Alamance Regional Medical Center, ARMC-EMERGENCY ROOMCITY:
Exempt: No | FTE: 0.9 (36 hours/week) | Schedule: 3p-3a/7p-7a | On Call: NOJOB SUMMARY:
Assesses, plans, implements, documents, organizes prioritize, delegates, supervises and coordinates the care of neonatal, pediatric, adolescent, adult, geriatric as prescribed within parameters of the NC Nurse Practice Act.
Graduation from a BSN, ADN or Nursing Diploma program, consideration may be given to RN's holding a certificate from approved foreign nursing programs. All registered nurses without a BSN or higher will be required to enroll in a BSN program within one year of their hire date with completion of the program occurring within four years of hire.
New RN Graduates: Acceptance into Cone Health New Graduate program or completion of an acute care new graduate program.
Experienced RN : One year of Acute Care RN experience is preferred. Hiring leader may consider other RN experience at their discretion.
RN | Registered Nurse licensed in North Carolina or a Compact state.
BLS (CPR) | AHA Health Care Provider BLS
The following certifications are preferred and may be required within a certain timeframe of hire as defined by the specific nursing unit.
Advanced Cardiac Life Support (ACLS)
Pediatric Advanced Life Support (PALS)
Neonatal Resuscitation Program (NRP)
Critical Care Registered Nurse (CCRN)
Safe Training and Responsible Restraints (STARR)
Cone Health is an equal opportunity employer. If you require assistance with our online job submission process, please contact our team at 866-266-3767 to request an accommodation.
SCOPE OF SERVICES
1. Department Description
Emergency services are provided on the Annie Penn (AP), Alamance RegionalMedical Center (ARMC), Wesley Long (WL), MedCenter High Point (MCHP) and theMoses Cone Health Campuses. Medical, Nursing and ancillary care is provided forall patient populations presenting with a variety of emergency andnon-emergency conditions. In providing this care, the Emergency Departmentssupport the mission of Cone Health to continually improve the healthcare of ourpatients and our community as the regions' best healthcare system.
The Emergency Department on the Annie Penn campus is located in Reidsville Itconsists of 23 beds which includes five Fast Track rooms, two resuscitationsrooms and two negative pressure rooms. There is one triage room and a dedicatednurse first area located at registration. There is telemetry capability in 21rooms plus three portable monitors. A decontamination shower is located nearthe ambulance entrance with easy access from the outside.
The Wesley Long Campus is located in Greensboro. The Emergency Department atWesley Long consists of 55 beds; which includes a secured 10 bed all privaterooms Behavioral Health area. There are (4) triage rooms, (6) Fast Track rooms,one- (2) bed resuscitation/critical care room and (33) private treatment rooms(which includes an (8) bed Transitional Care Unit). All beds havetelemetry/hardwire capability with a capacity to monitor up to 55 patients. Adecontamination shower is also located near the ambulance bay with access fromthe outside and there are three negative pressure rooms
The Emergency Department at MedCenter High Point is a freestanding EmergencyDepartment located in High Point. The treatment area consists of 2 Triagerooms, 12 treatment rooms including an isolation room, and one trauma/criticalcare room with capability for two beds. All of the beds at MCHP havetelemetry/hardwire capability. A Decontamination shower is also located nearthe ambulance bay with access from the outside. Patients requiring hospitaladmission are transported to MC, WL or a hospital of patient's choice.
The Emergency Department on the Moses Cone Campus is a designated Level IITrauma Accredited, Chest Pain Accredited, LVAD Accredited, and Stroke Center.It is divided into designated treatment areas: triage, Acute Care Rooms,Trauma, Fast Track, and a pediatric area. Our ED acute care rooms are designedin PODs (A, B, C, D, E, PEDs, Fast Track) based on evidence based care. We have6 PODs in the adult ED with 61 rooms all telemetry/hardwire capabilities. InPOD D, we have 3 designated trauma rooms. One of the trauma rooms serves as aresuscitation room. We have 8 fast track rooms where one room serves as anOphthalmology/ENT room. We have three negative pressure rooms. There is a12-bed pediatric area.
The Emergency Department of Alamance Regional Medical Center consists of 58beds: 26 beds in the major care section; 15 beds in the Flex Care area; 9 bedsin the transitional unit; and 8 beds in the secured Behavioral Health area.Hours of operation are 24 hours/day, 7 days a week. ARMC functions as a LevelIII emergency service and is staffed with at least two Emergency Physicians atall times. Nurse Practitioners and Physician Assistants are utilized andsupervised by the Emergency Physicians. There is a daily call schedule ofmultidisciplinary staff physicians for referrals, admissions, andconsultations. The Emergency Department's staff is composed of RegisteredNurses, Emergency Department Technicians, and Departmental Secretaries. Thedepartment works closely with Alamance County Emergency Medical Services andwith regional ground and air ambulance services.
All of the Emergency Departments contain a patient registration area, waitingarea, private family consultation area, and a security station. The waitingareas contain: TVs, snack machines, and telephones. There is also a supply ofreading and educational material available. All Emergency Departments providean outside covered entrance area to protect the patients/families duringinclement weather.
Lounge and restroom facilities are provided for all staff. The nursing stationis located in close proximity to critical treatment areas for visualization.The nursing stations contain computers, manuals, charts and documents tofacilitate patient care. On all campuses, patient rooms are equipped withtelephones and televisions for use by patients/families. Adult and pediatricemergency carts, monitors and defibrillators are strategically located toprovide immediate response to patient needs.
Medical leadership is under the direction of the Chief of Emergency Servicesand Medical Directors for the Moses Cone, Wesley Long, MedCenter High Point,and Annie Penn Campuses. Similarly, nursing leadership is under the directionof the Executive Director of Emergency Services and each Emergency Departmenthas a Nursing Department Director. Medical and Nursing leadership isresponsible for maintaining quality improvement programs.
Nursing utilizes the Shared Governance structure (Nursing AdministrativeManual) to provide consistent, effective and efficient nursing care. Throughthis structure, the nursing staff has a direct impact on clinical decisionsspecific to the department, by participating in various committees: DepartmentShared Governance Council, Service Shared Governance Council, Clinical Policyand Procedure, and Nursing Executive Council.
The Emergency Department nursing leadership and the Medical Directors approvepolicies and procedures specific to the department. They are consistent withhospital policies, medical staff rules and regulations, and federal and stateregulations (EMTALA). Additionally, Joint Commission rules and regulationsguide the provided services.
2. Population/Client Served
Emergency Services provide a comprehensive array of patient care.
Example types of patients frequently seen include: chest pain, respiratorydistress, abdominal pain, orthopedic trauma, motor vehicle collisions, surfacetrauma, behavioral health and general medical complaints. Trauma patients areusually transported and stabilized/treated on the Moses Cone Campus where thededicated Trauma Program is located. (Refer to Trauma Scope of Service)Specific therapeutic interventions include: airway management, circulatorysupport, medication administration, cardiac monitoring, splinting and casting,infection control, safety measures and education to patient andfamily/significant others. All patients are seen regardless of their ability topay. The population is diverse not only in language, but also in age aspatients are seen throughout the continuum of life.
3. Services Provided
The Emergency Departments provide emergency care 24 hours a day 7 days a week.Patients may be self-referred, physician referred, or as directed by employeehealth. Patients are triaged, according to established triage categorizationguidelines. A licensed independent practitioner with appropriate clinicalprivileges determines the scope of assessment and care for patients in need ofemergency care. All patients are medically screened and cleared by a physicianor physician extender. Patients may be evaluated and treated by the EmergencyDepartment physician or extender, their private physician, or assigned tophysicians participating in an on-call schedule.
Obstetrical patients who present for non-pregnancy related conditions aretreated according to their presenting complaints. Appropriate transfer of theOB patient depends on her medical stability and need.
A full service laboratory is available 24 hours a day. Non-routine studies mayalso be performed at an outside lab. Additionally point-of-care testing isperformed by trained personnel.
Diagnostic radiology services are available at all times (refer to RadiologicScope of Service) to provide routine studies using both fixed and mobileequipment. Angiography of all types, Sonography, Nuclear Scanning, MRI and CTscanning are available as needed.
A variety of other Departments support the Emergency Departments in deliveringcare: Surgical Services, Endoscopy, Heart and Vascular Center, and multipleIntensive Care Units. These departments are available to treat patients usingestablished criteria for admission/treatment.
Patients are discharged from the department or admitted to the hospital asinpatients. In the event that the patient requires services that are notprovided at the presenting facility, provision is made for transfer within oroutside the system according to EMTALA guidelines. Emergent stabilizing care isprovided until the transfer is complete.
The Emergency Departments are staffed 24 hours a day, 7 days a week. TheEmergency Departments are staffed with a medical director, physicians,department director, registered nurses, nursing technicians, emergency medicaltechnicians, unit secretaries/monitor technicians, physician assistants ornurse practitioners, materials management staff and volunteers. Other patientcare providers include Flow Managers, Patient Representatives, RespiratoryTherapists, Laboratory Technicians, Radiology Technicians, Care Management,Social Work, and Pastoral Care. Specialty consultation is available by membersof the medical staff on a 24-hour basis. MICN's, Paramedics, CareLink, andEmergency Department physicians accomplish pre-hospital care andcommunications.
Staff Competencies and Skills to Provide Services
Staff have the training, credentials, experience and competencies to providethe care as defined by their job description. Registered Nurses, EmergencyMedical Technicians, Respiratory Therapist and Nursing Technicians must havecurrent licensure or certification. They also complete an orientation programspecific to their job description, which encompasses some of the following:(refer to orientation pathways for complete description)
v Patients rights andconfidentiality
v Age specificguidelines
v Care of the trauma patient(minor to major)
v Care of chest painpatient
v Care of renalpatient
v Care of abdominalpatient
v Care of theneurology patient
v Care of alteredlevel of conscious patient
v Care of respiratorydistress patient
v Care of pediatricpatient (trauma, fever, seizure)
v Care of psychiatricpatients
v Care of sickle cellpatients
v IV initiation andmaintenance
v Computer/ FlowsheetDocumentation
v Equipment specificto patient care
v ASAP (Epic)
Emergency Medical Technicians/ Nursing Technicians
v Patient rights andconfidentiality
v Age specificguidelines
v Anticipating andsetting up equipment for various procedures ( suturing, pelvic exam)
v Proper technique forobtaining/sending EKGs
v Collection of labspecimens
v Safe transportationof patients/ wheelchairs/stretchers
v Equipment designatedfor patient care
v POC training
Nursing Secretary/Monitor Technicians
v Telephone usage
v Fax machine
v Paging System
v Physician Callsystem
v ASAP (EPIC)
v Rhythm recognition
v POC training
All direct caregivers must hold current licensure in CPR. It is stronglyrecommended that Registered Nurses become certified in ACLS, ENPC or PALS,TNCC, CATN, and staff at the Trauma Center is expected to complete TNCC afterone year of employment. Emergency Department staff also complete a crisis inresolution training (CPI).
5. Competency/ Education Plan
Each role has a defined orientation pathway or competency validation list thatis completed prior to the person taking an independent assignment. This pathwayhas key competencies that must be demonstrated by direct observation by theindividual's preceptor or another experienced staff member. The Department Directordetermines, with input from the preceptor, educator, and by observation, whenorientation is complete.
On going competency, validated by direct observation and record review, isdetermined by the Department Director, Assistant Director, Educator, and shiftleadership. Competency is also maintained through Skills Fairs, routine reviewof low volume and problem prone procedures and EKG revalidation.
Competency for the EDs consist of Triage competency (ESI) for RNs; Charge Nursecompetency for select RNs; mandatory education for all staff; new stafforientation; Trauma and Stroke education, and EMTALA. It is stronglyrecommended that Registered Nurses become certified in ACLS, ENPC or PALS,TNCC, CATN, and staff at the Trauma Center is expected to complete TNCC afterone year of employment.