Registered Nurse - PACU

Post Anesthesia Care Unit (PACU) – Registered Nurse - PRN

• 14 - bed unit that provides post anesthesia care to age groups from infants to adults. 
• Hours of Operation: Monday – Friday from 7am – 9pm. 
• Call: Coverage Monday – Friday from 9pm – 11pm and on weekends/holidays from 7am – 7am, providing 24-hour coverage. Option to join On Call program rotation with 7-day call coverage Monday – Friday 9pm – 7am and 7am – 7am Saturday and Sunday.
• PRN - will need to work a min of 24 hours off shift per 6-week schedule.
• 10-hour day/evening
• Weekend and Holiday as needed.
• Shift and Weekend Differential Eligibility

The Registered Nurse is responsible and accountable for implementing, directing and coordinating the care of patients through the use of the nursing process: assessment, planning implementation and evaluation.  Included is recognition and treatment of the physical and psychosocial changes unique to the age/population group served on the specific unit.

Responsibilities

Essential Functions and Responsibilities
Job Class Specifics
1.   Demonstrates safe medication practice.
2.   Maintains a professional image that reflects the employee’s role in health care, with confidence and a positive impression.
3.   Completes chart check to ensure no missed orders. 
4.   Accurately transcribes physician’s orders.
5.   Demonstrates therapeutic communication skills.
6.   Demonstrates ability to assess patient education needs and use of patient education resources.
7.   Demonstrates involvement in unit by attending 50% of staff/committee meetings and in-services for area.
8.   Demonstrates leadership through the nursing process and supervision while maintaining accountability for treatment and patient outcomes.
9.   Acts as a resource person regarding patient care, specialty area, orientation and teaching of staff.
10.   Responds to delays in a calm manner.  Apologizes for inconveniences and gives alternatives.
11.   Analyzes assessment data, identifies priority problems and documents on Plan of Care in PCS for patients and families and significant others.
12.   Uses effective problem-solving skills to plan patient care.
13.   Identifies critical factors evidencing changes in patient condition and responds appropriately.
14.   Completes and documents discharge assessment against plan of care goals.
15.   Initiates and maintains Intravenous Therapy according to IV standards. 
16.   Responds appropriately to emergency situations. 
17.    Utilizes proper body mechanics to prevent injury to self and others.  Safely positions, transfers and transports patients.
18.    Functions as a virtual nurse as assigned which includes, but is not limited to, admissions, discharges, education, documentation through a virtual platform and working collaboratively with the bedside nursing staff. 

DI/PACU/PAT/Same Day Services: 
1.   Demonstrates ability to function in the resource role.
2.   Demonstrates correct patient identification by following the universal protocol.
3.   Completes preoperative teaching and documents PAT assessment information.
4.   Demonstrates compliance with screening criteria for assessment by Department of Anesthesia for all PAT assessments.
5.   Demonstrates excellent customer service skills in the collection of data during the completion of phone interviews and in the collection and sharing of data from allied health professionals. 
6.   Demonstrates proficiency in the preparation of patient documentation, including review of diagnostic studies, completion of consents, and presence of H&P’s and notification of physician of abnormal results. 
7.   Verbalizes knowledge of the most commonly used medications, including actions, side effects and rationale for use and including the use of the medication grid.
8.   Obtains and maintains equipment needed to implement standards of care.
9.   Abides by self-scheduling guidelines to assure proper patient care/safety.

PACU/Same Day Services: 
1.   Anticipates the need for pain relief upon emergence from anesthesia.
2.   Verbalizes and effectively uses appropriate pain assessment and interventions.
3.   Assesses and evaluates patient response to procedures and therapies.
4.   Effectively uses appropriate interventions to manage patient’s post-operative/post-procedure care.
5.   Verbalizes concepts in selection of drug delivery routes for effective and safe pain management strategies.
6.   Demonstrates proficiency in the use of CPAP/BiPAP equipment.
7.   Completes annual urine pregnancy testing competency.
8.   Completes annual glucometer competency.
9.   Demonstrates sterile technique and proper healthcare asepsis.
10.   Demonstrates correct patient identification; completes universal protocol, including time out.
11.   Follows established criteria in assessing patients for discharge readiness.
12.   Demonstrates competency on radiation safety by completing radiation safety education.
13.   Participates in the annual malignant hyperthermia drill.

PACU: 
1.   Demonstrates ability to maintain an open airway for the anesthetized patient.
2.   Identifies signs/symptoms of airway obstruction, laryngospasm, bronchospasm, aspiration, and respiratory arrest, and takes appropriate action to correct the problem.
3.   Demonstrates ability to program and to troubleshoot the ventilator, and verbalizes the process to include the Respiratory Therapy practitioner in the care of the patient.
4.   Safely extubates patient, when indicated.
5.   Demonstrates the ability to calibrate and to draw blood from an arterial line.
6.   Demonstrates ability to utilize the autotransfusion device.
7.   Demonstrates ability to assist with the insertion of a chest tube, including set-up and post-insertion patient care.
8.   Demonstrates working knowledge of high-risk medications that require independent double-checks, including dose calculation and key points and including the use of the medication grid (e.g., patient-controlled analgesia, epidural analgesia, or critical care drip medications).  

Qualifications

Qualifications and Standards

Education:
•   Graduate of an accredited School of Nursing required; Bachelor of Science in Nursing is preferred.
•   Evidence of participation in educational programs to update and maintain current knowledge and clinical skills.

Experience:   
•   Experience applying customer service behaviors and communication skills required. 
•   Previous nursing experience in specialty area preferred.
•   For Cath Lab, one year of acute care nursing experience (ED, Cath Lab, CCU, IMCU, Tele-Observation) preferred.     
•   For Cardiac Rehab, two years experience in Critical Care and/or Progressive Care required.
•   For Cardiovascular Services, two years of experience reading cardiac monitors and be self directed in responding to abnormalities or cardiac arrests codes as a team member.
•   For Device Clinic, at least one year of device management services required. Successful completion of EKG course required. At least two years of acute care nursing required (Tele-Observation, IMCU, CCU, Cath Lab, ED).
•   For Emergency Department, at least one year of RN experience in ED or Critical Care required. 
•   For Family Birthing Services, a minimum of 1 year Labor and Delivery experience (within the last five years); For Family Birthing position posted as a trainee position, requirement of at least 1 year of experience as an RN with preferred areas of ICU, CCU, IMCU, EDor internal nurse intern upon successfully completing accredited nursing program. Experience requirement does not apply to an RN in the Family Birthing Services Fellowship Program (FBSFP)
•   For Infusion Services, 6 months of infusion nursing experience required, and 6 months Midline and PICC experience required.
•   For Wound Care Center, two years experience and expertise in the nursing process related to wound care required. Experience in advanced wound care initiatives preferred.
•   For Outpatient Behavioral Health Services, two years experience in Behavioral/Psychiatric nursing is required. Previous experience in a Behavioral Health Outpatient setting preferred. Child Abuse Recognition and Reporting Training in accordance with Act31 of 2014 required. Federal Bureau of Investigation (FBI) Clearance and finger printing required.
•   For Rapid Admission, requires one year acute care experience and successful completion of EKG course within six months of hire.  
•   For SDS / PACU, must have experience with, and be familiar with, reading cardiac monitors and be self directed in responding to abnormalities or cardiac arrest as a team member. Must have recent clinical experience with cardiopulmonary resuscitation and have the ability to lead a Code Blue in the absence of a higher level professional.
•   For Medical Surgical (Renal, Oncology and Pediatrics), pediatric experience is preferred.
•   For Level II NICU, a minimum of one year NICU experience (within the last five years); For Level II NICU position posted as a trainee position, requirement of at least 2 years of experience in: NICU Level 1, Labor and Delivery, Post-Partum, Nursery, PICU, ICU, ED, or CCU. Or, for Level II NICU position posted as a trainee position, requirement of a new graduate RN with (A) practicum/capstone in Labor and Delivery, Nursery, or NICU, or (B) experience as Tech/Aide in Labor and Delivery, Post-Partum Nursery, or NICU.   

Certifications/Licensure:   
•   Eligible for or currently licensed as a Registered Professional Nurse in Pennsylvania.  
•   Certification in specialty preferred.  
•   CPR certification required.  
•   ACLS required for Cardiovascular Services, CCU, Device Clinic, Emergency, IMCU, FBS, Tele Observation, PACU/SDS, or achieved within one year of start date.
•   ACLS required for Cardiac Rehab or achieved within 3 months of hire/transfer.
•   Proficiency in cardiac monitor interpretation, conscious sedation, and ACLS required for Cath Lab or achieved within 6 months of hire/transfer.
•   ACLS required for Float Pool.
•   PALS required for Emergency, PACU, and Pediatric trained staff within one year from start date.
•   PALS and Conscious Sedation is required for SDS, or must be achieved within four months of hire/transfer.
•   CNOR preferred for OR. 
•   CPAN/CAPA preferred for PACU/SDS.  
•   CRRN preferred for Rehabilitation Medicine.
•   NRP required for Level II NICU.
•   NRP and Fetal Monitoring education required for Family Birthing Services within one year from start date.
•   PMH-BC preferred for BHS (IP and OP).
•   Proficiency in cardiac monitor interpretation required for PACU/SDS, IMCU, Tele Observation, CCU, Cardiac Rehab, Cardiovascular Services, Cath Lab, and Emergency.
•   Temporarily reassigned personnel will work in a limited scope of practice consistent with credentials and be supervised by appropriately credentialed staff. 
•   WOCNCB or CWCN preferred for Wound Care Center.