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REGISTERED NURSE PACU- Shenango Valley Outpatient Surgery Center

Identifies patient upon arrival to PACU by name band and verbal report from Anesthesia provider. Reports pertinent observations, changes, and reactions regarding patients to the appropriate person (physician, manager, charge nurse, supervisor, etc.) Records these observations, changes and reactions accurately, concisely and legibly. Reports relative perioperative information to licensed nurse using SBAR method upon discharge from PACU. Documents on patient record observations, changes and reactions and reports them to the appropriate person (physician, supervisor/manager, charge nurse etc.) Communicates with patient’s family and physician changes in patient’s condition while in PACU. Assesses the patient’s condition and nursing needs. Develops and implements individual plan of care. Makes revisions as patient’s condition and needs change. Completes nursing assessment upon admission to the unit. Develops and implements a nursing plan of care according to patient’s assessed needs. Revises care plan as condition needs change. Utilizes services of ancillary departments, as ordered, to meet the needs of the patients. Maintains the standards of nursing care within the guidelines of the nursing department, PNA, ASA, and ASPAN Standards. Demonstrates knowledge of standards of nursing care when implementing the plan of care including PNA, ASA, and ASPAN Standards. Demonstrates knowledge of, implements and adheres to PACU specific, Administrative and Nursing policies and procedures. Administers, directs, supervises and evaluates nursing care provided to post-anesthesia patients. Directs and supervises other team members. Confers with other team members about patient’s condition. Documents patient’s condition as needed on patient record. Provides direct professional nursing care. Participates in Unit Q.A. Implements appropriate PACU physician orders pertaining to PACU care. Administers medications, including IV’s according to hospital policy and procedure. Documents medications according to hospital procedure. Obtains ordered medication and documents on PACU record. Documents controlled substance waste according to MMC policy. Demonstrates cost-conscious use of supplies; maintains equipment in a clean and safe manner. Participates in the orientation of new staff and in the clinical experience of students, interns and/or residents. Maintains skills in the assessment, treatment, and care appropriate to the unique needs of the post-operative patient (i.e. age groups, disease process of the patient). AGE/DEPARTMENT SPECIFIC COMPETENCIES Communicates with patient based on growth and developmental needs of individual. Demonstrates gentle speech and handling of infant/toddler. Permits child to have security object. Modifies speech tone; permits hearing devices. Speak clearly to facilitate hearing in aging adult. Includes interpreter, family member, significant other to translate/sign for hearing impaired patient. Includes information for parent / guardian about what to expect in perioperative process. Safety: Identifies patient’s correct parent or guardian by matching patient name band to that worn by responsible adult. Observed matching patient name band to that of responsible parent/guardian. Identifies patient at risk for falls. Follows hospital protocol to avoid restraint use whenever possible. Assessment: Assesses pain intensity utilizing scale appropriate for age. Utilize FLACC or CRIES scale for infant pain assessment. Utilize FACES pain scale for the pediatric patient. Utilize numeric pain score for non-verbal pain scale for adolescent, adult, geriatric. Recognize presence of pain and document findings in the non-communicated patient. Identifies appropriate equipment for age/size of patient. Applies appropriate size NIBP cuff. Applies appropriate size pulse oximeter probe to promote adequate oxygenation. Utilizes appropriate oxygen therapy for age. Places pediatric patient in side-lying position. Inserts correct sized nasal/oral airway. Effectively applies correct sized BVM. Recognize signs of decreased endurance. Applies supplemental oxygen as needed. Recognize normal physiological differences based on age. Recognize and report findings that are outside the normal range. SPECIFIC JOB DEMANDS Strength: Medium Work - Lifting, Carrying, Pushing, Pulling 20 - 50 Lbs. occasionally, 10 - 25 Lbs. frequently or up to 10 Lbs. constantly. Stooping: Occasionally - Bending body downward and forward by bending spine at the waist, requiring full use of the lower extremities and back muscles. Reaching: Frequently - Extending hand(s) or arm(s) in any direction. Handling: Frequently - Seizing, holding, grasping, turning, or otherwise working with hand or hands. Fingers are involved only to the extent that they are an extension of the hand, such as to turn a switch or shift automobile gears. Fingering: Frequently - Picking, pinching, or otherwise working primarily with fingers rather than with the whole hand or arm as in handling. Feeling: Frequently - Noting attributes of objects, such as size, shape, temperature, or texture, by touching with skin, particularly that of fingertips. Talking: Frequently - Expressing or exchanging ideas by means of the spoken word to impart oral information to clients or to the public and to convey detailed spoken instructions to other workers accurately, loudly, or quickly. Hearing: Frequently - Perceiving the nature of sounds by ear. Near Acuity: Frequently - Clarity of vision at 20 inches or less. Accommodation: Occasionally - Adjustment of lens of eye to bring an object into sharp focus. This factor is required when doing near point work at varying distances from the eye. Color Vision: Frequently - Ability to identify and distinguish colors. MINIMUM EDUCATION, KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED Professional knowledge of nursing theory and practice at a level normally acquired through completion of an accredited School of Nursing. Current State Nursing License. Working knowledge of ASPAN and ASA Standards at completion of orientation. ACLS and PALS Certification within 6 months of employment. Recredentialing of Unit Specific skills annually. Recommend - previous experience in Med/Surg nursing, ICU experience, Coronary Care Class, CPAN Certification. Completes/maintains biannual ACLS certification. Completes/maintains biannual PALS certification. Completes annual house wide and PACU specific recredentialing. Analytical skills necessary to develop and implement a plan for nursing care appropriate to the patient, and to solve problems concerning patient’s mental or physical well-being. Ability to concentrate and prioritize, plan and perform professional nursing care, resolve patient care problems, and interact with patients, families, and other team members - often during stressful situations. Ability to initiate and interpret physiological monitoring and perform emergency treatment to include: a.Noninvasive BP monitoring b.Pulse oximetry c.Cardiac monitoring d.Hemodynamic monitoring Respiratory ventilation -- Ambu bag and ventilator Defibrillation Malignant Hyperthermia Protocol Within one year of being in the position, must complete the Trauma Nursing Core Certification (TNCC). Thereafter, must complete 8 hours of trauma continuing education annually. WORKING CONDITIONS Normal patient care environment with little exposure to excessive noise, dust, and temperature changes. A large part of work time is standing or walking. Subject to certain distasteful patient care activities and exposure to communicable diseases. May work overtime and take after hours, weekend, and holiday call. May be exposed to potential hazards such as chemical wastes, body wastes, fluids and other possible infectious material. DISCLOSURE MMC commits to review, under the intent of this standard, and in coordination with medical professional opinion’s and physical demands job analysis performed by certified professionals, an individual’s ability to be reasonably accommodated within the role they are responsible and qualified to perform. MMC is committed to complying with the Americans with Disabilities Act (“ADA”) and providing equal opportunity employment for qualified persons with disabilities. All employment practices and activities are conducted on a nondiscriminatory basis. Meadville Medical Center will follow any state or local law that provides individuals with disabilities greater protection that the ADA. Every effort has been made to make your job description as complete as possible. However, this in no way states or implies that these are the only duties you will be required to perform. The omission of specific tasks does not exclude them from the position if the task is similar, related, or is a logical assignment to the position, or is imperative for patient care and to meet emergency situations.

REGISTERED NURSE PACU- Shenango Valley Outpatient Surgery Center

Meadville Medical Center Hermitage, PA

Identifies patient upon arrival to PACU by name band and verbal report from Anesthesia provider. Reports pertinent observations, changes, and reactions regarding patients to the appropriate person (physician, manager, charge nurse, supervisor, etc.) Records these observations, changes and reactions accurately, concisely and legibly. Reports relative perioperative information to licensed nurse using SBAR method upon discharge from PACU. Documents on patient record observations, changes and reactions and reports them to the appropriate person (physician, supervisor/manager, charge nurse etc.) Communicates with patient’s family and physician changes in patient’s condition while in PACU. Assesses the patient’s condition and nursing needs. Develops and implements individual plan of care. Makes revisions as patient’s condition and needs change. Completes nursing assessment upon admission to the unit. Develops and implements a nursing plan of care according to patient’s assessed needs. Revises care plan as condition needs change. Utilizes services of ancillary departments, as ordered, to meet the needs of the patients. Maintains the standards of nursing care within the guidelines of the nursing department, PNA, ASA, and ASPAN Standards. Demonstrates knowledge of standards of nursing care when implementing the plan of care including PNA, ASA, and ASPAN Standards. Demonstrates knowledge of, implements and adheres to PACU specific, Administrative and Nursing policies and procedures. Administers, directs, supervises and evaluates nursing care provided to post-anesthesia patients. Directs and supervises other team members. Confers with other team members about patient’s condition. Documents patient’s condition as needed on patient record. Provides direct professional nursing care. Participates in Unit Q.A. Implements appropriate PACU physician orders pertaining to PACU care. Administers medications, including IV’s according to hospital policy and procedure. Documents medications according to hospital procedure. Obtains ordered medication and documents on PACU record. Documents controlled substance waste according to MMC policy. Demonstrates cost-conscious use of supplies; maintains equipment in a clean and safe manner. Participates in the orientation of new staff and in the clinical experience of students, interns and/or residents. Maintains skills in the assessment, treatment, and care appropriate to the unique needs of the post-operative patient (i.e. age groups, disease process of the patient). AGE/DEPARTMENT SPECIFIC COMPETENCIES Communicates with patient based on growth and developmental needs of individual. Demonstrates gentle speech and handling of infant/toddler. Permits child to have security object. Modifies speech tone; permits hearing devices. Speak clearly to facilitate hearing in aging adult. Includes interpreter, family member, significant other to translate/sign for hearing impaired patient. Includes information for parent / guardian about what to expect in perioperative process. Safety: Identifies patient’s correct parent or guardian by matching patient name band to that worn by responsible adult. Observed matching patient name band to that of responsible parent/guardian. Identifies patient at risk for falls. Follows hospital protocol to avoid restraint use whenever possible. Assessment: Assesses pain intensity utilizing scale appropriate for age. Utilize FLACC or CRIES scale for infant pain assessment. Utilize FACES pain scale for the pediatric patient. Utilize numeric pain score for non-verbal pain scale for adolescent, adult, geriatric. Recognize presence of pain and document findings in the non-communicated patient. Identifies appropriate equipment for age/size of patient. Applies appropriate size NIBP cuff. Applies appropriate size pulse oximeter probe to promote adequate oxygenation. Utilizes appropriate oxygen therapy for age. Places pediatric patient in side-lying position. Inserts correct sized nasal/oral airway. Effectively applies correct sized BVM. Recognize signs of decreased endurance. Applies supplemental oxygen as needed. Recognize normal physiological differences based on age. Recognize and report findings that are outside the normal range. SPECIFIC JOB DEMANDS Strength: Medium Work - Lifting, Carrying, Pushing, Pulling 20 - 50 Lbs. occasionally, 10 - 25 Lbs. frequently or up to 10 Lbs. constantly. Stooping: Occasionally - Bending body downward and forward by bending spine at the waist, requiring full use of the lower extremities and back muscles. Reaching: Frequently - Extending hand(s) or arm(s) in any direction. Handling: Frequently - Seizing, holding, grasping, turning, or otherwise working with hand or hands. Fingers are involved only to the extent that they are an extension of the hand, such as to turn a switch or shift automobile gears. Fingering: Frequently - Picking, pinching, or otherwise working primarily with fingers rather than with the whole hand or arm as in handling. Feeling: Frequently - Noting attributes of objects, such as size, shape, temperature, or texture, by touching with skin, particularly that of fingertips. Talking: Frequently - Expressing or exchanging ideas by means of the spoken word to impart oral information to clients or to the public and to convey detailed spoken instructions to other workers accurately, loudly, or quickly. Hearing: Frequently - Perceiving the nature of sounds by ear. Near Acuity: Frequently - Clarity of vision at 20 inches or less. Accommodation: Occasionally - Adjustment of lens of eye to bring an object into sharp focus. This factor is required when doing near point work at varying distances from the eye. Color Vision: Frequently - Ability to identify and distinguish colors. MINIMUM EDUCATION, KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED Professional knowledge of nursing theory and practice at a level normally acquired through completion of an accredited School of Nursing. Current State Nursing License. Working knowledge of ASPAN and ASA Standards at completion of orientation. ACLS and PALS Certification within 6 months of employment. Recredentialing of Unit Specific skills annually. Recommend - previous experience in Med/Surg nursing, ICU experience, Coronary Care Class, CPAN Certification. Completes/maintains biannual ACLS certification. Completes/maintains biannual PALS certification. Completes annual housewide and PACU specific recredentialing. Analytical skills necessary to develop and implement a plan for nursing care appropriate to the patient, and to solve problems concerning patient’s mental or physical well-being. Ability to concentrate and prioritize, plan and perform professional nursing care, resolve patient care problems, and interact with patients, families, and other team members - often during stressful situations. Ability to initiate and interpret physiological monitoring and perform emergency treatment to include: a.Noninvasive BP monitoring b.Pulse oximetry c.Cardiac monitoring d.Hemodynamic monitoring Respiratory ventilation -- Ambu bag and ventilator Defibrillation Malignant Hyperthermia Protocol Within one year of being in the position, must complete the Trauma Nursing Core Certification (TNCC). Thereafter, must complete 8 hours of trauma continuing education annually. WORKING CONDITIONS Normal patient care environment with little exposure to excessive noise, dust, and temperature changes. A large part of work time is standing or walking. Subject to certain distasteful patient care activities and exposure to communicable diseases. May work overtime and take after hours, weekend, and holiday call. May be exposed to potential hazards such as chemical wastes, body wastes, fluids and other possible infectious material. DISCLOSURE MMC commits to review, under the intent of this standard, and in coordination with medical professional opinion’s and physical demands job analysis performed by certified professionals, an individual’s ability to be reasonably accommodated within the role they are responsible and qualified to perform. MMC is committed to complying with the Americans with Disabilities Act (“ADA”) and providing equal opportunity employment for qualified persons with disabilities. All employment practices and activities are conducted on a nondiscriminatory basis. Meadville Medical Center will follow any state or local law that provides individuals with disabilities greater protection that the ADA. Every effort has been made to make your job description as complete as possible. However, this in no way states or implies that these are the only duties you will be required to perform. The omission of specific tasks does not exclude them from the position if the task is similar, related, or is a logical assignment to the position, or is imperative for patient care and to meet emergency situations.

LPN