Pre Post Operative Ambulatory RN DM

City/State

West Nyack, New York

Department

West Nyack Ambulatory Surgery Center_2

Work Shift

Day

Work Days

DAYS VARY

Scheduled Hours

6:30 AM-3 PM, 7:30 AM-4:30 PM, 7 AM-3:30 PM, 8 AM-4:30 PM

Scheduled Daily Hours

8.5 HOURS

Scheduled Weekly Hours

0

Hourly Rate/Range

$55+ per hour

For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differential, experience, education or other relevant factors.

Job Summary

Utilizes the nursing process to provide comprehensive nursing care during the pre and post-operative phase. Coordinates total patient care for appropriate age groups at the ASC in coordinator with other health team members particularly the Center's team. Functions as a patient advocate utilizing the Patient's Bill of Rights. Demonstrates professional growth and development by accepting responsibility and accountability for one's nursing practice.

Essential Functions

• Competency to assess the physiological health status of the patient.

a. Verifies the operative procedure using the consent form, the patient’s statement and if needed the surgeon’s verification prior to procedure.

b. Notes the condition of the skin for rashes, bruises, lesions, and previous incisions.

c. Determines mobility of the body using the patient’s statement, range of motion, and the history and physical.

d. Reports deviation of diagnostic studies such as lab or radiology reports.

e. Checks pre-operative vital signs upon admission to surgery: blood pressure, pulse, respirations, and temperature.

f. Identifies presence of prosthesis such as dentures, pacemaker, and joint prosthesis/implants.

g. Notes nutritional status sucha as patient has been NPO.

h. Communicates and documents physiological data to other members of the surgical and health care team in verbal or written report, including data which might be relevant to surgery and discharge planning.

• Competency to assess the psychological health status of the patient/family.

a. Performs a complete system assessment of assigned patients upon admission to the units and at intervals.

b. Reviews and implements all prescriber orders in a timely manner.

c. Elicits patient expectations of care and outcome of surgery.

d. Determines level of knowledge and ability to understand, such as language barrier and seeks assistance as necessary.

e. Identifies philosophical, religious, and cultural beliefs concerning the intraoperative phase, such as blood transfusions, disposition of limbs, and sacraments.

f. Communicates and documents psychological data to other members of the surgical and health care team in verbal and written report, including data which might be relevant to discharge planning.

• Formulates nursing diagnosis based on health status data
• Competency to establish realistic and attainable goals based on nursing diagnosis and to develop a plan of care based on nursing actions to achieve patient goals.

a. Collaborates with physicians, peers, and other members of the health care team to facilitate and coordinate appropriate delivery to the established patient population from initial assessment to discharge.

b. Participates in Pre-Op phone calls to give patients Pre-Op instructions, including time of surgery, time of arrival, maintain NPO status and other pertinent information.

c. Provides positioning aids during the intraoperative phase to prevent skin breakdown or impairment of the nervous or vascular system.

d. Provides equipment to insure patient safety in regard to electrosurgery and laser.

e. Coordinates use of supplies and equipment for intraoperative care.

f. Organizes nursing activities in logical sequence, prioritizing nursing actions.

g. Coordinates patient care needs with other members of the surgical and health care team.

h. Assigns activities to appropriate personnel based on their qualifications and patient needs.

i. Maintains required certifications (CPR/ACLS) and performs effectively in an emergency situation.

j. Communicates and documents patient’s plan of care to other members of the surgical and health care team in verbal and written report, including that which might be relevant to discharge planning.

k. Ensures critical patient information and data are communicated effectively across the continuum using appropriate hand off techniques

• Competency to implement nursing actions in transferring the patient according to the plan of care.

a. Confirms the patient identity using bracelet.

b. Selects appropriate personnel for transport as determined by patient acuity and number of staff needed.

c. Determines appropriate and safe method of transport and provides for emotional needs during transport.

d. Perform discharge transport as needed, depending on staffing needs.

e. Communicates and documents method of transport.

• Competency to participate in patient/family teaching..

a. Participates in pre-operative teaching as needed, such as explanation of surgical routine and environment.

b. Communicates and documents patient/family teaching

• Competency to provide equipment and supplies based on patient needs.

a. Anticipates needed equipment and supplies on the unit, including DME and any other equipment required in discharge plan.

b. Selects equipment and supplies in an organized, timely and cost effective manner throughout the peri-operative phase. Restocks of patient areas including stock room, linen carts, and patient bays.

c. Assures all equipment is functioning before use. Performs turnover of patient bays after discharge utilizing required disinfectant.

d. Operates mechanical, electrical, and powered equipment according to manufacturer’s instructions and the Center policy.

e. Removes malfunctioning equipment from service, tags it appropriately and initiates repair.

f. Uses supplies judiciously and in a cost-effective manner.

g. Communicates and documents provision of equipment and supplies including charges

• Competency to administer drugs and solutions as prescribed.

a. Administers medications according to policy.

b. Communicates and documents administration of medications and solutions according to policy, including medication errors.

c. Participates in daily narcotic count with a peer or manager/administrator.

• Competency to physiologically monitor the patient during the pre and post-operative phase,

a. Assists/monitors physical symptoms, behavioral changes, intake and output, and vital signs.

b. Initiates nursing actions or obtains physician order as appropriate, based on interpretation of physiological data/changes.

c. Communicates and documents patient’s physiological response to other members of the surgical and health care team in verbal or written report, including that which might be relevant to discharge planning.

d. Identifies emergency situations promptly, initiates action and summons assistance.

• Competency to monitor and control the environment.

a. Controls the environment to provide ultimate patient care, such as temperature of room, sensory stimuli, and traffic and noise level.

b. Adheres to all safety policies and procedures.

c. Maintains appropriate traffic pattern in the peri-operative environment.

d. Adheres to sanitation policies for infection control including confine and contain and waste disposal.

e. Communicates and documents environmental controls or breaks in technique promptly and appropriately.

f. Maintains appropriate level of competency in using information systems.

• Competency to respect patient’s rights.

a. Demonstrates awareness and practices according to the Patient’s Bill of Rights and Center policy.

b. Provides for patient safety and maintains patient confidentiality.

c. Communicates and documents provision for patient’s rights as appropriate

• Competency to perform nursing actions that demonstrate accountability.

a. Exercises safe judgment in decision-making.

b. Demonstrates flexibility and adaptability to changes in nursing practice.

c. Responds in a positive manner to constructive criticism or recommendations for improvement.

d. Demonstrates tact, understanding and good guest relations when dealing with patients, visitors, team members, and other units.

e. Practices within ethical and legal guidelines.

f. Seeks opportunities of continued learning.

g. Communicates and documents nursing actions.

• Competency to evaluate patients.

a. Develops outcome criteria and measures degree of achievement.

b. Communicates and documents degree of goal achievement to other members of the surgical and health care team in verbal and written report, including that which might be relevant to discharge planning.

• Competency to evaluate effectiveness of nursing care.

a. Continuously evaluates the patient’s needs, plan of care, and nursing actions, adjusting the plan as required to provide optimum patient outcomes.

b. Assesses the patient post-operatively and determines the effectiveness of care to desired patient goals.

c. Communicates and documents effectiveness of care and results of nursing care to other members of the surgical and health care team in verbal or written report, including that which might be relevant to discharge planning.

d. Participates in the Quality Improvement Program activities including identification of aspects of care, collection and analysis of data, formulation of recommendations, implementation of an improvement plan and evaluation of the process.

• In keeping with the teamwork philosophy, acts as a resource person to other staff.
• Adheres to OSHA guidelines for Universal Precautions for exposure to blood and body fluids, using appropriate personal protective equipment (PPE).
• Participates in the orientation of new employees, students and approved program participants
• Attends Center staff and unit meetings, and educational opportunities
• Demonstrates attendance and shift flexibility in meeting the needs of the Center.
• Follows AORN Recommended Practices and the Center’s policy at all times.
• Assists visitors, staff and physicians, utilizing good guest relations
• Reports for duty punctually and maintains satisfactory attendance record.
• Demonstrates the knowledge of nursing unit and departmental standards, institutional policy and regulatory requirements.
• Attends staff meetings/huddles and/or acknowledges meeting minutes.

Qualifications

• Associate Degree Required or
• Bachelor Degree Preferred
• Minimum of 1 years perioperative or critical care experience, preferably in an ambulatory setting. Prior knowledge of Pre & Post-Operative equipment or ability to learn.
• Registered Nurse New York - New York State Board of Nursing Required
• BLS Basic Life Support - American Heart Association Required
• ACLS Advanced Cardiac Life Support - American Heart Association Required

Montefiore Nyack Hospital is an equal employment opportunity employer. Montefiore Nyack Hospital will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law.