(Archived) Registered Nurse - Critical Care / ICU

• Coordinate patient care in collaboration with a wide array of healthcare professionals. Facilitate the achievement of optimal outcomes in relation to clinical care, quality, and cost effectiveness.
• Ensure compliance with standards of care and practice in accordance with all established policies, procedures, and guidelines used in the MTF.
• Perform physical exam and health histories.
• Provide health promotions, counseling, and education.
• Administer medications, wound care, and numerous other personalized interventions.
• Direct and supervise care provide by other healthcare professionals.
• Accountable for making patient care assignments based on the scope of practice and skill level of assigned personnel.
• Recognize adverse signs and symptoms and quickly react in emergency situations. Ability to react with alertness and skill in any emergency situation, (e.g., cardiac or respiratory arrest, hemorrhage, shock, severe physical trauma and psychiatric reaction). Serves as member of the Rapid Response Team (RRT) and Code Blue resuscitation/response team.
• Communicate and collaborate with a diverse group of people for the purpose of informing the healthcare team of plans/actions, for teaching/education to benefit the patient/family and organization.
• Make referral appointments and arrange specialty care as appropriate.
• Perform nursing services identified in the TO.
• Conduct research in support of improved practice and patient outcomes.
• Knowledge of interpersonal relationships and the ability to maintain composure and react appropriately while relating to patients, families, physicians, coworkers and ancillary staff; manage distraught, irritable, unreasonable or angry individuals; and, maintain positive rapport with all individuals involved in patient care.
• Knowledge of a wide range of medical disorders and conditions as appropriate and seen in critically ill patients (e.g., Ventilator Associated pneumonia and the VAP bundle, Sepsis, and ARDS).
• Knowledge of professional care theories, principles, practices, and procedures to perform nursing assignments of critically ill patients. Demonstrates knowledge of growth and development, and pathophysiology of disease processes specific to the critical care unit population to include all ages from adult to geriatrics.
• Assess patients' conditions for potential or life-threatening crises. Distinguish between normal and abnormal physical findings (from physical assessment and vital sign assessment). Plan appropriate nursing care. Notify physician if needed and carry out appropriate interventions as ordered.
• Identify impending or existing emotional or psychiatric crisis and provide appropriate intervention.
• Reassess patient's condition and revise plan of care based on identified nursing problems.
• Assess patient/family knowledge level, implement plan of instructions and record patient/family demonstrated level of understanding.
• Implement the Nursing process (assessment, planning, diagnosis, intervention and evaluation) to include holistic approach.
• Effectively communicates and collaborates with a diverse group of people for the purpose of informing the healthcare team of plans/actions, for teaching/education to benefit the patient/family and organization. Effectively uses appropriate communication format in addressing professional issues.
• Obtain patient history, pertinent family history, and document in patient’s medical record.
• Utilize appropriate nursing personnel to assist in delivery of care when indicated (LPN's/paraprofessionals).
• Transcribe or verify transcription of physician orders.
• Carry out prescribed physician orders and document in patient medical record.
• Communicate pertinent patient data to charge nurse and/or physician as appropriate.
• Reassess patient's condition and revise plan of care based on identified nursing problems.
• Possess knowledge of a variety of pharmacological agents used in treatment of critically ill patients, the desired effects, side effects, complications and usual dosage of their use as well as the accurate administration of the pharmacologic agent, including dosage calculations as required.
• Administer prescribed critical care medications to include multiple critical care medication drips and intravenous push drugs (e.g., sedatives, narcotics, vasoactive medications, neuromuscular blockades, antidysrhythmics, antihypertensives, thrombolytics, and emergency drugs). Administration consideration based on protocols, policy, and recommendations by medical references.
• Assess and document patient response to medications administered and intervene if desired response is not achieved.
• Instruct patient/family regarding prescribed medications/therapies and surgical/diagnostic procedures that must be accomplished.
• Administer inhalation therapy treatments, with knowledge of medications utilized in this treatment and reactions.
• Properly apply cardiac monitor leads and 12 lead EKG machine, analyze rhythm strips and notify Physician of any abnormal results (e.g., dysrhythmias for patient situation). Be able to interpret cardiac rhythms and their implications, intervene on emergent changes.
• Assess patient/family knowledge level, implement plan of instructions and record patient/family demonstrated level of understanding.
• Care for patients with a variety of hemodynamic monitors to include pressure lines/transducers, Swan-Ganz catheters, and arterial lines. Obtain hemodynamic parameters and interpret results. Notify physician of any parameters outside of expected results.
• Participate in Discharge Planning as appropriate.
• Demonstrate use and operation of defibrillator to include emergency defibrillator.
• Obtain Arterial Blood Gas by drawing from arterial line. Interpret results, notify physician of abnormal results and anticipate intervention as appropriate.
• Perform the Postoperative Recovery and discharge within established criteria.
• Draw blood from invasive monitoring lines, lab value interpretation and intervene as appropriate (follow hospital protocols when applicable and/or notify physician).
• Care of patients on ventilators to include knowledge of the modes of ventilation, Ventilator Associated Pneumonia Bundle.
• Be able to initiate life saving measures in the absence of a physician.
• Operate infusion pumps, enteral feeding pumps, and Patient Controlled Analgesia pumps, epidural pumps, electronic thermometers, wound vacs, and CRRT equipment.
• Administration of Blood products.
• Preceptor to new nurses if requested. Consists of overseeing new nurse’s orientation to patient care during a 12-hour shift. Includes teaching/orienting to use of electronic charting system, location of supplies, and reporting new nurse progress to critical care unit leadership.