of the nursing processes; health care systems, structure, and functions; and community resources.
• Demonstrates understanding of healthcare technology, equipment, and supplies. 
• Demonstrates familiarity with state law on nursing care, nurse practice guidelines, and RCCA Central Jersey Division policies and procedures. 
• Utilizes nursing judgment in the decision-making process when responding to patient calls and questions. 
• Demonstrates critical thinking using logic and reasoning to identify strengths and weaknesses of alternative solutions, conclusions, or approaches to problems.
• Performs assessment/data collection in an ongoing and systematic manner, focusing on physiologic, psychological, and cognitive status.
• Formulates a goal-directed plan of care, prioritized and based on determined nursing diagnosis and patient outcome.
• Implements care in a knowledgeable, skillful, consistent, and compassionate manner.
• Functions to establish priorities of patient care based on essential patient needs and available resources of time, personnel, equipment, and supplies.
• Evaluate the effectiveness of the care given by all healthcare team members. This includes environmental factors and instrumentation in the progression of the patient toward outcomes.
• Demonstrates sound knowledge of the ONS and OSHA guidelines.
• IV therapy techniques reflect a sound knowledge base of the principles of practice.
• Chemotherapy administration techniques reflect a sound knowledge base of the principles of practice
• Demonstrates knowledge of medical record documentation requirements and federal/state laws related to the release of health care information.
• Maintains and demonstrates knowledge of telephone-based clinical assessment techniques.
• Demonstrates knowledge of medical practice telephone triage protocols.
• Demonstrates knowledge of appropriate home health information to follow until a visit with the physician, if they do not need immediate hospitalization.
• RNs should be familiar with the most common side effects of each drug they are administering. They should as the patient if they are experiencing any of these specific side effects before administering subsequent cycles of the drug.

Technical Skills:

• Demonstrates competency in physical assessment of oncology and hematology patients.
• Demonstrates competency in all aspects of chemotherapy administration, monoclonal antibody therapy, IV therapy, subcutaneous and intramuscular injection administration.
• Knowledgeable and practices within the ONS guidelines during any adverse event while administering chemotherapy, i.e. extravasations, infiltrations, or chemotherapy spill incidents.
• Demonstrates competency in the use of all intravenous access devices, including the intra-hepatic infusion pumps.  
• Must demonstrate proficiency in performing all laboratory testing on-site, including documentation and QC. 
• Obtain blood specimens for analysis by fingerstick or venipuncture depending on the specific test ordered
• Review all specimens for acceptability.
• Educate patients on the proper technique for the collection of midstream urine samples for culture.
• Collects specimens for culture using the sterile technique for blood cultures, throat cultures, sputum cultures, or superficial wound cultures.
• Instructs patients in the proper collection of twenty-four-hour urines. Verifies that the containers contain the proper preservative and instruct the patient in refrigeration or acid precautions if appropriate.
• Performs daily Quality Control (QC) on the Hematology Analyzer Instrument including start-up, reagent check, and analysis of three levels of Commercial Quality Control material. Maintains documentation of the results in the Hematology QC log book or smart card.
• Investigate all out-of-range results and document the corrective action taken.
• Disposes of all biohazard waste according to OSHA standards.
• Perform an instrument check on the Coagulation Instrument prior to use. Maintains documentation of all results. 
• Perform an instrument check on the Glucose Instrument prior to use. Maintains documentation of all results.
• Perform Urinalysis Quality Control if a Urinalysis is performed. Maintains documentation of all results.

Emergency Intervention:

• Handles all emergency situations in a calm, efficient, and confident manner.
• Demonstrates knowledge of standing orders during emergent situations.
• Notifies the physician and nursing manager immediately of any emergency.
• Documents the event and outcome thoroughly and accurately

Patient Education:

• Demonstrates the ability to identify the learning needs of oncology patients and their families and then implements appropriate measures to meet those needs.
• Prepares for and implements a chemotherapy teaching session for all patients new to chemotherapy.

Documentation:

• Documents appropriate information in the patient’s medical record in a concise, neat and, legible manner with complete signature and title.
• Documents thoroughly the physical assessment of the patient, the administration of all medications and infusions according to the guidelines set forth by the state/federal and ONS recommendations, including start and stop times, tolerance of treatment, education provided to patient/family, etc. 
• Charges the appropriate service rendered accurately on the RCCA Central Jersey Division superbill.
• Documents telephone triage encounters accurately in the patient’s medical record.
• Documents all medication refills in the patient’s medical record.

Safety and Infection Control

• Practices OSHA safety standards. Maintains Universal Precautions.
• Disposes all biohazard waste and adheres to all guidelines set forth by the state/federal, ONS, and OSHA standards.
• Understands and incorporates infection control into practice by demonstrating and maintaining sterile and clean techniques accordingly.
• Maintains cleanliness of the working environment.

Communication/Working Relationship and Legal Issues:

• Demonstrates effective communication skills, is able to clearly address patient issues with the physician and other members of the healthcare team.
• Follows the chain of command appropriately when necessary.
• Must comply with all State, Federal and Local Regulations.
• Must possess good analytical judgment and the ability to pay close attention to detail because small differences or changes in test substance or numerical readouts can be crucial to diagnosis.
• Must demonstrate good problem-solving skills and the ability to work under pressure. 
• Conducts practice without discrimination based on age, sex, race, religion, sexual preference, national origin or handicap.
• Demonstrates the ability to work well with peers while ensuring a strong cohesive team.
• Follows the chain of command appropriately when necessary.
• Respects and maintains the patient’s right to privacy by protecting confidential information by adhering to HIPAA guidelines.
• Is aware of legal requirements related to patient care.
• Directs performance in a manner aimed at minimizing risk for the patients as well as employees.
• Appropriately reports areas identified as a potential risk for the patients and employees.

Telephone Triage:

• Performs a short evaluation of the patient situation to estimate the severity of illness and/or injury including learning about the patients’ chief complaint and, as possible obtaining vital signs and mental status information.
• Talks directly to the patients on the telephone and then directs them accordingly, whether it is home care, arranging a visit with their physician, or directing them to the emergency room.
• Determines the urgency of seeing the patient based on brief assessment and on familiarity with a patient’s condition and history. Confers with the physician as needed.
• Provides appropriate home health advice to those patients who do not need to be evaluated by the physician or sent to the ER for immediate help.
• Sends those with high-risk chief complaints to ER immediately. 
• Sets up or arranges for an appointment scheduler to make an appointment for the patients, which need to be seen by the physician or NP.
• Handles routine information requests from patients, including reporting lab results and diagnostic testing as directed by the physician.
• Refills patient’s prescriptions, including obtaining prior authorizations for medications when necessary.
• Arranges home care or hospice needs, including arranging for the appropriate durable medical equipment needed.

Miscellaneous:

• Must comply with all State, Federal and Local Regulations.
• Must possess good analytical judgment and the ability to pay close attention to detail because small differences or changes in test substance or numerical readouts can be crucial to diagnosis.
• Must demonstrate good problem-solving skills and the ability to work under pressure. 
• Assumes responsibility and accountability for individual judgments and actions.
• Performs duties of the LPN, Medical Assistant, Lab Technician, and Clinical Secretary in event of their absence.
• Conducts practice without discrimination based on age, sex, race, religion, sexual preference, national origin, or handicap.
• Demonstrates the ability to work well with peers while ensuring a strong cohesive team.
• Follows the chain of command appropriately when necessary.
• Respects and maintains the patient’s right to privacy by protecting confidential information by adhering to HIPAA guidelines.
• Assists in filing and maintaining medical records.
• All other duties as assigned.
• Attempt to attend two educational in-services yearly to enhance and maintain knowledge
• Responsible for working at all RCCA Central Jersey Division locations as needed.

Competencies:

• Availability – The degree to which employee is prompt, follows rules concerning break and meal periods, and overall attendance.
• Adherence to Policy – The degree to which employee follows rules and regulations.
• Behavior Pattern – Stability, politeness, and judgment shown on the job.
• Creativity – The degree to which an employee suggests ideas, discovers new and better ways of accomplishing goals.
• Dependability – The degree to which an employee can be relied upon to complete a job.
• Independence – The degree of work accomplished with little or no supervision.
• Initiative – The degree to which an employee searches out new tasks and expands abilities professionally and personally.
• Interpersonal Relationships – The willingness and ability to communicate, cooperate, and work with co-workers, supervisors, and patients.

Requirements

Education and Experience:

• R.N. Completion of nursing training from an accredited school of nursing. BSN preferred program. Cancer-specific knowledge base preferred.
• Minimum of two years of professional nursing experience.
• Out-patient clinic experience preferred.

Certifications, Licenses, Registrations:

• Current State of Licensure in Professional Nursing
• ONS Chemotherapy Certification
• Current CPR certification
• Oncology Nurse Certification