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RN--Neuro Medical Progressive Care Unit, 12 hours/week, Moses H. Cone Hospital

Job ID: 88
Facility: Moses Cone Hospital, Greensboro
City: Greensboro

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Job Description

LOCATION : Moses Cone Hospital, Greensboro

JOB DETAILS :
Exempt: No
FTE: 0.3 (12 hours/week)
Schedule: Varies
On Call: No

EDUCATION:
Required:
Associates Nursing
Preferred:
Bachelors
Additional Information
Graduate of a School of Nursing. BSN required or with approval of the VP of Nursing, experienced RN's with an AD or Diploma with an active plan to obtain their BSN within four years from date of hire may be considered.

LICENSURE/CERTIFICATION/REGISTRY/LISTING:
Required:
Registered Nurse licensed in North Carolina or a Compact state.
A current American Heart Association (AHA), Basic Life Support (BLS) card for Health Care Provider
Preferred:
Advanced Cardiovascular Life Support
Pediatric Advanced Life Support

BASIC PURPOSE:
Assesses, plans, implements, documents, organizes, prioritize, delegates, supervises and coordinates the care of neonatal, pediatric, adolescent, adult, geriatric patients as prescribed within the parameters of the NC Nurse Practice Act and hospital complex.

Moses H. Cone Memorial Hospital

Scope of Service

Neuroscience Unit

Department Description

The Neuroscience Unit is a 32 bed Medical-Surgical Department located on the Midwest and Central towers, on the 5th floor of the Moses Cone Campus. It is fully telemetry capable and part of the Neuroscience Center of Excellence. All rooms are private and handicapped accessible. 8 beds are video monitored beds which are used for high fall risk patients. These patients will be cared for according to the video monitoring policy. There are also two negative pressure rooms for respiratory isolation.

Population/ Diagnoses Served

The unit provides care to patients' with Neurosurgical and Neuromedical Diagnoses. Priority admission is given to patients with the primary diagnoses of Stroke, TIA, TBI, Spine and Cranial Surgery, and Seizures.

• Any patient requiring 24 hour nursing care with a stable neuromedical or neurosurgical diagnosis is considered a priority admission.

• Vital Signs or Neuro Assessments must not exceed a frequency of every 1 hour beyond 4 hours, with exception of acute post tPA patients.

• Any patient requiring more frequent assessments or is hemodynamically unstable, is not appropriate for the unit.

• Routine assessments occur at least every 12 hours, with focused reassessments as indicated.

• Telemetry Monitoring is for Neurovascular Management.

• No Primary Cardiovascular Diagnoses are appropriate.

• If while on telemetry the patient develops changes or events which require cardiac unit monitoring, the MD will be notified and a transfer requested to a cardiac monitored unit.

• No Cardiac Drips can be initiated or maintained, except in an emergency transfer situation by Rapid Response. Additionally no hypertonic drips will be initiated or accepted.

• Routine IV drips and Insulin, Heparin or Morphine drips are accepted.

• Patients will be discharged home or to a lower level of care when their condition no longer requires the level of services provided on the Neuroscience Unit.

Services Provided

Patient care is provided 24 hours per day, 7 days per week by licensed staff, supported by an ancillary staff of Nursing Technicians and Nursing Secretary/ Monitor Techs. A Department Director and Assistant Director are readily available for employee and department operational management. Other resources are Unit and Service Based Educators, Physical /Occupational /Speech Therapists, RN and Social Work Case Managers and Nutrition, Pharmacy, and Chaplaincy Services. Discharge criteria are guided by physician order, meeting clinical outcomes as defined by diagnosis specific core measures and /or placement in a post-acute care setting.

Staffing Plan / Ratios

Staff are scheduled for 6 week periods via self-assisted scheduling in Optilink. Staff are distributed within the schedule based on daily and shift census and staff experience / skill mix. Patient assignments are based upon patient acuity and staff skill. Optimal ratios are:

RN budgeted ratios are 1:4-6 on all shifts.

Nursing Technician ratios are 1:8-10 on all shifts.

Monitor Tech/Nursing Secretary 2 (0700-2300)

Staff Competencies

RN

• All health system requirements including: current licensure, CPR, restraints, blood administration life safety (fire safety, infection control, general safety)

• Basic EKG (initial EKG class & quarterly CBLs)

• System approved orientation competencies, including but not limited to:

Care of Stroke Patients, NIHSS certification, Swallow Screen Certification,

• Safe Patient Handling (Diligent No-Lift Equipment, application of braces,

mobility training utilizing gait belts, walkers & other assistive devices).

NT

• All health System requirements including: current NTI & NTII certification, CPR, restraints, life Safety (fire safety, infection control, general safety)

• Performance of 12 lead EKGs

• Safe Patient Handling (Diligent No-Lift Equipment, application of braces, mobility training utilizing gait belts, walkers & other assistive devices).

Monitor Tech/ NS

• All health system requirements including: life safety (fire safety, infection control, general safety).

Competency / Education Plan

Orientation / Ongoing

Each role has a defined orientation pathway or competency validation list that is completed or nearly complete, prior to the person taking an independent assignment. Key competencies are validated by direct observation by the individual preceptor or qualified observers. The department director determines with input from preceptors, RN4, CNS & AD, when the orientation is complete.

Ongoing competency is determined by direct observation, continuing education review, routine review of high risk procedures & re-validation by qualified observers.

MAJOR WORK ACTIVITIES:
Provides nursing care via the nursing process for the development, implementation and evaluation of nursing care. Collects and analyzes patient/significant other data. Completes an admission database and ongoing assessment to include collaboration with patients, significant others and other health care providers. Implements a plan of care for each patient (utilizing clinical pathways where applicable) and individualizes to meet the age specific needs of patients/significant others. Identifies variances and makes adjustments in the plan of care based on evaluation of the plan and effectiveness of nursing interventions. Documents and updates the plan of care, nursing care, nursing interventions and patient response to care, and keeps healthcare team, patients and significant other informed. Contributes to the discharge plan by identifying homecare needs. Recognizes changes in patients? conditions and revises the plan of care appropriately. Demonstrates advanced competencies and critical thinking skills in day to day practice. Identifies and implements educational needs for patients/significant others. (30%)

Establishes a caring and therapeutic nurse/healthcare team/patient/significant other relationships. Recognizes communication barriers, identifies resources and establishes plans to resolve barriers to communication. Demonstrates respect for diversity and cultural differences in patient/significant others related to age, ethnicity, gender, religion, socioeconomics, education, personality, or other unique variable. Formulate individualized plans to address individual needs related to diversity, cultural difference or other unique variables. Advocates for the patient/significant other. Demonstrates skillful responses to customer needs based on particular context of the situation. (25%)

Supports an environment of evidence based practice/research/quality improvement. Demonstrates knowledge of Shared Governance accountabilities and principles, supports DSGC directly as a council member or indirectly by keeping informed of council activities/supporting council decisions, brings forth issues to council. Demonstrates knowledge of how to access reference documents containing policies, procedures, standards, and additional resources. Participates in QI/ Research activities based on role and major work activities as outlined in the research point system guidelines. Demonstrates knowledge of department QI plan. Demonstrates understanding of resource management and implements opportunities. Collects QI data and participates in analysis and action plan development, incorporates changes into practice. Facilitates ongoing activities to meet and adhere to regulatory standards (TJC, DFS, OSHA). (20%)

Supervises other members of the team. Contributes to a supportive and healthy work environment. Holds self and others accountable for complying with policies, procedures and standards. Participates in learning needs assessments. Provides input into and supports the precepting and mentoring process. Delegates appropriate tasks to support staff, ensure completion of delegated tasks and provides feedback as needed. Demonstrates team spirit and collegiality. Supervises select personnel in performance/patient care. (15%)

Demonstrates effective conflict resolution/negotiation skills. Promotes positive, supportive, and professional work environment free of disruptive behavior. Practices, in all professional relationships, with compassion and respect for the inherent dignity, worth and uniqueness of every individual. Follows Chain of Command for assistance with issues related to unresolved/problem-solving and/or conflict resolution. Provides, seeks and receives constructive feedback. Provides peer to peer feedback and seeks mediation as necessary. Promotes effective conflict resolution. (10%)

PATIENT POPULATION SERVED:
Neonate, Pediatric, Adolescent, Adult, Geriatric

WORKING CONDITIONS:
Occurs over two-thirds of the time:
• Exposure to bloodborne pathogens
• Hazardous waste and/or toxic/caustic chemicals
• Fumes or airborne particles

iCARE - COMMITMENTS TO CARE:

Communication
I will create and engage in conversations of possibility.
I will be open to innovation and creativity.
I will listen to understand.
I will bring ideas for solutions and be open to alternative ideas.
I will be open to constructive feedback.
I will not engage or listen to negativity or gossip.
I will be positive when speaking about Cone Health, my department, and my coworkers.
I will be approachable.
I will focus on behaviors, not the person, during conflict.

Accountability I will honor my word.
I will do what I say when I say I will.
I will "clean it up" when I can't keep my word.

I will honormy work agreement.
I will be "on the court" instead of "in the stands."
I will follow up in a timely manner on commitments and requests.
I will apologize when someone experiences less than excellent service.
I will take responsibility for my actions, decisions and performance.
I will protect patient safety (best practices: ex - hand hygiene).

Respect
I will assume the best of intentions and embrace differences.
I will collaborate and seek other people's input.
I will demonstrate courtesy, compassion, and respect with my tone of voice and body language.
I will speak positively about Cone Health - managing up coworkers, physicians, departments, patients and visitors.
I will ask the person directly involved when I don't know.
I will include diverse skills, abilities, strengths, and backgrounds to create better outcomes.
I will care for myself while also respecting others.

Empowerment
I will own it, solve it, and celebrate it!
I will offer solutions when problems are identified.
I will share my input for decisions by participating in forums such as shared governance, town halls, employee engagement survey, brown bag discussions, employee councils, staff meetings, or directly with my manager.
I will take charge and do the right thing at the right time.
I will make decisions keeping a balance of service, quality, and cost in mind.
I will demonstrate Cone Health values.
I will seek opportunities to celebrate and have fun.
I will recognize good work.

I have seen and reviewed the job description in its completed form and understand that I will be required to perform all functions listed if hired for this position. I recognize that, if hired, it is my responsibility to notify my manager as soon as possible if I am unable to perform any of the functions of my position for any reason. This job description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the job.

Exceptional People Providing Exceptional Care!

Cone Health is a state of the art network of facilities providing patients access to the latest developments in medical care from their first moments of life through later years. Our network offers the most breakthrough treatments and technology available in healthcare today. As a teaching hospital, we offer employees the opportunity to become leaders in the industry and continued growth from their first day on.

Extraordinary patient care is about being "high-touch" as well as "high-tech". Community service and superior patient care are the cornerstones of our organization, a philosophy that is demonstrated by each and every one of our valued team members. We are proud to be the largest private, not-for-profit employer of choice in the Piedmont, NC area community!

Cone Health is an equal opportunity employer. If you require assistance with our online job submission process, please contact our Talent Acquisition team at 866-266-3767 to request an accommodation. Additionally, Cone Health invites interested deaf and hard of hearing applicants to use Video Relay Service (VRS).

KNOWLEDGE, SKILLS, AND ABILITIES:
Required:
• Responds appropriately to emergency situations (Cone Health Codes) and demonstrates knowledge of how to respond. Always uses appropriate safety devices and techniques (examples: using safe lift equipment and needle safe devices; pushing carts; correctly lifting copy paper).
• Ability to present information to a group
• Ability to communicate effectively through both oral and written formats.
• Leadership Skills
• Medical Terminology
• Ability to work independently
• Takes responsibility for own actions, including the impact of own decisions on patients and others. Also takes responsibility for actions of any direct reports, avoiding blame or excuses. Takes appropriate action when anyone in the organization violates standards or regulations, viewing it as unacceptable to "look the other way".
• Effectively assesses and adjusts to changes in circumstances, resources, or environment, using the creativity and flexibility required to remain effective. Views change as a constant, accepting and adjusting to twists and turns. Adjusts to the especially unpredictable nature of a healthcare environment, shifting focus as necessary, and taking reasonable action, even when faced with various levels of uncertainty.
• Accepts responsibility for effective two-way communication using clear and well organized oral and written techniques. Demonstrates self-awareness of non-verbal messages, keeping verbal and non-verbal messages consistent. Incorporates recognition of cultural impact on understanding and effectively uses interpreters and language translation devices.
• Working knowledge of personal computer and communications technology.
• Possess knowledge of concepts, procedures and troubleshooting techniques.
• Identifies practices or procedures that are not working effectively and challenges underlying assumptions. Includes a representative number of persons when addressing issues (including patients and their families), resulting in the best resolution from various perspectives. Looks for the root cause of any problem, resulting in solutions that are enduring and sustainable.
• Ability to demonstrate proficiency in the application of tools, test equipment and meters to effectively diagnose equipment problems and/or failures consistently.
• Reacts promptly when requests are made or situations clearly call for it. Shifts priorities when a timely response is essential. Actions reflect sensitivity to patient/customer needs and sense of urgency. Balances speed of response with safety concerns.
• Establishes priorities during routine daily operations, addressing time-sensitive matters first, while also accomplishing day-to-day tasks and duties. Effectively triages tasks and events according to urgency level, impact on patients and outcomes desired under special conditions (e.g., during crises and emergencies). Makes choices that result in maximum completion of essential duties and minimum personal stress.
• Ability to remain calm and composed in stressful situations (ie: fast paced environment, meeting deadlines/work quotas, etc.)
• Demonstrates an unwavering commitment to do what is ethically "right". Consistently tells the truth unless doing so would violate confidentiality or compromise the safety or privacy rights of patients or others. Behaves in a manner fully consistent with stated intentions and commitments, even when there is n
ne to witness activities. Stands
up for what is right even when there are personal risks or when there are clear rewards for doing otherwise.
• Demonstrates an ability to interact with others in a courteous and professional manner and establish good working relationships.
• Ability to delegate
• Ability to influence others not under direct control

PHYSICAL REQUIREMENTS:
Medium Work:
• Exerting 20 to 50 pounds of force occasionally (up to 1/3 of the time), and/or; 10 to 25 pounds of force frequently (1/3 to 2/3 of the time), and/or; greater than negligible up to 10 pounds of force constantly (2/3 or more of the time) to lift, carry, push, pull, or otherwise move objects, including the human body.
• Respirator Fit Testing

HEARING/VISION:
• Hear and differentiate low volume sounds in order to make judgments regarding actions needed
• Hear alarm bells, verbal conversations, telephone voices and normal volume sounds
• Close vision (clear vision at 20 inches or less)
• Distance vision (clear vision at 20 feet or more)
• Depth perception (three-dimensional vision, ability to judge distances and spatial relationships)
• Color vision (ability to identify and distinguish colors)

CONDITIONS OF EMPLOYMENT
* Annual flu shot
* Annual TB test (if applicable to your job location)
* Annual CBLs (Safety at Work and Corporate Compliance)
* Maintain licensure/certification/registry/listing (if applicable to your job)
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