Registered Nurse (RN) - Acute Care - Rotating

The Acute Care Unit at Tappahannock treats medical/surgical patients with a multitude of acute medical conditions, such as, diabetes, congestive heart failure, respiratory, pain management, surgical procedures, GI, and orthopedic. The unit is capable of offering telemetry monitoring when needed. The unit is structured with 24 private rooms and 6 rooms can be converted to semi-private to allow for 30 patients, three of these rooms have negative pressure. Skill mix includes RNs, LPNs, Patient Care Techs, and Unit Secretaries. There is one full time Nurse Director and one full-time Clinical Coordinator managing both Acute Care Unit and ICU. Staffing is based on patient census, acuity and adjusted accordingly per shift. Initial nursing data base assessments are completed within 24 hours of admission and reassessment minimum standards are every 12 hours or by adherence to appropriate nursing policies.

The Clinical Nurse I job Integrates technical skills and theoretical knowledge to meet the needs of the patient and family. This job assists the health care team with the prevention of illness and injury, maintenance of wellness, and provision of comfort. This job provides direction, education, and begins to acquire leadership skills at the unit level. This job delivers and accurately documents direct, age-specific care to a patient or group of patients based on medical orders and an integrated, multidisciplinary plan of care. This job also safely administers prescribed medications, identifying incompatibilities and/or interactions.

The Clinical Nurse II job demonstrates a mastery of clinical skills and begins to apply this knowledge to a specific patient population. This job assists the health care team with the prevention of illness and injury, maintenance of wellness, and provision of comfort. This job recognizes changes in patient situations and intervenes appropriately. This job mobilizes resources to meet the individualized needs of patient/families. This job provides direction, education, and assumes leadership responsibilities at the unit level. This job delivers and accurately documents direct, age-specific care to a patient or group of patients based on medical orders and an integrated, multidisciplinary plan of care. This job safely administers prescribed medications, identifying incompatibilities and/or interactions.

The Clinical Nurse III job demonstrates clinical knowledge at the unit level and begins to apply this knowledge to a specific patient population. This job assists the health care team with the prevention of illness and injury, maintenance of wellness, and provision of comfort. This job anticipates changes in patient situations and intervenes appropriately. This job provides direction, education, and serves as a role model in a clinical setting. This job delivers and accurately documents direct, age-specific care to a patient or group of patients based on medical orders and an integrated, multidisciplinary plan of care. This job safely administers prescribed medications, identifying incompatibilities and/or interactions.

Licensure, Certification, or Registration Requirements for Hire:
Clin I, Clin II, Clin III: Current RN licensure in Virginia or eligible or compact state

Licensure, Certification, or Registration Requirements for continued employment:
Clin I, Clin II, Clin III: Current RN licensure in Virginia, AHA BLS HCP Certification or equivalent

Experience REQUIRED:
Clin I: N/A
Clin II: 12 to 24 months RN experience
Clin III: 3 years of clinical experience

Experience PREFERRED:
Clin I: Experience as an LPN, nursing assistant or care partner in either an acute care setting or as applicable to area of practice
Clin II, Clin III: Academic Health Care Experience; Experience with similar patient population in either an acute care setting or as applicable to area of practice

Education/training REQUIRED:
Clin I, Clin II, Clin III: Diploma or Associates Degree from a professional nursing program recognized and/or approved by the corresponding state’s Board of Nursing.
All registered nurses without a Bachelor's degree in Nursing (or higher) will be required to enroll in an approved RN to BSN program within two years of their start date and to complete the program within five years of their start date unless grandfathered under previous requirements.

Education/training PREFERRED:
Clin I, Clin II, Clin III: Completion of a Bachelor’s Degree in Nursing (or higher) from an accredited program Clin III: Certification in specialty area

Independent action(s) required:
Follows documented physician/licensed independent provider orders.
Practices within the boundaries of the regulations governing the practice of nursing in the Commonwealth of Virginia.
Practice is guided by the ANA Code of Ethics for Nursing and established national nursing practice standards.
All practice is guided by and follows the VCUHS policies and procedures and established practice.

Supervisory responsibilities (if applicable):
Clin I, Clin II, Clin III: Organizes work and delegates and supervises others (RN's, LPN's, Care Partners, Unit Secretaries, etc.) in carrying out assignments.

Additional position requirements:
Clin I, Clin II, Clin III: Clinicians work all three shifts, weekends and holidays.
Individual shift rotation and schedules will be established with your specific Nurse Manager/Practice Manager.
Schedules, including requirements of shift rotations and hours of work may be adjusted as necessary to meet unit requirements and/or as needed.

Age Specific groups served:
As appropriate based on unit assignment.

Physical Requirements (includes use of assistance devices as appropriate):
Physical: Lifting 20-50 lbs.
Other: Exposure to potentially hazardous and infectious substances
Activities: Prolonged standing, Prolonged sitting, Frequent bending, Walking (distance), Climbing (steps, ladder, other), Reaching (overhead, extensive, repetitive)
Mental/Sensory: Strong recall, Reasoning, Problem solving, Hearing, Speak clearly, Write legibly, Reading, Logical thinking
Emotional: Fast pace environment, Steady pace, Able to handle multiple priorities, Frequent and intense customer interactions, Noisy environment

Rotating

EEO Employer/Disabled/Protected Veteran/41 CFR 60-1.4.

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This job delivers and accurately documents direct, age-specific care to a patient or group of patients based on medical orders and an integrated, multidisciplinary plan of care. This job safely administers prescribed medications, identifying incompatibilities and/or interactions. Performance Expectation: Pertains to staff in licensed Nursing positions ONLY Employee must complete 15 contact hours of Continuing Nursing Education during this evaluation cycle. Effective July 2012: CN-III must complete 20 contact hours; Failure to achieve the required number of contact hours will result in the employee being ineligible to receive an overall performance rating above "Fully Meets". Performance Expectation: Nursing Process The Clinical Nurse II demonstrates competent use of the nursing process as a problem-solving model in performance of job duties as evidenced by: Focuses assessment to target areas most productive for a given patient population or situation. Recognizes subtle changes in clinical situations; evaluates and appropriately alters the plan of care. Consistently makes sound clinical decision. Prioritizes and organizes patient care and ensures follow through with planned care. Initiates discharge care planning in assigned patients and actively coordinates utilizing the multidisciplinary/interdisciplinary approach. The Clinical Nurse III demonstrates competent use of the nursing process as a problem-solving model in performance of job duties as evidenced by: Synthesizes knowledge and experience to anticipate and plan to meet patient and family needs. Takes a proactive role in implementing multidisciplinary care planning for specific patient population. Performance Expectation: Nurse–Patient Relationship The Clinical Nurse II demonstrates ability to develop and maintain a therapeutic nurse/patient relationship throughout the health care continuum as evidenced by: Demonstrates effective communication styles based on individual patient/family needs. Identifies factors affecting patient’s physical and/or psychosocial comfort. Individualizes approaches accordingly. Seeks consultation if necessary to achieve patient outcome. Assesses patient/family readiness to be involved in planning. Involves them in planning and implementing care. Incorporates an individualized, holistic and non-judgmental approach to care. Mobilizes appropriate resources in response to situations that have the potential to negatively impact patient/family outcomes. The Clinical Nurse III develops and maintains a therapeutic nurse/patient relationship throughout the health care continuum. Respect for patients’ rights is an integral part of the nurse/patient relationship as reflected in our values statement as evidenced by: Adapts communication styles and techniques based on individual patient/family needs. Anticipates variables affecting patient comfort. Alters physical and/or psychosocial interventions accordingly, using a variety of modalities. Assists patient/family to gain sense of control. Facilitates patient/family’s participation in his/her recovery. Consistently utilizes an individualized, holistic and non-judgmental approach to patient care. Challenges situations and engages in activities to promote positive patient outcomes. Performance Expectation: Education The Clinical Nurse II demonstrates a commitment to meeting the learning needs of patients and families as evidenced by: Accurately assesses patient/family readiness to learn, organize and execute individualized teaching plan. Evaluates patient’s understanding and modifies approach as necessary. Assists individual members of the health care team in developing their clinical skills. The Clinical Nurse III demonstrates a commitment to meeting the learning needs of patients and families as evidenced by: Utilizes a variety of teaching strategies appropriate to the patient’s needs. Seeks out challenging patient/family teaching opportunities. Assumes responsibility for identifying staff learning needs. Develops, implements and evaluates formal and informal patient and/or staff educational plans. Performance Expectation: Leadership/Collaboration and Professional Development The Clinical Nurse II demonstrates respect and understanding for peers and other clinical disciplines and participates as an effective member of the patient care team to formulate an integrated approach based upon current evidence and on the mission of the department as evidenced by: Participates in unit activities which improve patient care or administrative systems. Utilizes available resources to maintain current knowledge base relevant to practice. Asks clinical questions related to nursing care of patients. Demonstrates ability to locate and obtain evidence to answer clinical questions. Seeks out and utilizes resources to identify nursing practice issues, including those that require evidence-based evaluation/research. Shares findings of personal review of evidence (literature/QA/experts, etc.) with peers and generates dialogue. May initiate steps toward problem resolution based on current best evidence. Initiates referrals. Coordinates the health care team to meet patient and family’s individualized needs. Consistently utilizes effective communication, feedback and conflict resolution skills. Demonstrates the ability to critique own nursing practice. Identifies a plan for professional development. The Clinical Nurse III demonstrates respect and understanding for peers and other clinical disciplines and participates as an effective member of the patient care team to formulate an integrated approach based upon current evidence and on the mission of the department as evidenced by: Leads or participates in unit or division activities which improve patient care or administrative systems. Maintains awareness of current practice in specialty area. Assists others in translating and applying this knowledge to the practice setting. Evaluates nursing practice based on current best evidence. Initiates steps towards problem resolution based on current best evidence. Questions clinical practice at the unit and/or department level, and incorporates the use of current best evidence, clinical judgment and patient values/preferences. May implement solutions towards problem resolution based on current best evidence. Shares current best evidence (e.g. critical pathways, practice guidelines, protocols, and standards) with peers and others. Contributes to the revision and development of unit and/or department nursing care guidelines and/or policies and procedures based on current best evidence. Promotes the development of collaborative relationships with other health professionals by focusing on patient outcomes. Takes responsibility for problem-solving and conflict resolution. Describes their professional practice goals and plans for achieving them on the individual and unit level. Demonstrates how they have accomplished some of their professional practice goals in the last two years. Performance Expectation: Performs other Duties and Participates in Special Projects The Clinical Nurse II: Readily volunteers and/or participates in special projects in order to support the mission of VCUHS and department. The Clinical Nurse III: Provides assistance to team members. Accepts alternate assignments, as required. Initiates and/or delegates other duties as assigned and/or participates in special projects in order to support the mission of VCUHS and department. Makes use of diverse talents of team members, promotes team dynamics. Suggests and or supports/alternate assignments, displays emotional stability. Education/training REQUIRED: Clin II, Clin III Diploma or Associates Degree from a professional nursing program recognized and/or approved by the corresponding state’s Board of Nursing. All registered nurses without a Bachelor's degree in Nursing (or higher) will be required to enroll in an approved RN to BSN program within two years of their start date and to complete the program within five years of their start date unless grandfathered under previous requirements. Education/training PREFERRED: Clin II, Clin III Completion of a bachelor’s degree in Nursing (or higher) from an accredited program Clin III: Certification in specialty area Licensure, Certification, or Registration Requirements for Hire: Clin II, Clin III: Current RN licensure in Virginia or eligible or compact state Experience REQUIRED: Clin II: 12 to 24 months RN experience Clin III: 3 years of clinical experience Clin II, Clin III Academic Health Care Experience; Experience with similar patient population in either an acute care setting or as applicable to area of practice Other Knowledge, Skills and Abilities Required: Follows documented physician/licensed independent provider orders. Practices within the boundaries of the regulations governing the practice of nursing in the Commonwealth of Virginia. Practice is guided by the ANA Code of Ethics for Nursing and established national nursing practice standards. All practice is guided by and follows the VCUHS policies and procedures and established practice. Clinicians work all shifts, weekends and holidays. Individual shift rotation and schedules will be established with your specific Nurse Manager/Practice Manager. Schedules, including requirements of shift rotations and hours of work may be adjusted as necessary to meet unit requirements and/or as needed Age Specific groups served: As appropriate based on unit assignment. Physical Requirements (includes use of assistance devices as appropriate): Physical: Lifting 0-50 lbs. Other: Exposure to potentially hazardous and infectious substances Activities: Prolonged standing, Prolonged sitting, Frequent bending, Walking (distance), Climbing (steps, ladder, other), Reaching (overhead, extensive, repetitive) Mental/Sensory: Strong recall, Reasoning, Problem solving, Hearing, Speak clearly, Write legibly, Reading, Logical thinking Emotional: Fast pace environment, Steady pace, Able to handle multiple priorities, Frequent and intense customer interactions, Noisy environment Nights EEO Employer/Disabled/Protected Veteran/41 CFR 60-1.4.