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Assess, plan, and implement care for patients in the operating room, recovery room, and outpatient surgery. Manage surgical supplies and equipment while providing essential pre- and post-operative education to patients and families.
Requirements summary
Requires a two to four-year RN degree and a current Missouri state nursing license. Mandatory certifications include ACLS and BLS, with PALS preferred.
Purpose: To assess, plan, implement, and evaluate the care of all patients assigned to the operating room, recovery room, and outpatient surgery, as well as to manage the supplies and equipment in the OR/RR/ASU, and to provide pre and post-op education.
Formal
Policy-Setting
Responsibilities: Formally responsible for providing input into policies associated with the job’s purpose and essential responsibilities.
Routine
Decision
Making: If pre-op lab and results are sufficient; surgical case schedule; if patient meets criteria for discharge from PACU/ASU.
Formal
Supervisory
Responsibility: No formal supervisory responsibility.
Required
Knowledge: A&P; disease process; sterile technique; standards set by Association of Operating Room Nurses Association (AORN); functions and mechanism of multiple operating room equipment.
Required
Skills and
Ability: Computer skills; good communication skills; good organizational skills.
Unusual
Working
Conditions: Risk of blood, body fluid contamination.
Education and
Certification/
Registration required for the
Position: Two to four-year RN degree; currently licensed in the state of Missouri; ACLS/BLS required; PALS preferred.
Age
Specific
Competencies: Provides care for birth to pediatric (birth-2 yrs.), pediatric/child patients between (2 yrs-12 yrs); adolescent patients between 12 to 18 years of age; adult patients between 18 to 64 years; and geriatric patients 65 years and older.
PART
TWO: Essential Responsibilities and Tasks A. Assesses, Plans, implements and evaluates patients receiving high risk specialty procedures. (40% of time) 1. Performs pre-procedure interviews per paper/computer correctly on all patients, evaluates the information obtained, and formulates a plan of care prior to the patient procedure. 2. Identifies the patients using two patient identifiers prior to the procedure 100% of the time. 3. Performs a comprehensive nursing assessment on patients and documents completely including appropriate signatures, times and dates. Revises plan of care as indicated from the assessment. 4. Interprets physiological information from technical equipment, on each patient and applies this information to the plan of care. 5. Documents the findings from all assessments, evaluations and implementations on the patient record where, when, and how daily. 6. Reports all critical abnormal assessments and lab values to the physician, per hospital policy and implements further orders immediately and documents details on the patient record. 7. Adequately assess and reassess pain. Utilizes appropriate pain management techniques. Educates the patient and family regarding pain management. 8. Utilizes AIDET (acknowledge, introduce, duration, explain and thank) initiatives to include managing up with each patient. 9. Utilizes only approved abbreviations in patient documentation. B. Provides patient education. (15% of time) 1. Provides pre-operative and post-operative teaching to all patients. 2. Evaluates patient learning ability and motivational levels. Implements alternative learning measures, as evidenced by patient or caregiver verbalization or return demonstrations, as documented on the patient record i.e.; effectively communicates. 3. Effectively communicates discharge instructions to patient and responsible party at the time of discharge, per departmental discharge policy. 4. Explains all procedures and medications to patients prior to implementation. C. Maintains a safe and comfortable environment. (25% of time) 1. Removes malfunctioning equipment from unit immediately upon discovering problem. 2. Complete requisition for repair or malfunctioning equipment by the end of shift. 3. Cleans and stocks supplies within the department, as needed. 4. Effectively communicates the plan of care on each patient to ancillary departments, case management and pharmacy staff as indicated by the orders received, patient diagnosis or condition. 5. Ensures all required documents are on the chart prior to going into the procedure room (H&P, informed consent, test results if applicable). 6. Evaluates the effectiveness of the communication, as evidenced by the preparedness of the patient and takes appropriate actions, including notifying performing physician. 7. Demonstrates thorough knowledge of location, care and operation of all departmental equipment. 8. Accurately records, handles and labels specimens; demonstrates care of specimens. 9. Ensures alarms on any assigned area are audible to alert staff. 10. Assists with the cleaning and care of surgical instrument. 11. Assists with terminally cleaning of OR rooms and documents on cleaning schedule. 12. Positions patients on operating table to facilitate surgical approach and to ensure patient safety for each case. 13. Uses padding on any boney prominences for each patient and documents on operating room record. 14. Applies cautery pads on muscular areas close to surgical site and away from any implants on each patient and documents on record. 15. Applies safety belt to each patient having surgery and documents on record. 16. Checks code blue carts each shift and upon using the cart, ensuring it has an intact tag attached. 17. If assigned as the scrub nurse, is fully responsible for care of instruments prior to, during and after the surgical case including appropriate transporting to decontamination. 18. Follows manufactures instructions for the sterilization equipment; knows responsibilities and the necessity for biological/chemical monitoring. 19. Able to accurately see and read color changes to biological and chemical monitors. D. Demonstrates utilization of the nursing process through planning for patient care. (10% of the time) 1. Pulls supplies for next day’s cases daily from departmental supplies according to physicians’ preference cards. 2. Orders special equipment as requested by physician or on preference card to have prior to surgery start time. 3. Updates preference cards to meet physician’s preferences so surgeon does not need to ask more than once. E. Develops and promotes hospital/unit initiatives and professional relations. (5% of the time) 1. Establishes and maintains effective communication and good working relationship with co-workers for the patients benefit. 2. Utilizes initiatives; strives to maintain steady level of productivity; self-motivated; manages activity and time; does not waste. 3. Participates in planning ways to solve problems and make improvements in the department as needed. 4. Represents the organization in a positive and professional manner. F. Other duties as directed. (5% of the time)
Essential
Physical
Requirements
TYPE
OF
WORK (Check
One)
Sedentary
Work: Lifting 10# maximum and occasionally lifting and/or carrying such articles as dockets, ledgers and small tools. Jobs are sedentary; if walking and standing are required only occasionally.
Light
Work: Lifting 20# maximum with frequent lifting and/or carrying of objects weighing up to 10#. Even though the weight lifted may be only a negligible amount, a job is in this category when it requires walking or standing to a significant degree or pushing and pulling of arm and/or leg controls.
Medium
Work: Lifting 100# maximum with frequent lifting and/or carrying of objects weighing up to 25#. x
Heavy
Work: Lifting 100# maximum with frequent lifting and/or carrying of objects weighing up to 50#.
Very
Heavy
Lifting: Lifting objects in excess of 100# with frequent lifting and/or carrying of objects weighing 50# or more.
Physical
DEMANDS (Check those which apply) x
Lifting: Raising or lowering an object from one level to another (includes upward pulling). x
Carrying: Transporting an object, usually holding it in hands or arms or on the shoulders. x
Pushing: Exerting force upon an object so that the object moves away from the force (including slapping, striking, kicking, and treadle actions). x
Pulling: Exerting force upon an object so that the object moves toward the force (includes jerking).
Climbing
Ascending or descending ladders, stairs, scaffolding, ramps, poles, ropes, and the like, using the feet and the legs and/or hands and arms.
Balancing
Maintaining body equilibrium to prevent falling when walking, standing, crouching, or running on a narrow, slippery, or erratically moving surfaces; or maintaining body equilibrium when performing gymnastic feats. x
Hearing: Ability to determine audible communication. x
Stooping: Bending the body downward and forward by bending the spine at the waist. x
Kneeling: Bending the legs at the knees to come to rest on the knee or knees. x
Crouching: Bending the body downward and forward by bending the legs and spine. x
Crawling: Moving about on the hands and knees or hands and feet. x
Reaching: Extending the hands and arms in any direction. x
Handling: Seizing, holding, grasping, turning, or otherwise working with the hand or hands (fingering not involved). x
Fingering: Picking, pinching, or otherwise working with the fingers primarily (rather than with the whole hand or arms as in handling).
Repetitive
Motions: Substantial movements (motions) of the wrist, hands, and/or fingers. x
Feeling: Perceiving such attributes of objects and materials as size, shape, temperature, or texture by means of receptors in the skin, particularly those of the finger tips. x
Speaking: Expressing or exchanging ideas by means of the spoken word. Those activities in which they must convey detailed or important spoken instructions to other workers accurately, loudly, or quickly. x
Seeing: Obtaining impressions through the eyes of the shape, size, distance, motion, color or other characteristics of objects. Including Major Visual Functions Acuity, far - clarity of vision at 20 feet or more. x Acuity, near - clarity of vision at 20 inches or less. x Depth perception - ability to judge distance and space relationships so as to see objects where and as they actually are. x Field of vision - area seen up and down or to the right or left while eyes are fixed. x Accommodations - adjustment of the lens of the eye to bring an object into sharp focus. x Color vision- the ability to identify and distinguish colors.
WORKING
CONDITIONS (Check those which apply) x
Inside: Worker spends approximately 75% or more of time inside.
Outside
Worker spends approximately 75% or more time outside.
In/Outside: Activities occur inside or outside in approximately equal amounts.
Extremes of
Cold: Temperature sufficiently low to cause marked bodily discomfort unless worker is provided with exceptional protection.
Extremes of
Heat: Temperature sufficiently high to cause marked bodily discomfort unless worker is provided with exceptional protection.
Temperature
Changes: Variations in temperature which are sufficiently marked and abrupt to cause noticeable bodily reactions. x
Wet: Contact with water or other liquids.
Humid
Atmospheric condition with moisture content sufficiently high to cause marked bodily discomfort. x
Noise and
Vibration: Sufficient noise, either constant or intermittent to cause marked distraction or possible injury to the sense of hearing and /or sufficient vibration (production of an oscillating movement or strain on the body or its extremities from motion or shock) to cause bodily harm if endured day after day. x
Hazards: Situations in which the individual is exposed to the definite risk of the bodily injury. x
Fumes: Smoky or vaporous exhalations, usually odorous, thrown off as the result of combustion or chemical reaction. x
Odor: Noxious smells, either toxic dust, fumes, gases, vapors, mists or liquids which cause general or localized disabling conditions as a result of inhalation or action to the skin.
Toxic
Conditions: Exposure to toxic dust, fumes, gases, vapors. Mists or liquids which cause general or localized disabling conditions as a result of inhalations or action to the skin.
Infectious
Disease: Risk of exposure to biohazardous materials, blood, body fluid contamination.
Dust
Air filled with small particles of any kind, such as textiles dust, flour, wool, leather, feathers, etc., and inorganic dust including silica and asbestos, which make the workplace unpleasant or are the source of occupational disease.
Poor
Ventilation: Insufficient movement of air causing a feeling of suffocation; or exposure to drafts. Identify and describe any additional physical demands or unusual working conditions that were not previously covered. _____________________________________________________ QualificationsEducation and
Certification/
Registration required for the
Position: Two to four-year RN degree; currently licensed in the state of Missouri; ACLS/BLS required; PALS preferred.
