Clinical Nurse - Med Surg

Under general supervision, following established policies, procedures, and professional guidelines, delivers nursing care to patients. Plans and implements nursing care; documents nursing assessments; identifies and reports situations requiring further intervention; formulates and communicates goal-directed plan of care; assures patient rights. Responsible for performing job duties in accordance with the mission, vision and values of Tampa General Hospital and principles of quality improvement

Essential Functions

• Assesses and analyzes the health status of patients in assigned nursing unit in a comprehensive manner. Performs and/or assures completed assessments on all patients admitted within the designated time delineated in policy/unit standards.
• Performs on-going assessments and documents according to policy and procedure, reports significant findings of admission and on-going assessments to appropriate member of heath care team.
• Initiates discharge planning process with initial admission assessment.
• Plans patient care on assigned unit in collaboration with the patient, family, and health care team.
• Formulates individualized patient plan of care based on assessment data within the designated time delineated in policy/unit standards.
• Updates plan of care based on the patient assessment within appropriate time period.
• Directs, implements and coordinates patient care activities on assigned unit to ensure the delivery of quality care.
• Communicates the plan of care to other members of the healthcare team through daily worksheet conferences, verbally during the shift and shift report.
• Directs care team members in accordance with their scope of practice.
• Communicates and documents all patient care given including assessments, plan of care, interventions, patient response, and follow-up. Transcribes and directs the implementation of physician orders. Provides patient education based on assessed needs and evaluates understanding.
• Conducts ongoing evaluation of patient outcomes and documents effectiveness of planned and implemented interventions and strategies in relation to the plan of care within time frames per policy/unit standards. Includes patient and family in the evaluation process.
• Provides appropriate patient assessment and care specific to the needs of the patient populations served (e.g. age groups, patients of size; diagnosis-based).
• Demonstrates knowledge and awareness of the specific physical, psychosocial and developmental needs of patients as appropriate to the populations served.

Education Qualifications

• Associate’s Degree Nursing

Licenses and Certifications

• Registered Nurse
• Basic Life Support (BLS) through American Heart Association or American Red Cross

Experience Qualifications

• Unit specific certifications may be required.
• May include but not limited to:Advanced Cardiovascular Life Support (ACLS)Pediatric Advance Life Support (PALS)STROKENational Institutes of Health Stroke Scale (NIHSS)STABLE

Skills and Abilities

• Knowledge of assessment techniques and diagnostic tools.
• Ability to conduct thorough assessments, interpret clinical data, and apply critical thinking to respond to changes in patient condition.
• Knowledge of evidence-based practices for care planning.
• Skill in developing, implementing, and modifying patient care plans in collaboration with the healthcare team, ensuring effective care coordination.
• Understanding of patient education principles and ability to provide clear, personalized education to patients and families and assess their comprehension to ensure understanding and compliance.
• Knowledge of outcome measurement and quality improvement processes.
• Ability to evaluate patient progress and adjust care plans based on patient responses, contributing to ongoing improvement initiatives.
• Familiarity with healthcare documentation standards and legal requirements.
• Ability to document patient care accurately and timely, ensuring compliance with legal, ethical, and institutional standards.