POSITION DUTIES:

1. The Clinical/Critical Care Nurse functions as a clinical staff member and is part of the Department of Surgery.

a. Collaborates with surgeons in one or more surgical services to assess, coordinate, plan and implement the newest approaches and practices in order to deliver efficient, cost effective surgical care for the beneficiary population. Coordinates with physicians and other staff preoperatively to develop a multidisciplinary, intraoperative plan of care. Ensures availability of equipment, instruments and supplies for surgical cases. Independently establishes surgical nursing protocols and coordinates activities of all team members.

b. Performs preoperative and postoperative patient care. Uses hard-copy and automated documentation systems to obtain a patient history. Utilizes appropriate interview skills to accurately identify existing and potential problems, and formulate a nursing assessment. Utilizes the perioperative nursing process to identify patient problems and generate nursing diagnoses; designs a plan of care, writes and implements nursing orders to achieve established goals, evaluates nursing interventions relative to desired outcomes based upon a patient's response to care; documents patient's status on a continual basis and revises plan of care accordingly. Describes the patient's appearance, emotional status, interaction with staff-and/or family, and knowledge level of disease process in writing. Interprets and/or makes inferences regarding patient's verbal and non-verbal actions/responses. Documents nursing process in hard copy and automated documentation systems.

c. May be assigned as charge nurse of a particular shift and will assume the responsibility for promoting quality, cost-effective nursing care within the framework of the philosophy and mission objectives of the Department of Surgery and the Command. Has the delegated authority and responsibility to implement, coordinate and supervise nursing care for that shift. As charge nurse uses management skills to identify, distribute and balance workload and tasks among personnel based on their competency level and experience, makes adjustment to assignments to accomplish work in accordance with established priorities to ensure timely, accomplishment of tasks and procedures. Monitors and reports on status and progress of work; reviews completed work to insure supervisor's instructions on work priorities, methods, quality and deadlines have been met. Resolves simple, informal complaints of employees, patients, and other interdisciplinary team members and refers issues to supervisors or appropriate management person as appropriate.



2. Utilizes professional nursing theories, principles, and procedures in planning, providing, administering, overseeing, and documenting professional patient care, in accordance with nursing standards of practice, licensed independent provider (LIP), and established policies and procedures. Utilizes the nursing process to formulate patient care plans; identifies, documents, and implements nursing care, appropriate to patient care problems. Obtains patient history and completes a full nursing assessment. Identifies and documents the effectiveness of care provided and revises care plan, as needed. Implements individualized nursing care plans based on American Association of Operating Room Nurse (AORN) Perioperative Nursing Standards of Practice and Care to include safety precautions, correct positioning, infection control precautions and practices, aseptic practices, personnel assignments, and medication administration. Utilizes critical thinking to select the course of action in implementing healthcare provider orders and interpreting their appropriateness to the patient’s present condition. Collaborates with healthcare providers to make changes to nursing care plans. Establishes criteria and evaluates/assesses effectiveness of patient treatment. Interprets and ensures compliance with established policies, procedures, and standards of care and practice. Collects and interprets health information; identifies wellness and risk factors, along with variations from norms, and makes an assessment. Utilizes professional nursing methods and processes to identify and manage immediate health care needs for non-urgent patient problems; recommends self-care, as appropriate, for nursing assessment, and as advised by approved clinical protocols. In the absence of a physician, independently determines and implements proper emergency/lifesaving measures, often identifying and interpreting life threatening conditions; facilitates transfer to the emergency department, as necessary. Assists surgeons and anesthesiologists with complex, or potentially life-threatening procedures such as insertion of invasive lines, chest tubes, tracheotomies, or removal of foreign bodies from the trachea. Assists Certified Registered Nurse Anesthetist (CRNA) with insertion of invasive lines, endotracheal tubes and nasogastric tubes. Briefs post anesthesia nursing staff on perioperative nursing orders and their pertinent data. Conducts Postoperative nursing assessment immediately following and within 48 hours after surgery to determine validity of nursing care plan, outcomes, and long-range patient goals.

3. Sets up, operates and monitors specialized medical equipment such as cardiac monitors, oxygen delivery systems, arterial lines, chest tubes, defibrillators, suction devices, pulse oximeter, hypothermic devices, laparoscopes, microscopes, powered pneumatic and electrical drills and saws, prevaccum flash sterilizers, electro cautery units and suction devices. Utilizes and instructs others in simple as well as highly sophisticated equipment including lasers, sophisticated digital and computerized equipment, ultra sonic machines, operative microscopes, cryo-surgery equipment, endoscopy equipment, insufflators, fiber optic equipment, and high speed drills, other technology as required. Ensures equipment is working properly preoperatively and throughout surgical procedures. Remains aware of the patient’s condition and takes appropriate action, as needed. Monitors all ongoing process (anesthesia surgery, aseptic techniques, equipment functions, patient's response), interpreting signs and symptoms and initiates and intervenes with immediate corrective action. Facilitates obtaining timely lab tests, X-rays, and EKGs as needed. Administers medication (oral, subcutaneous, IV), including potent narcotics, in accordance with physician's orders. Makes independent perioperative nursing judgment and appropriate revisions in care plan, monitors safety hazards, ensuring immediate actions are taken to resolve or correct. Interprets findings and reports to the healthcare provider, those findings which indicate a detrimental variation in the progress of the patient.
Instructs patients and family members regarding disease processes and provides emotional support, as needed. Educates and enhances health prevention and promotion to strive for a state of wellness. Serves as facilitator to mediate complaints and concerns of patients, family members, and staff by taking immediate action to resolve or refer to a higher level. Collaborates with an interdisciplinary team to develop strategies to improve patient care services. Collaborates with designated personnel, utilizing a proactive approach to solve problems and develop projects to improve work flow processes. Determines staffing requirements and skill mix. Plans, delegates, and directs nursing care, based on patient care requirements and staff skill levels. Serves as mentor to newly assigned staff, as assigned.

Performs other duties as assigned.