Appalachian Regional Healthcare

Nurse Extern Tier II

Overview The Nurse Extern Tier II is accountable for providing nursing assistance and performing basic nursing procedures to groups of patients within an assigned nursing department, under the supervision, guidance, and direction of a Registered Nurse who may delegate subversion to other Team Member such as; Licensed Practical Nurse and/or State Registered Nursing Assistant. In addition, the Nurse Extern can gain additional clinical practice to enhance their preparation as future licensed nurses Responsibilities Under the continuous direct on-site supervision of a Certified Nursing Assistant:• Interprets plan of medical care and provides input on nursing care plan and assist in the following provided they have been deemed clinically competent by their nursing instructor.• Completes the nursing assessment form with oversight and approval of RN.• Provides personal care including bath, shampoo, shave, back rub, positions changes, makes beds, prepares patients for meals, feeds patients and passes ice water.• Answers call lights and bells promptly to determine and meet patient needs.• Collects specimens, stool, urine, sputum, etc.• Collects input and output and records appropriately.• Collects and records vital signs on patient. Obtains and records pertinent patient information per hospital policy.• Assist and/or feeds patients. (enteral feedings included), provides between meal nourishments, provides fresh drinking water and encourages fluids when indicated.• Assists in progressive ambulation of patients by wheelchair, stretcher and bed.• Administers enemas, douches and inserts rectal tubes and documents appropriately.• Applies ace bandages and elastic stockings and sequential compression devices.• Inserts catheters and feeding tubes.• Applies restraints and side rails to ensure safety of patients.• Observes isolation technique and give direct care to patients in isolation.• Assists in ostomy care and education.• Set up orthopedic appliances.• Maintains records and reports necessary information in regard to patient care.• Prepares patients for surgery and other therapeutic and diagnostic procedures.• Maintains a safe environment for patient care.• Performs other duties as assigned. Qualifications Education • High school diploma or GED equivalent.• Enrollment in Board of Nursing approved School of Nursing Registered Nurse Program• Completion of basic Nursing Fundamentals and/or Certified Nursing Assistant Course• Current Transcripts and Copy of Skills Evaluation on basic procedures• Recommendation Letter from 2 Instructors Minimum Work Experience • N/A Required Skills, Knowledge, and Abilities • Ability to function in and adapt appropriately to a fast-moving, cross-unit team environment.• Strong problem-solving skills.• Prior experience handling confidential matters with appropriate discretion.• To handle multiple, simultaneous tasks in a timely manner.• Collaborative attitude with the many different departments.• Must maintain positive, professional communications skills when working with co-workers • Detail oriented
Appalachian Regional Healthcare

Registered Nurse Tier 1 ICU

Overview The Registered Nurse requires substantial specialized knowledge, judgement and nursing skills based upon the principles of psychological, biological, physical, and social sciences in the application of the nursing process in the respective departments in which assigned. The RN must collaborate with physicians and multidisciplinary team members; provide physical and psychological support to patients, friends, and families; supervising assigned team members and students. Responsibilities Completes patient assessments, formulates plan of care, oversees implementation of plan of care, evaluate and adjust plan of care utilizing critical thinking skills The performance of other nursing acts which are authorized or limited by the board, and which are consistent either with American Nursing’s Association Standards of Practice or with Standards of Practice established by nationally accepted organizations of registered nurses. Care, counsel health teaching and promotion, utilizes Teach Back methodology as affirmation of comprehension The administration of medication, intravenous therapy and treatment as prescribed by a LIP Supervision, delegation and follow-through to other personnel in the performance of activities relating to nursing care. Mentors and precepts students and orient new staff as assigned Reports up chain of command Clinical Nurse Manager/Nurse Manager/House Nurse Coordinator pertinent information Participates on various teams, committees or performance improvement initiatives Ensures a safe and secure environment for patients, coworkers and self Participates in Discharge Planning and Transition of Care (able to define pt needs) Serves as a patient advocate and escalates patient related concerns timely Timely documents pertinent findings in medical record Assist patients in performing activities of daily living and functions as an active team member Assumes responsibility for personnel professional development Utilizes effective communication skills and active listening, exhibits compassionate and empathetic attitude Practices Hands Off communication utilizing SBAR; Performs Bedside Shift reporting utilizing SBAR (unless contradicted) Functions as a positive influence, role model and adheres to professional code of conduct Respects dignity and confidentiality of all matters relating to patients Refer to Special Addendum and Staff Nurse Position Description Performs other job duties as assigned. Qualifications Associate's Degree Graduation from an accredited school of nursing. Required Bachelor's Degree Preferred Up to 1 year Preferred Minimum of one (1) year acute care nursing experience (1) year of experience should be relevant to specific department in which they will be working. Refer to addendums for additional requirements. Experience with Electronic Health Record Preferred. Preferred Operates critical care equipment such as respirators, temporary pacemakers, defibrillators, and other emergency equipment. Set-up, maintains, interprets results of cardiac and hemodynamic monitor required and takes action as indicated by nursing practice and hospital procedures. Perform special procedures such as endotracheal and tracheostomy suctioning; tracheostomy care; extubation; cardio-pulmonary resuscitation; arterial punctures; care of chest tubes and pleurevac; set up and assistance with peritoneal dialysis, paracentesis, thoracentesis. Able to manage specialty drips using approved protocols Prior to assignment to unit as sole RN provider, the nurse must successfully complete critical care course acceptable to the Community Chief Nursing Officer and demonstrate mastery of equipment, diagnostic responsibilities, and procedures required of the critical care nurse. Such course work shall include: • Cardiopulmonary resuscitation and management of an obstructed airway. • EKG interpretation. • Drug therapy, including emergency drug therapy via the I.V. route, or routes normally left to the physician. • Hemodynamic monitoring. • Critical care procedures. The nurse shall be adequately oriented to unit policies, procedures and equipment. Orientation shall include safety procedures, infection control practices, and performance improvement activities. Completion of the following Competencies: Moderate Sedation Completion of Stroke Modules Restraints Registered Nurse Required Advanced Dysrhythmia/EKG Required NIH Stroke Certification Required BLS Required Advanced Life Support Certification Required De-Escalation Training within 6 months of hire Required Pediatric Advanced Life Support Certification (recommended) Preferred
Appalachian Regional Healthcare

Registered Nurse Tier 1

Overview The Registered Nurse requires substantial specialized knowledge, judgement and nursing skills based upon the principles of psychological, biological, physical, and social sciences in the application of the nursing process in the respective departments in which assigned. The RN must collaborate with physicians and multidisciplinary team members; provide physical and psychological support to patients, friends, and families; supervising assigned team members and students. Responsibilities Completes patient assessments, formulates plan of care, oversees implementation of plan of care, evaluate and adjust plan of care utilizing critical thinking skills The performance of other nursing acts which are authorized or limited by the board, and which are consistent either with American Nursing’s Association Standards of Practice or with Standards of Practice established by nationally accepted organizations of registered nurses. Care, counsel health teaching and promotion, utilizes Teach Back methodology as affirmation of comprehension The administration of medication, intravenous therapy and treatment as prescribed by a LIP Supervision, delegation and follow-through to other personnel in the performance of activities relating to nursing care. Mentors and precepts students and orients new staff as assigned Reports up chain of command Clinical Nurse Manager/Nurse Manager/House Nurse Coordinator pertinent information Participates on various teams, committees or performance improvement initiatives Ensures a safe and secure environment for patients, coworkers and self Participates in Discharge Planning and Transition of Care (able to define pt needs) Serves as a patient advocate and escalates patient related concerns timely Timely documents pertinent findings in medical record Assist patients in performing activities of daily living and functions as an active team member Assumes responsibility for personnel professional development Utilizes effective communication skills and active listening, exhibits compassionate and empathetic attitude Practices Hands Off communication utilizing SBAR; Performs Bedside Shift reporting utilizing SBAR (unless contradicted) Functions as a positive influence, role model and adheres to professional code of conduct Respects dignity and confidentiality of all matters relating to patients Performs other job duties as assigned. Qualifications Bachelor's Degree Preferred Associate's Degree Required Mastery of problem solving and decision making skills. Mastery of collaboration and teamwork. Mastery of growth mindset (agility and developing yourself and others) skills. Mastery of execution and delivery (planning, delivering, and supporting) skills. Ability to consider the relative costs and benefits of potential actions to choose the most appropriate one. Ability to function in clinical setting with diverse cultural dynamics of clinical staff and patients. Mastery knowledge of phases of care transitions and resources available for patients. Mastery of digital literacy skills. Registered Nurse. Required BLS upon hire Required De-Escalation Training within 6 months of hire Required Advanced Dysrhythmia/EKG (Med/Surg telemetry unit ONLY) Required
Appalachian Regional Healthcare

Nurse Extern Tier II

Overview The Nurse Extern Tier II is accountable for providing nursing assistance and performing basic nursing procedures to groups of patients within an assigned nursing department, under the supervision, guidance, and direction of a Registered Nurse who may delegate subversion to other Team Member such as; Licensed Practical Nurse and/or State Registered Nursing Assistant. In addition, the Nurse Extern can gain additional clinical practice to enhance their preparation as future licensed nurses Responsibilities Under the continuous direct on-site supervision of a Certified Nursing Assistant:• Interprets plan of medical care and provides input on nursing care plan and assist in the following provided they have been deemed clinically competent by their nursing instructor.• Completes the nursing assessment form with oversight and approval of RN.• Provides personal care including bath, shampoo, shave, back rub, positions changes, makes beds, prepares patients for meals, feeds patients and passes ice water.• Answers call lights and bells promptly to determine and meet patient needs.• Collects specimens, stool, urine, sputum, etc.• Collects input and output and records appropriately.• Collects and records vital signs on patient. Obtains and records pertinent patient information per hospital policy.• Assist and/or feeds patients. (enteral feedings included), provides between meal nourishments, provides fresh drinking water and encourages fluids when indicated.• Assists in progressive ambulation of patients by wheelchair, stretcher and bed.• Administers enemas, douches and inserts rectal tubes and documents appropriately.• Applies ace bandages and elastic stockings and sequential compression devices.• Inserts catheters and feeding tubes.• Applies restraints and side rails to ensure safety of patients.• Observes isolation technique and give direct care to patients in isolation.• Assists in ostomy care and education.• Set up orthopedic appliances.• Maintains records and reports necessary information in regard to patient care.• Prepares patients for surgery and other therapeutic and diagnostic procedures.• Maintains a safe environment for patient care.• Performs other duties as assigned. Qualifications Education • High school diploma or GED equivalent.• Enrollment in Board of Nursing approved School of Nursing Registered Nurse Program• Completion of basic Nursing Fundamentals and/or Certified Nursing Assistant Course• Current Transcripts and Copy of Skills Evaluation on basic procedures• Recommendation Letter from 2 Instructors Minimum Work Experience • N/A Required Skills, Knowledge, and Abilities • Ability to function in and adapt appropriately to a fast-moving, cross-unit team environment.• Strong problem-solving skills.• Prior experience handling confidential matters with appropriate discretion.• To handle multiple, simultaneous tasks in a timely manner.• Collaborative attitude with the many different departments.• Must maintain positive, professional communications skills when working with co-workers • Detail oriented
Appalachian Regional Healthcare

Registered Nurse Tier 1 Psych

Overview The Registered Nurse requires substantial specialized knowledge, judgement and nursing skills based upon the principles of psychological, biological, physical, and social sciences in the application of the nursing process in the respective departments in which assigned. The RN must collaborate with physicians and multidisciplinary team members; provide physical and psychological support to patients, friends, and families; supervising assigned team members and students. Responsibilities Completes patient assessments, formulates plan of care, oversees implementation of plan of care, evaluate and adjust plan of care utilizing critical thinking skills The performance of other nursing acts which are authorized or limited by the board, and which are consistent either with American Nursing’s Association Standards of Practice or with Standards of Practice established by nationally accepted organizations of registered nurses. Care, counsel health teaching and promotion, utilizes Teach Back methodology as affirmation of comprehension The administration of medication, intravenous therapy and treatment as prescribed by a LIP Supervision, delegation and follow-through to other personnel in the performance of activities relating to nursing care. Mentors and precepts students and orients new staff as assigned Reports up chain of command Clinical Nurse Manager/Nurse Manager/House Nurse Coordinator pertinent information Participates on various teams, committees or performance improvement initiatives Ensures a safe and secure environment for patients, coworkers and self Participates in Discharge Planning and Transition of Care (able to define pt needs) Serves as a patient advocate and escalates patient related concerns timely Timely documents pertinent findings in medical record Assist patients in performing activities of daily living and functions as an active team member Assumes responsibility for personnel professional development Utilizes effective communication skills and active listening, exhibits compassionate and empathetic attitude Practices Hands Off communication utilizing SBAR; Performs Bedside Shift reporting utilizing SBAR (unless contradicted) Functions as a positive influence, role model and adheres to professional code of conduct Respects dignity and confidentiality of all matters relating to patients Performs other job duties as assigned. Qualifications Associate's Degree in Nursing Required Bachelor's Degree in Nursing Preferred Up to 1 year Preferred Mastery of problem solving and decision making skills. Mastery of collaboration and teamwork. Mastery of growth mindset (agility and developing yourself and others) skills. Mastery of execution and delivery (planning, delivering, and supporting) skills. Ability to consider the relative costs and benefits of potential actions to choose the most appropriate one. Ability to function in clinical setting with diverse cultural dynamics of clinical staff and patients. Mastery knowledge of phases of care transitions and resources available for patients. Mastery of digital literacy skills. Registered Nurse Required BLS upon hire Required De-Escalation Training within 6 months of hire Required
Appalachian Regional Healthcare

Head Nurse Manager

Overview The Head Nurse Manager is accountable for the supervision of nursing services within an assigned unit in order to provide safe, effective and efficient nursing care. Responsibilities Supervises the department in an efficient manner by planning, organizing and controlling all activities of the department. Implement, interpret and enforce work standards and procedures within the unit that are in compliance with hospitals policies, governmental regulations and various regulatory agency requirements. Serve as a role model for nursing staff by complying with established policies and procedures. Incorporate total quality management concepts into unit operations. Develop, implement, monitor and enforce the principles of effective nursing care on the unit. Develop effective communications between unit personnel, physicians and other departments to assure continuity, coordination and collaboration in delivering services. Provides direct patient care when higher levels of skill and judgement are required. Demonstrate the skills and knowledge necessary to provide care appropriate to the age of the patient served. Relieve other Head nurse managers and Nurse Supervisors as required. May work different shifts and/or days for orientation, training and evaluation of personnel in the unit. Maintain up-to-date knowledge in the field so they may recommend new services, products and equipment. Continue professional development by attending education programs designed for nursing leaders. Interview, select, evaluate, discipline and terminate personnel or recommending such action as necessary. Assure that employees receive orientation and required in-service training and that they maintain required licensure or certification. Maintain personnel records as required. Develop work schedules and assign unit personnel on the basis of patient needs and appropriate nursing intervention. Head Nurse Manager Position Description Page 2 Supervise labor relations activities in the assigned area. Prepare the departmental budget, routine and special reports and various forms and documents as required. Attend or conduct meetings as necessary. Adhere to the infection control policies and procedures of the hospital. May work off shifts, weekends and holidays, be on-call and work more than standard hours. Perform other related duties as assigned. Qualifications Graduation from an approved school of nursing and current non-limited licensure in state. BS or MSN is preferred. Minimum of five (5) years experience and demonstrated management and clinical skills.
Appalachian Regional Healthcare

Clinical Nurse Manager

Overview The Clinical Nurse Manger (CNM) is a direct supervisory leadership role and a key member of the Nursing leadership team. The CNM ensures and delivers high quality, patient-centered care and coordination of all functions in the unit/department during the designated shift. In collaboration with other members of the management team, the CNM directs, monitors, and evaluates nursing care in accordance with established policies/procedures, serves as a resource person for staff, and models a commitment to the organization's vision/mission/values to support an unparalleled patient experience and clinical outcomes that contribute to overall departmental performance. The CNM provides feedback and coaching to staff members, recognizing them for their contributions while fostering a high-performance culture. Responsibilities Ensures that clinical assignments are based on patient care needs and demonstrated staff competencies.Assists with admission and discharge processes to ensure efficient throughput and high quality, patient-centered care.Participates in the ongoing assessment of the quality of patient care services provided on the unit, in collaboration with other members of the management team.Collaborates with subject matter experts and other managers to create an environment of teamwork that supports improved outcomes and service.Supports a patient-first philosophy and engages in service recovery when necessary.Supports the efforts of the facility to improve engagement by operationalizing current nursing strategies, including nurse leader rounding, employee rounding, hourly rounds, bedside shift report and other initiatives.Provides recommendations related to interviewing, selecting, and training new staff.Recommends and implements courses of action, including training and development, conflict resolution, personnel policy compliance, completion of performance evaluations, and/or disciplinary actions to ensure a competitively better organization.Assists with staff scheduling. Manages all practical aspects of staff labor in accordance with patient care needs and established productivity guidelines.Supports proper inventory control and assists with managing supplies and equipment.Works with medical staff to coordinate management of patient care.Shows leadership and initiative in situations where supervision is not present or required.Appropriately escalates problems relating to rules and regulations in a timely and effective manner. Qualifications Education (experience can be substituted for education) Associate's Degree in Nursing RequiredBachelor's Degree in Nursing Preferred Work Experience (education can be substituted for experience) 1-3 years Minimum of 1 year clinical experience required – 2 years, preferred. Required Knowledge, Skills and Abilities Evidence of leadership experience abilities required.Knowledge of general nursing principles and practice skills;Knowledge of organizational functions, policies and regulations;Applicable knowledge of technical skills related to worked clinical area. Licenses and Certifications Current licensure to practice nursing in the State of KY or WV, depending on legal state of residence. RequiredBLS RequiredACLS within six (6) months of hire (ED, Critical Care, OR and Specialty Areas/Units Only) RequiredPALS within six (6) months of hire (ED, OR, Med/Surg Peds) RequiredNRP and AWHONN fetal monitoring w/in six (6) months (Maternal/Child Only) RequiredTNCC within six (6) months of hire (ED Only) RequiredDe-Escalation Training within six (6) months of hire (all units) RequiredProfessional Nursing Certification Preferred
Appalachian Regional Healthcare

Nurse Extern Tier II

Overview The Nurse Extern Tier II is accountable for providing nursing assistance and performing basic nursing procedures to groups of patients within an assigned nursing department, under the supervision, guidance, and direction of a Registered Nurse who may delegate subversion to other Team Member such as; Licensed Practical Nurse and/or State Registered Nursing Assistant. In addition, the Nurse Extern can gain additional clinical practice to enhance their preparation as future licensed nurses Responsibilities Under the continuous direct on-site supervision of a Certified Nursing Assistant:• Interprets plan of medical care and provides input on nursing care plan and assist in the following provided they have been deemed clinically competent by their nursing instructor.• Completes the nursing assessment form with oversight and approval of RN.• Provides personal care including bath, shampoo, shave, back rub, positions changes, makes beds, prepares patients for meals, feeds patients and passes ice water.• Answers call lights and bells promptly to determine and meet patient needs.• Collects specimens, stool, urine, sputum, etc.• Collects input and output and records appropriately.• Collects and records vital signs on patient. Obtains and records pertinent patient information per hospital policy.• Assist and/or feeds patients. (enteral feedings included), provides between meal nourishments, provides fresh drinking water and encourages fluids when indicated.• Assists in progressive ambulation of patients by wheelchair, stretcher and bed.• Administers enemas, douches and inserts rectal tubes and documents appropriately.• Applies ace bandages and elastic stockings and sequential compression devices.• Inserts catheters and feeding tubes.• Applies restraints and side rails to ensure safety of patients.• Observes isolation technique and give direct care to patients in isolation.• Assists in ostomy care and education.• Set up orthopedic appliances.• Maintains records and reports necessary information in regard to patient care.• Prepares patients for surgery and other therapeutic and diagnostic procedures.• Maintains a safe environment for patient care.• Performs other duties as assigned. Qualifications Education • High school diploma or GED equivalent.• Enrollment in Board of Nursing approved School of Nursing Registered Nurse Program• Completion of basic Nursing Fundamentals and/or Certified Nursing Assistant Course• Current Transcripts and Copy of Skills Evaluation on basic procedures• Recommendation Letter from 2 Instructors Minimum Work Experience • N/A Required Skills, Knowledge, and Abilities • Ability to function in and adapt appropriately to a fast-moving, cross-unit team environment.• Strong problem-solving skills.• Prior experience handling confidential matters with appropriate discretion.• To handle multiple, simultaneous tasks in a timely manner.• Collaborative attitude with the many different departments.• Must maintain positive, professional communications skills when working with co-workers • Detail oriented
Appalachian Regional Healthcare

Registered Nurse

Overview The Registered Nurse requires substantial specialized knowledge, judgement and nursing skills based upon the principles of psychological, biological, physical, and social sciences in the application of the nursing process in the respective departments in which assigned. The RN must collaborate with physicians and multidisciplinary team members; provide physical and psychological support to patients, friends, and families; supervising assigned team members and students. Responsibilities Completes patient assessments, formulates plan of care, oversees implementation of plan of care, evaluate and adjust plan of care utilizing critical thinking skills The performance of other nursing acts which are authorized or limited by the board, and which are consistent either with American Nursing’s Association Standards of Practice or with Standards of Practice established by nationally accepted organizations of registered nurses. Care, counsel health teaching and promotion, utilizes Teach Back methodology as affirmation of comprehension The administration of medication, intravenous therapy and treatment as prescribed by a LIP Supervision, delegation and follow-through to other personnel in the performance of activities relating to nursing care. Mentors and precepts students and orient new staff as assigned Reports up chain of command Clinical Nurse Manager/Nurse Manager/House Nurse Coordinator pertinent information Participates on various teams, committees or performance improvement initiatives Ensures a safe and secure environment for patients, coworkers and self Participates in Discharge Planning and Transition of Care (able to define pt needs) Serves as a patient advocate and escalates patient related concerns timely Timely documents pertinent findings in medical record Assist patients in performing activities of daily living and functions as an active team member Assumes responsibility for personnel professional development Utilizes effective communication skills and active listening, exhibits compassionate and empathetic attitude Practices Hands Off communication utilizing SBAR; Performs Bedside Shift reporting utilizing SBAR (unless contradicted) Functions as a positive influence, role model and adheres to professional code of conduct Respects dignity and confidentiality of all matters relating to patients Refer to Special Addendum and Staff Nurse Position Description Performs other job duties as assigned. Qualifications Bachelor's Degree Preferred Associate's Degree Required Mastery of problem solving and decision making skills. Mastery of collaboration and teamwork. Mastery of growth mindset (agility and developing yourself and others) skills. Mastery of execution and delivery (planning, delivering, and supporting) skills. Ability to consider the relative costs and benefits of potential actions to choose the most appropriate one. Ability to function in clinical setting with diverse cultural dynamics of clinical staff and patients. Mastery knowledge of phases of care transitions and resources available for patients. Mastery of digital literacy skills. Registered Nurse. Required BLS upon hire Required De-Escalation Training within 6 months of hire Required Advanced Dysrhythmia/EKG (Med/Surg telemetry unit ONLY) Required
Appalachian Regional Healthcare

Registered Nurse

Overview The Registered Nurse requires substantial specialized knowledge, judgement and nursing skills based upon the principles of psychological, biological, physical, and social sciences in the application of the nursing process in the respective departments in which assigned. The RN must collaborate with physicians and multidisciplinary team members; provide physical and psychological support to patients, friends, and families; supervising assigned team members and students. Responsibilities Completes patient assessments, formulates plan of care, oversees implementation of plan of care, evaluate and adjust plan of care utilizing critical thinking skills The performance of other nursing acts which are authorized or limited by the board, and which are consistent either with American Nursing’s Association Standards of Practice or with Standards of Practice established by nationally accepted organizations of registered nurses. Care, counsel health teaching and promotion, utilizes Teach Back methodology as affirmation of comprehension The administration of medication, intravenous therapy and treatment as prescribed by a LIP Supervision, delegation and follow-through to other personnel in the performance of activities relating to nursing care. Mentors and precepts students and orient new staff as assigned Reports up chain of command Clinical Nurse Manager/Nurse Manager/House Nurse Coordinator pertinent information Participates on various teams, committees or performance improvement initiatives Ensures a safe and secure environment for patients, coworkers and self Participates in Discharge Planning and Transition of Care (able to define pt needs) Serves as a patient advocate and escalates patient related concerns timely Timely documents pertinent findings in medical record Assist patients in performing activities of daily living and functions as an active team member Assumes responsibility for personnel professional development Utilizes effective communication skills and active listening, exhibits compassionate and empathetic attitude Practices Hands Off communication utilizing SBAR; Performs Bedside Shift reporting utilizing SBAR (unless contradicted) Functions as a positive influence, role model and adheres to professional code of conduct Respects dignity and confidentiality of all matters relating to patients Refer to Special Addendum and Staff Nurse Position Description Performs other job duties as assigned. Qualifications Bachelor's Degree Preferred Associate's Degree Required Mastery of problem solving and decision making skills. Mastery of collaboration and teamwork. Mastery of growth mindset (agility and developing yourself and others) skills. Mastery of execution and delivery (planning, delivering, and supporting) skills. Ability to consider the relative costs and benefits of potential actions to choose the most appropriate one. Ability to function in clinical setting with diverse cultural dynamics of clinical staff and patients. Mastery knowledge of phases of care transitions and resources available for patients. Mastery of digital literacy skills. Registered Nurse. Required BLS upon hire Required De-Escalation Training within 6 months of hire Required Advanced Dysrhythmia/EKG (Med/Surg telemetry unit ONLY) Required
Appalachian Regional Healthcare

Registered Nurse Tier 1 ICU

Overview The Registered Nurse requires substantial specialized knowledge, judgement and nursing skills based upon the principles of psychological, biological, physical, and social sciences in the application of the nursing process in the respective departments in which assigned. The RN must collaborate with physicians and multidisciplinary team members; provide physical and psychological support to patients, friends, and families; supervising assigned team members and students. Responsibilities Completes patient assessments, formulates plan of care, oversees implementation of plan of care, evaluate and adjust plan of care utilizing critical thinking skills The performance of other nursing acts which are authorized or limited by the board, and which are consistent either with American Nursing’s Association Standards of Practice or with Standards of Practice established by nationally accepted organizations of registered nurses. Care, counsel health teaching and promotion, utilizes Teach Back methodology as affirmation of comprehension The administration of medication, intravenous therapy and treatment as prescribed by a LIP Supervision, delegation and follow-through to other personnel in the performance of activities relating to nursing care. Mentors and precepts students and orients new staff as assigned Reports up chain of command Clinical Nurse Manager/Nurse Manager/House Nurse Coordinator pertinent information Participates on various teams, committees or performance improvement initiatives Ensures a safe and secure environment for patients, coworkers and self Participates in Discharge Planning and Transition of Care (able to define pt needs) Serves as a patient advocate and escalates patient related concerns timely Timely documents pertinent findings in medical record Assist patients in performing activities of daily living and functions as an active team member Assumes responsibility for personnel professional development Utilizes effective communication skills and active listening, exhibits compassionate and empathetic attitude Practices Hands Off communication utilizing SBAR; Performs Bedside Shift reporting utilizing SBAR (unless contradicted) Functions as a positive influence, role model and adheres to professional code of conduct Respects dignity and confidentiality of all matters relating to patients Performs other job duties as assigned. Qualifications Associate's Degree Graduation from an accredited school of nursing. Required Bachelor's Degree Preferred Up to 1 year Preferred Minimum of one (1) year acute care nursing experience (1) year of experience should be relevant to specific department in which they will be working. Refer to addendums for additional requirements. Experience with Electronic Health Record Preferred. Preferred Operates critical care equipment such as respirators, temporary pacemakers, defibrillators, and other emergency equipment. Set-up, maintains, interprets results of cardiac and hemodynamic monitor required and takes action as indicated by nursing practice and hospital procedures. Perform special procedures such as endotracheal and tracheostomy suctioning; tracheostomy care; extubation; cardio-pulmonary resuscitation; arterial punctures; care of chest tubes and pleurevac; set up and assistance with peritoneal dialysis, paracentesis, thoracentesis. Able to manage specialty drips using approved protocols Prior to assignment to unit as sole RN provider, the nurse must successfully complete critical care course acceptable to the Community Chief Nursing Officer and demonstrate mastery of equipment, diagnostic responsibilities, and procedures required of the critical care nurse. Such course work shall include: • Cardiopulmonary resuscitation and management of an obstructed airway. • EKG interpretation. • Drug therapy, including emergency drug therapy via the I.V. route, or routes normally left to the physician. • Hemodynamic monitoring. • Critical care procedures. The nurse shall be adequately oriented to unit policies, procedures and equipment. Orientation shall include safety procedures, infection control practices, and performance improvement activities. Completion of the following Competencies: Moderate Sedation Completion of Stroke Modules Restraints Registered Nurse Required Advanced Dysrhythmia/EKG Required NIH Stroke Certification Required BLS Required Advanced Life Support Certification Required De-Escalation Training within 6 months of hire Required Pediatric Advanced Life Support Certification (recommended) Preferred
Appalachian Regional Healthcare

Nurse Extern Tier II

Overview The Nurse Extern Tier II is accountable for providing nursing assistance and performing basic nursing procedures to groups of patients within an assigned nursing department, under the supervision, guidance, and direction of a Registered Nurse who may delegate subversion to other Team Member such as; Licensed Practical Nurse and/or State Registered Nursing Assistant. In addition, the Nurse Extern can gain additional clinical practice to enhance their preparation as future licensed nurses Responsibilities Under the continuous direct on-site supervision of a Certified Nursing Assistant:• Interprets plan of medical care and provides input on nursing care plan and assist in the following provided they have been deemed clinically competent by their nursing instructor.• Completes the nursing assessment form with oversight and approval of RN.• Provides personal care including bath, shampoo, shave, back rub, positions changes, makes beds, prepares patients for meals, feeds patients and passes ice water.• Answers call lights and bells promptly to determine and meet patient needs.• Collects specimens, stool, urine, sputum, etc.• Collects input and output and records appropriately.• Collects and records vital signs on patient. Obtains and records pertinent patient information per hospital policy.• Assist and/or feeds patients. (enteral feedings included), provides between meal nourishments, provides fresh drinking water and encourages fluids when indicated.• Assists in progressive ambulation of patients by wheelchair, stretcher and bed.• Administers enemas, douches and inserts rectal tubes and documents appropriately.• Applies ace bandages and elastic stockings and sequential compression devices.• Inserts catheters and feeding tubes.• Applies restraints and side rails to ensure safety of patients.• Observes isolation technique and give direct care to patients in isolation.• Assists in ostomy care and education.• Set up orthopedic appliances.• Maintains records and reports necessary information in regard to patient care.• Prepares patients for surgery and other therapeutic and diagnostic procedures.• Maintains a safe environment for patient care.• Performs other duties as assigned. Qualifications Education • High school diploma or GED equivalent.• Enrollment in Board of Nursing approved School of Nursing Registered Nurse Program• Completion of basic Nursing Fundamentals and/or Certified Nursing Assistant Course• Current Transcripts and Copy of Skills Evaluation on basic procedures• Recommendation Letter from 2 Instructors Minimum Work Experience • N/A Required Skills, Knowledge, and Abilities • Ability to function in and adapt appropriately to a fast-moving, cross-unit team environment.• Strong problem-solving skills.• Prior experience handling confidential matters with appropriate discretion.• To handle multiple, simultaneous tasks in a timely manner.• Collaborative attitude with the many different departments.• Must maintain positive, professional communications skills when working with co-workers • Detail oriented
Appalachian Regional Healthcare

Nurse Extern Tier II

Overview The Nurse Extern Tier II is accountable for providing nursing assistance and performing basic nursing procedures to groups of patients within an assigned nursing department, under the supervision, guidance, and direction of a Registered Nurse who may delegate subversion to other Team Member such as; Licensed Practical Nurse and/or State Registered Nursing Assistant. In addition, the Nurse Extern can gain additional clinical practice to enhance their preparation as future licensed nurses Responsibilities Under the continuous direct on-site supervision of a Certified Nursing Assistant:• Interprets plan of medical care and provides input on nursing care plan and assist in the following provided they have been deemed clinically competent by their nursing instructor.• Completes the nursing assessment form with oversight and approval of RN.• Provides personal care including bath, shampoo, shave, back rub, positions changes, makes beds, prepares patients for meals, feeds patients and passes ice water.• Answers call lights and bells promptly to determine and meet patient needs.• Collects specimens, stool, urine, sputum, etc.• Collects input and output and records appropriately.• Collects and records vital signs on patient. Obtains and records pertinent patient information per hospital policy.• Assist and/or feeds patients. (enteral feedings included), provides between meal nourishments, provides fresh drinking water and encourages fluids when indicated.• Assists in progressive ambulation of patients by wheelchair, stretcher and bed.• Administers enemas, douches and inserts rectal tubes and documents appropriately.• Applies ace bandages and elastic stockings and sequential compression devices.• Inserts catheters and feeding tubes.• Applies restraints and side rails to ensure safety of patients.• Observes isolation technique and give direct care to patients in isolation.• Assists in ostomy care and education.• Set up orthopedic appliances.• Maintains records and reports necessary information in regard to patient care.• Prepares patients for surgery and other therapeutic and diagnostic procedures.• Maintains a safe environment for patient care.• Performs other duties as assigned. Qualifications Education • High school diploma or GED equivalent.• Enrollment in Board of Nursing approved School of Nursing Registered Nurse Program• Completion of basic Nursing Fundamentals and/or Certified Nursing Assistant Course• Current Transcripts and Copy of Skills Evaluation on basic procedures• Recommendation Letter from 2 Instructors Minimum Work Experience • N/A Required Skills, Knowledge, and Abilities • Ability to function in and adapt appropriately to a fast-moving, cross-unit team environment.• Strong problem-solving skills.• Prior experience handling confidential matters with appropriate discretion.• To handle multiple, simultaneous tasks in a timely manner.• Collaborative attitude with the many different departments.• Must maintain positive, professional communications skills when working with co-workers • Detail oriented
Appalachian Regional Healthcare

Registered Nurse Tier 2

Overview ACCOUNTABILITY OBJECTIVE: The Staff Nurse is accountable for interpreting the plan of Medical care, assessment of patients clinical decision-making regarding nursing care, assuring nursing care is provided in a safe and competent manner, providing individualized nursing care, and evaluating nursing care for groups of patients. REPORTING RELATIONSHIPS: The Staff Nurse reports to the Nurse Manager or Nurse Supervisor and provides clinical supervision to LPNs, Nursing Aides, ORT's, and Nursing Service Clerks where applicable. Special Instructions Float position for ED RN. Must be able to work weekends. Will include some night shifts and mid shifts. Responsibilities MAJOR ACTIVITIES: Takes report from prior shift and gives report to oncoming shift which includes condition of patients, diagnosis, treatments, procedures given and required and other aspects of the plan of care. Performs assessments and reassessments of patients. Reviews ancillary service reports, communicates abnormal results to physicians, and notifies supervisor and physician when ancillary services are not completed. Interprets plan of medical care, evaluates patients, and devises patient plan of care. Maintains proper control of medicine, equipment and supplies specific to the assigned unit. Plans for discharge of patient considering all available resources and continuum of care needs. Refers patients to chaplain, social worker, and agencies as required. Provides a safe and secure environment for the patient. Implements the patient plan of care by assigning tasks to nursing and non-nursing personnel, and continuously assessing and evaluating patient care and patient's responses to nursing care. Performs nursing treatments and procedures and total patient care which may require expert skill and judgment in accordance with established nursing standards. May accompany physicians when possible on rounds, communicates pertinent information about patient to the physician, and assists the physician with treatments and procedures or delegate if not possible. Staff Nurse Page 2 Performs certain special procedures for which specialized training and supervised experience has been received. Plans for and provides effective patient and family education. Documents pertinent findings, plan of care and evaluation of care in the medical record. Assists patients in performing activities of daily living to meet the basic human needs. Prepares and maintains reports, charts, records, and forms as required by hospital, state, and federal regulations. May accompany patients who are transferred to another medical facility. Notifies supervisor, doctor, and/or family/guardian as appropriate when patient's condition changes. Observes and evaluates work performed by LPNs, Nursing Aides, ORT's and Clerks to validate that treatments and procedures are being performed in compliance with the plan of care and established hospital guidelines. Participates in teaching activities for other hospital personnel and nursing students. Participates in the orientation of new employees. Participates in committee meetings as requested. Attends inservice programs per contract. Assumes responsibility for personal professional development. Assists in the development of review and revision of Nursing policies and procedures. Respects the dignity and confidentiality of all matters relating to the patients. Performs other related duties as required within the scope of the job classification. Qualifications EDUCATION, TRAINING, AND EXPERIENCE REQUIREMENTS: Graduation from a State accredited or approved school of nursing. Licensed in State of employment.
Appalachian Regional Healthcare

Registered Nurse ER

Overview The Registered Nurse requires substantial specialized knowledge, judgement and nursing skills based upon the principles of psychological, biological, physical, and social sciences in the application of the nursing process in the respective departments in which assigned. The RN must collaborate with physicians and multidisciplinary team members; provide physical and psychological support to patients, friends, and families; supervising assigned team members and students. Responsibilities Completes patient assessments, formulates plan of care, oversees implementation of plan of care, evaluate and adjust plan of care utilizing critical thinking skills The performance of other nursing acts which are authorized or limited by the board, and which are consistent either with American Nursing’s Association Standards of Practice or with Standards of Practice established by nationally accepted organizations of registered nurses. Care, counsel health teaching and promotion, utilizes Teach Back methodology as affirmation of comprehension The administration of medication, intravenous therapy and treatment as prescribed by a LIP Supervision, delegation and follow-through to other personnel in the performance of activities relating to nursing care. Mentors and precepts students and orient new staff as assigned Reports up chain of command Clinical Nurse Manager/Nurse Manager/House Nurse Coordinator pertinent information Participates on various teams, committees or performance improvement initiatives Ensures a safe and secure environment for patients, coworkers and self Participates in Discharge Planning and Transition of Care (able to define pt needs) Serves as a patient advocate and escalates patient related concerns timely Timely documents pertinent findings in medical record Assist patients in performing activities of daily living and functions as an active team member Assumes responsibility for personnel professional development Utilizes effective communication skills and active listening, exhibits compassionate and empathetic attitude Practices Hands Off communication utilizing SBAR; Performs Bedside Shift reporting utilizing SBAR (unless contradicted) Functions as a positive influence, role model and adheres to professional code of conduct Respects dignity and confidentiality of all matters relating to patients Refer to Special Addendum and Staff Nurse Position Description Performs other job duties as assigned. Training for all personnel assigned to the Emergency Room shall consist of the following: 1.State and federal regulations related to emergency services. 2.Nursing management of trauma. 3.Nursing management of cardiac related disorders. 4.Performance of EKG procedures, EKG interpretation, and appropriate nursing intervention. 5.Pharmacological intervention (IV therapy). 6.Patient assessment (triage). 7.Nursing management of pediatric emergencies. 8.Medicolegal aspects, particularly related to proper documentation. 9.Nursing management of obstetrical emergencies. 10.Patient/family emotional response. 11.Cardiopulmonary resuscitation and airway management. Qualifications Associate's Degree Graduation from an accredited school of nursing. Required Bachelor's Degree Preferred Up to 1 year Preferred Minimum of one (1) year acute care nursing experience (1) year of experience should be relevant to specific department in which they will be working. Refer to addendums for additional requirements. Experience with Electronic Health Record Preferred. Preferred Excellent interpersonal skills and ability to work with providers at all levels essential. Able to communicate clearly in writing and verbally and effectively influence others to achieve necessary outcomes. Demonstrated ability to follow direction and facilitate a working environment conducive to change, enabling positive outcomes in a highly complex system. Exhibit Critical Thinking Skills Must possess basic computer skills. Ability to pass Medication Exam. Completion of hospital approved training program and documented competence in emergency care procedures as determined by the Director of Nursing Services. Moderate Sedation Completion of Stroke Modules Restraints The nurse shall be adequately oriented to the unit policies, procedures, and equipment. Orientation shall include safety procedures, infection control practices and performance improvement monitoring. Registered Nurse in State Required BLS Required De-Escalation Training within 6 months of hire Required ACLS Required Trauma Nurse Core Curriculum Certification Required Pediatric Advanced Life Support Certification Required NIH Stroke Certification Required Advanced Dysrhythmia/EKG Required Rural Trauma Team Development Course Preferred Emergency Nurse Pediatric Course Preferred
Appalachian Regional Healthcare

Registered Nurse Tier 1

Overview The Registered Nurse requires substantial specialized knowledge, judgement and nursing skills based upon the principles of psychological, biological, physical, and social sciences in the application of the nursing process in the respective departments in which assigned. The RN must collaborate with physicians and multidisciplinary team members; provide physical and psychological support to patients, friends, and families; supervising assigned team members and students. Responsibilities Completes patient assessments, formulates plan of care, oversees implementation of plan of care, evaluate and adjust plan of care utilizing critical thinking skills The performance of other nursing acts which are authorized or limited by the board, and which are consistent either with American Nursing’s Association Standards of Practice or with Standards of Practice established by nationally accepted organizations of registered nurses. Care, counsel health teaching and promotion, utilizes Teach Back methodology as affirmation of comprehension The administration of medication, intravenous therapy and treatment as prescribed by a LIP Supervision, delegation and follow-through to other personnel in the performance of activities relating to nursing care. Mentors and precepts students and orient new staff as assigned Reports up chain of command Clinical Nurse Manager/Nurse Manager/House Nurse Coordinator pertinent information Participates on various teams, committees or performance improvement initiatives Ensures a safe and secure environment for patients, coworkers and self Participates in Discharge Planning and Transition of Care (able to define pt needs) Serves as a patient advocate and escalates patient related concerns timely Timely documents pertinent findings in medical record Assist patients in performing activities of daily living and functions as an active team member Assumes responsibility for personnel professional development Utilizes effective communication skills and active listening, exhibits compassionate and empathetic attitude Practices Hands Off communication utilizing SBAR; Performs Bedside Shift reporting utilizing SBAR (unless contradicted) Functions as a positive influence, role model and adheres to professional code of conduct Respects dignity and confidentiality of all matters relating to patients Refer to Special Addendum and Staff Nurse Position Description Performs other job duties as assigned. Qualifications Bachelor's Degree Preferred Associate's Degree Required Mastery of problem solving and decision making skills. Mastery of collaboration and teamwork. Mastery of growth mindset (agility and developing yourself and others) skills. Mastery of execution and delivery (planning, delivering, and supporting) skills. Ability to consider the relative costs and benefits of potential actions to choose the most appropriate one. Ability to function in clinical setting with diverse cultural dynamics of clinical staff and patients. Mastery knowledge of phases of care transitions and resources available for patients. Mastery of digital literacy skills. Registered Nurse. Required BLS upon hire Required De-Escalation Training within 6 months of hire Required Advanced Dysrhythmia/EKG (Med/Surg telemetry unit ONLY) Required
Appalachian Regional Healthcare

Certified Nurse Aide-Non Union

Overview The Nurse Aide is responsible for performing basic nursing procedures in assisting in the care of patients. Responsibilities Provides personal care including bath, shampoo, shave, back rub, positions patients, makes beds, prepares patients for meals, feeds patients, and passes ice water. Answers all signal lights and bells promptly to determine and meet patient needs. Collects specimens, stool, urine, sputum, etc. Collects input and output and records appropriately. Collects and records vital signs on patient. Obtain and records pertinent patient information per hospital policy. Assists and/or feeds patients, provides between meal nourishment’s, provides fresh drinking water and encourages fluids when indicated. Assists in progressive ambulation of patients by wheelchair, stretcher, and bed. Administers enemas, douches and inserts rectal tubes and documents appropriately. Applies ace bandages and elastic stockings, fills hot water bottles, ice bags, pads and humidifiers. Cares for Foley catheters and Levine tubes as instructed by nurse. Applies condom drains and scrotal suspensatories, unsterile compresses, and binders. Gives postmortem care and transports body to morgue. Applies restraints and siderails to assure safety of patients. Observes isolation technique and gives direct patient care to patients on isolation. Assists in colostomy care. Sets up Orthopedic appliances. Runs errands, delivers messages, and answers telephone. Maintains a safe environment. Observes for and reports safety hazards, and prepares incident reports. Prepares patients for surgery, x-ray and other therapeutic and diagnostic procedures. Prepares patients for examination and treatment: Remains with patients unless relieved; Performs such duties as providing proper equipment, supplies, and adjusting lights; Cleaning up and restocking of area, including supplies and equipment. Assists in the orientation of the new patient to his surroundings. Assists in maintaining a sanitary and safe environment in service and nursing areas. Participates in team conferences, in-service education programs and staff meetings. Assists other hospital employees as needed, i.e. OR Aide returning patients from the Recovery Room, x-ray, etc. (when indicated). Assists with admissions, transfers, and discharges of patients. Performs other related duties as assigned. Qualifications Successful completion of hospital approved Nursing Aide Training Program. Three (3) months on-the-job training is required to attain proficiency of performance of assigned duties and responsibilities. Additional training may be required and given, to work in some areas; i.e. competency listing with the State of Kentucky to work in SNF.
Appalachian Regional Healthcare

Director of Nursing Services I

Overview The Director, Nursing Services is accountable for the overall administration of the department in order to meet the objectives of the hospital through planning, organizing, executing and evaluating the nursing care provided for patients in the hospital. Responsibilities Manage the department in an efficient manner by planning, organizing and controlling all activities of the department. Formulate and implement the objectives of the department in accordance with hospital goals. Develop, evaluate, implement, interpret and maintain hospital plans and work standards and procedures for the clinical practice of nursing that are in compliance with hospital policies, governmental regulations and various regulatory agency requirements. Serve as a role model for nursing staff by complying with established policies and procedures. Supervise the implementation of total quality management concepts which are used to determine effectiveness of nursing care delivery systems throughout the hospital. Participate as a member of the key management hospital team and in hospital strategic planning activities. Interpret the role of nursing for the hospital's strategic plans. Manage the personnel function by interviewing, selecting, evaluating, disciplining and terminating personnel or recommending such action as necessary. Assure that employees receive orientation and required in-service training, that they maintain required licensure or certification and that pertinent nursing education programs are developed and presented to promote clinical competency and staff development. Determine staffing needs and patterns and recommend appropriate staffing levels and classifications consistent with unit position authorization. Administer the Bargaining Agreements at the local level as it pertains to Nursing Service personnel. Coordinate the activities of various nursing units and establish productive working relationships with the medical staff and support services. Maintain up-to-date knowledge in the field so they may recommend new services, products and equipment. Continue professional development by attending education programs designed for nursing leaders. May provide direct patient care when higher levels of skill and judgement are required. Demonstrate the skills and knowledge necessary to provide care appropriate to the age of the patient served. Adhere to the infection control policies and procedures of the hospital. Formulate and prepare the departmental budget, routine and special reports and various forms and documents as required. Take administrative calls when delegated by the Administrator. Serve on hospital committee and attend meetings, as required. May work off shifts, weekends and holidays, be on-call and work more than standard hours. Perform other related duties as assigned. Qualifications EDUCATION, TRAINING AND EXPERIENCE : Graduation from an approved school of nursing and current non-limited licensure in state. Bachelor's degree preferred. Minimum of five years experience in nursing supervision and/or administration, with formalized training and/or experience in effective management techniques. Demonstrated leadership and ability to motivate and to work cooperatively with individuals and groups. POSITION PHYSICAL REQUIREMENTS: Must possess physical ability to endure prolonged sitting; moderate walking; lifting and carrying. May require exerting up to 20 pounds of force occasionally; and/or up to 10 pounds of force frequently; and/or a negligible amount of force constantly to move objects. Physical Demand requirements are in excess of those for sedentary work. SPECIFIC ACCOUNTABILITIES : Accountable for assuring the efficient operation of all nursing units in accordance with hospital objectives. Accountable for establishing and achieving nursing department objectives and goals. Accountable for providing a climate for professional growth and development through programs of orientation, evaluation, in-service and continuing education. Accountable for safe, effective patient care in all nursing areas in hospital. Accountable for supervising the implementation of total quality management concepts in all nursing areas in the hospital. Accountable for developing and administering the Nursing Department budget. Accountable for acting as liaison between Nursing Service and other hospital departments.
Appalachian Regional Healthcare

Registered Nurse Tier 1 ICU

Overview The Registered Nurse requires substantial specialized knowledge, judgement and nursing skills based upon the principles of psychological, biological, physical, and social sciences in the application of the nursing process in the respective departments in which assigned. The RN must collaborate with physicians and multidisciplinary team members; provide physical and psychological support to patients, friends, and families; supervising assigned team members and students. Responsibilities Completes patient assessments, formulates plan of care, oversees implementation of plan of care, evaluate and adjust plan of care utilizing critical thinking skills The performance of other nursing acts which are authorized or limited by the board, and which are consistent either with American Nursing’s Association Standards of Practice or with Standards of Practice established by nationally accepted organizations of registered nurses. Care, counsel health teaching and promotion, utilizes Teach Back methodology as affirmation of comprehension The administration of medication, intravenous therapy and treatment as prescribed by a LIP Supervision, delegation and follow-through to other personnel in the performance of activities relating to nursing care. Mentors and precepts students and orients new staff as assigned Reports up chain of command Clinical Nurse Manager/Nurse Manager/House Nurse Coordinator pertinent information Participates on various teams, committees or performance improvement initiatives Ensures a safe and secure environment for patients, coworkers and self Participates in Discharge Planning and Transition of Care (able to define pt needs) Serves as a patient advocate and escalates patient related concerns timely Timely documents pertinent findings in medical record Assist patients in performing activities of daily living and functions as an active team member Assumes responsibility for personnel professional development Utilizes effective communication skills and active listening, exhibits compassionate and empathetic attitude Practices Hands Off communication utilizing SBAR; Performs Bedside Shift reporting utilizing SBAR (unless contradicted) Functions as a positive influence, role model and adheres to professional code of conduct Respects dignity and confidentiality of all matters relating to patients Performs other job duties as assigned. Qualifications Associate's Degree Graduation from an accredited school of nursing. Required Bachelor's Degree Preferred Up to 1 year Preferred Minimum of one (1) year acute care nursing experience (1) year of experience should be relevant to specific department in which they will be working. Refer to addendums for additional requirements. Experience with Electronic Health Record Preferred. Preferred Operates critical care equipment such as respirators, temporary pacemakers, defibrillators, and other emergency equipment. Set-up, maintains, interprets results of cardiac and hemodynamic monitor required and takes action as indicated by nursing practice and hospital procedures. Perform special procedures such as endotracheal and tracheostomy suctioning; tracheostomy care; extubation; cardio-pulmonary resuscitation; arterial punctures; care of chest tubes and pleurevac; set up and assistance with peritoneal dialysis, paracentesis, thoracentesis. Able to manage specialty drips using approved protocols Prior to assignment to unit as sole RN provider, the nurse must successfully complete critical care course acceptable to the Community Chief Nursing Officer and demonstrate mastery of equipment, diagnostic responsibilities, and procedures required of the critical care nurse. Such course work shall include: • Cardiopulmonary resuscitation and management of an obstructed airway. • EKG interpretation. • Drug therapy, including emergency drug therapy via the I.V. route, or routes normally left to the physician. • Hemodynamic monitoring. • Critical care procedures. The nurse shall be adequately oriented to unit policies, procedures and equipment. Orientation shall include safety procedures, infection control practices, and performance improvement activities. Completion of the following Competencies: Moderate Sedation Completion of Stroke Modules Restraints Registered Nurse Required Advanced Dysrhythmia/EKG Required NIH Stroke Certification Required BLS Required Advanced Life Support Certification Required De-Escalation Training within 6 months of hire Required Pediatric Advanced Life Support Certification (recommended) Preferred
Appalachian Regional Healthcare

Registered Nurse Tier 1 Obstetrics

Overview The Registered Nurse requires substantial specialized knowledge, judgement and nursing skills based upon the principles of psychological, biological, physical, and social sciences in the application of the nursing process in the respective departments in which assigned. The RN must collaborate with physicians and multidisciplinary team members; provide physical and psychological support to patients, friends, and families; supervising assigned team members and students. Responsibilities Completes patient assessments, formulates plan of care, oversees implementation of plan of care, evaluate and adjust plan of care utilizing critical thinking skills The performance of other nursing acts which are authorized or limited by the board, and which are consistent either with American Nursing’s Association Standards of Practice or with Standards of Practice established by nationally accepted organizations of registered nurses. Care, counsel health teaching and promotion, utilizes Teach Back methodology as affirmation of comprehension The administration of medication, intravenous therapy and treatment as prescribed by a LIP Supervision, delegation and follow-through to other personnel in the performance of activities relating to nursing care. Mentors and precepts students and orients new staff as assigned Reports up chain of command Clinical Nurse Manager/Nurse Manager/House Nurse Coordinator pertinent information Participates on various teams, committees or performance improvement initiatives Ensures a safe and secure environment for patients, coworkers and self Participates in Discharge Planning and Transition of Care (able to define pt needs) Serves as a patient advocate and escalates patient related concerns timely Timely documents pertinent findings in medical record Assist patients in performing activities of daily living and functions as an active team member Assumes responsibility for personnel professional development Utilizes effective communication skills and active listening, exhibits compassionate and empathetic attitude Practices Hands Off communication utilizing SBAR; Performs Bedside Shift reporting utilizing SBAR (unless contradicted) Functions as a positive influence, role model and adheres to professional code of conduct Respects dignity and confidentiality of all matters relating to patients Performs other job duties as assigned. Training for Labor and Delivery shall consist of the following topics related to both normal and abnormal deliveries: *Admission of labor patient. *Care of the labor patient. *Delivery of labor patient. *Recognition and nursing care of abnormal conditions. *Fetal monitors and nursing intervention. *Appropriate nursing intervention. *Management of Obstetrical Emergencies The nurse shall be adequately oriented to unit policies, procedures and equipment. Orientation shall include safety procedures, infection control practices, and performance improvement activities. Qualifications Associate's Degree Nursing Required Bachelor's Degree Nursing Preferred 1-3 years Preferred Performs initial assessment to include physical exam of OB patient, recognizes abnormal signs and symptoms, and takes action as indicated. Performs special OB procedures as required. Sets up, operates and cleans OB equipment. Provides routine post-partum care including ongoing assessment. Registered Nurse. Required BLS Required Completion of Intermediate Fetal Monitoring Course (AWHONN) within 6 months of hire. Required Neonatal Resuscitation Program (NRP) Required De-Escalation Training within 6 months of hire Required
Appalachian Regional Healthcare

Registered Nurse Tier 2

Overview The Registered Nurse requires substantial specialized knowledge, judgement and nursing skills based upon the principles of psychological, biological, physical, and social sciences in the application of the nursing process in the respective departments in which assigned. The RN must collaborate with physicians and multidisciplinary team members; provide physical and psychological support to patients, friends, and families; supervising assigned team members and students. Responsibilities Completes patient assessments, formulates plan of care, oversees implementation of plan of care, evaluate and adjust plan of care utilizing critical thinking skills The performance of other nursing acts which are authorized or limited by the board, and which are consistent either with American Nursing’s Association Standards of Practice or with Standards of Practice established by nationally accepted organizations of registered nurses. Care, counsel health teaching and promotion, utilizes Teach Back methodology as affirmation of comprehension The administration of medication, intravenous therapy and treatment as prescribed by a LIP Supervision, delegation and follow-through to other personnel in the performance of activities relating to nursing care. Mentors and precepts students and orients new staff as assigned Reports up chain of command Clinical Nurse Manager/Nurse Manager/House Nurse Coordinator pertinent information Participates on various teams, committees or performance improvement initiatives Ensures a safe and secure environment for patients, coworkers and self Participates in Discharge Planning and Transition of Care (able to define pt needs) Serves as a patient advocate and escalates patient related concerns timely Timely documents pertinent findings in medical record Assist patients in performing activities of daily living and functions as an active team member Assumes responsibility for personnel professional development Utilizes effective communication skills and active listening, exhibits compassionate and empathetic attitude Practices Hands Off communication utilizing SBAR; Performs Bedside Shift reporting utilizing SBAR (unless contradicted) Functions as a positive influence, role model and adheres to professional code of conduct Respects dignity and confidentiality of all matters relating to patients Performs other job duties as assigned. Qualifications Bachelor's Degree Preferred Associate's Degree Required Mastery of problem solving and decision making skills. Mastery of collaboration and teamwork. Mastery of growth mindset (agility and developing yourself and others) skills. Mastery of execution and delivery (planning, delivering, and supporting) skills. Ability to consider the relative costs and benefits of potential actions to choose the most appropriate one. Ability to function in clinical setting with diverse cultural dynamics of clinical staff and patients. Mastery knowledge of phases of care transitions and resources available for patients. Mastery of digital literacy skills. Registered Nurse. Required BLS upon hire Required De-Escalation Training within 6 months of hire Required Advanced Dysrhythmia/EKG (Med/Surg telemetry unit ONLY) Required
Appalachian Regional Healthcare

Head Nurse Manager

Overview The Head Nurse Manager is accountable for the supervision of nursing services within an assigned unit in order to provide safe, effective and efficient nursing care. Responsibilities Supervises the department in an efficient manner by planning, organizing and controlling all activities of the department. Implement, interpret and enforce work standards and procedures within the unit that are in compliance with hospitals policies, governmental regulations and various regulatory agency requirements. Serve as a role model for nursing staff by complying with established policies and procedures. Incorporate total quality management concepts into unit operations. Develop, implement, monitor and enforce the principles of effective nursing care on the unit. Develop effective communications between unit personnel, physicians and other departments to assure continuity, coordination and collaboration in delivering services. Provides direct patient care when higher levels of skill and judgement are required. Demonstrate the skills and knowledge necessary to provide care appropriate to the age of the patient served. Relieve other Head nurse managers and Nurse Supervisors as required. May work different shifts and/or days for orientation, training and evaluation of personnel in the unit. Maintain up-to-date knowledge in the field so they may recommend new services, products and equipment. Continue professional development by attending education programs designed for nursing leaders. Interview, select, evaluate, discipline and terminate personnel or recommending such action as necessary. Assure that employees receive orientation and required in-service training and that they maintain required licensure or certification. Maintain personnel records as required. Develop work schedules and assign unit personnel on the basis of patient needs and appropriate nursing intervention. Head Nurse Manager Position Description Page 2 Supervise labor relations activities in the assigned area. Prepare the departmental budget, routine and special reports and various forms and documents as required. Attend or conduct meetings as necessary. Adhere to the infection control policies and procedures of the hospital. May work off shifts, weekends and holidays, be on-call and work more than standard hours. Perform other related duties as assigned. Qualifications Graduation from an approved school of nursing and current non-limited licensure in state. BS or MSN is preferred. Minimum of five (5) years experience and demonstrated management and clinical skills.
Appalachian Regional Healthcare

Certified Nurse Aide-Non Union

Overview The Nurse Aide is responsible for performing basic nursing procedures in assisting in the care of patients. Responsibilities Provides personal care including bath, shampoo, shave, back rub, positions patients, makes beds, prepares patients for meals, feeds patients, and passes ice water. Answers all signal lights and bells promptly to determine and meet patient needs. Collects specimens, stool, urine, sputum, etc. Collects input and output and records appropriately. Collects and records vital signs on patient. Obtain and records pertinent patient information per hospital policy. Assists and/or feeds patients, provides between meal nourishment’s, provides fresh drinking water and encourages fluids when indicated. Assists in progressive ambulation of patients by wheelchair, stretcher, and bed. Administers enemas, douches and inserts rectal tubes and documents appropriately. Applies ace bandages and elastic stockings, fills hot water bottles, ice bags, pads and humidifiers. Cares for Foley catheters and Levine tubes as instructed by nurse. Applies condom drains and scrotal suspensatories, unsterile compresses, and binders. Gives postmortem care and transports body to morgue. Applies restraints and siderails to assure safety of patients. Observes isolation technique and gives direct patient care to patients on isolation. Assists in colostomy care. Sets up Orthopedic appliances. Runs errands, delivers messages, and answers telephone. Maintains a safe environment. Observes for and reports safety hazards, and prepares incident reports. Prepares patients for surgery, x-ray and other therapeutic and diagnostic procedures. Prepares patients for examination and treatment: Remains with patients unless relieved; Performs such duties as providing proper equipment, supplies, and adjusting lights; Cleaning up and restocking of area, including supplies and equipment. Assists in the orientation of the new patient to his surroundings. Assists in maintaining a sanitary and safe environment in service and nursing areas. Participates in team conferences, in-service education programs and staff meetings. Assists other hospital employees as needed, i.e. OR Aide returning patients from the Recovery Room, x-ray, etc. (when indicated). Assists with admissions, transfers, and discharges of patients. Performs other related duties as assigned. Qualifications Successful completion of hospital approved Nursing Aide Training Program. Three (3) months on-the-job training is required to attain proficiency of performance of assigned duties and responsibilities. Additional training may be required and given, to work in some areas; i.e. competency listing with the State of Kentucky to work in SNF.
Appalachian Regional Healthcare

Registered Nurse Tier 1 (Union) OR

Overview The Registered Nurse requires substantial specialized knowledge, judgement and nursing skills based upon the principles of psychological, biological, physical, and social sciences in the application of the nursing process in the respective departments in which assigned. The RN must collaborate with physicians and multidisciplinary team members; provide physical and psychological support to patients, friends, and families; supervising assigned team members and students. Special Instructions RN circulator Monday-Friday 7:15am-3:45pm with call Responsibilities Completes patient assessments, formulates plan of care, oversees implementation of plan of care, evaluate and adjust plan of care utilizing critical thinking skills The performance of other nursing acts which are authorized or limited by the board, and which are consistent either with American Nursing’s Association Standards of Practice or with Standards of Practice established by nationally accepted organizations of registered nurses. Care, counsel health teaching and promotion, utilizes Teach Back methodology as affirmation of comprehension The administration of medication, intravenous therapy and treatment as prescribed by a LIP Supervision, delegation and follow-through to other personnel in the performance of activities relating to nursing care. Mentors and precepts students and orient new staff as assigned Reports up chain of command Clinical Nurse Manager/Nurse Manager/House Nurse Coordinator pertinent information Participates on various teams, committees or performance improvement initiatives Ensures a safe and secure environment for patients, coworkers and self Participates in Discharge Planning and Transition of Care (able to define pt needs) Serves as a patient advocate and escalates patient related concerns timely Timely documents pertinent findings in medical record Assist patients in performing activities of daily living and functions as an active team member Assumes responsibility for personnel professional development Utilizes effective communication skills and active listening, exhibits compassionate and empathetic attitude Practices Hands Off communication utilizing SBAR; Performs Bedside Shift reporting utilizing SBAR (unless contradicted) Functions as a positive influence, role model and adheres to professional code of conduct Respects dignity and confidentiality of all matters relating to patients Refer to Special Addendum and Staff Nurse Position Description Performs other job duties as assigned. Qualifications Associate's Degree Nursing Required Bachelor's Degree Preferred Up to 1 year Preferred Assures all members of the surgical team have been instructed in the surgical procedures performed and periodically updates personnel on new techniques, instrumentation and procedures. Prepares for each assigned case by ensuring the room is properly prepared and equipped, the required documentation is present on the medical record, and the patient is properly identified. Prepares the patient for operative procedure by positioning and grounding the patient as required, securing the patient on the table, assisting with intubation, and preparing operative site. Accompanies the patient to recovery room and may be required to provide nursing care in the recovery room. Monitors operative procedures by documenting proper patient positioning, breaks in sterile procedure, instrument, needle and sponge counts, preservation and labeling of all specimens, drugs and blood administration, and critical incidents during the operative procedure. Functions as a team member within the surgical department by assisting with gowning and gloving; procuring required medication, blood and supplies; coordinating involvement of other departments with the procedure; properly processing operative specimens. Maintains a safe and productive work environment by assisting with cleaning, maintenance, and re-supply. Successful completion of a training program and demonstrated competence in circulating nurse duties as determined by the Director of Surgical Services. The nurse shall be adequately oriented to unit policies, procedures and equipment. Orientation shall include safety procedures, infection control practices, and performance improvement activities. Training for OR shall consist of completion of competencies in various areas or roles the nurse will function. RN Required Basic Life Support Certification Required ACLS Required PALS Required De-Escalation Training within 6 months of hire Required
Appalachian Regional Healthcare

Care Manager I

Overview The Care Manager is accountable for outcomes as related to providing coordination of patient management through the continuum of care. Responsible for financial, clinical, and discharge planning evaluation for each assigned patient. Assures payment for services rendered, coordinates care, manages resources, and facilitates each patient encounter for efficient and effective outcomes as related to quality, clinical and cost areas. Responsibilities Manages an assigned caseload of patients from preadmission to discharge. Assumes responsibility for admission appropriateness (medical necessity), (outpatient, observation, inpatient admission), continued stay, and medical record monitoring Coordinates communication with third party payers, external review agencies and the Utilization Committee. Identify managed care issues and address promptly as related to denials management Coordinates and collaborate with physicians, provider, multidisciplinary team and other health care professionals concerning patient’s goals, plan of care and progress. Revise and adjust on a daily basis the plan of care to accommodate the needs of the individual patient based on continuing assessment of patient condition. Leads discharge planning multidisciplinary team meetings, ensures documentation of meetings Advocate for the patient/family and is knowledgeable of and act in accordance with legal principles of consent, healthcare proxies (power of attorney for healthcare) and advance medical directives. Stays abreast of developments in the case management field and seeks ongoing education to enhance practice skills. Care Management is willing to seek certification in case management field if made available through ARH. Stays abreast of regulatory agency guidelines as pertains to area of practice Initiate and monitor clinical care guidelines and analyze positive and negative variances Ensure continuity of care through formulation of discharge plan on admission and follow though until patient is discharged. Ensure appropriate use of resources. Monitor patient care for appropriate use of resources. Monitors length of stay on a concurrent, weekly, and monthly basis. Ensures that length of stay is appropriate based on medical necessity. Works with medical staff, hospital staff, and others to overcome barriers to discharge. Monitors in-house denials for extended lengths of stay. Participates in the denials management process to help ensure establishment of and adherence to processes that will minimize denials by third-party payers. Participates as a member of the Utilization Committee Assists in the collection of data to trend and analyze outcomes for identification of improvement opportunities. Participates in data collection, specific to outcomes data. Assesses the appropriateness of the level of care; diagnostic testing and clinical procedures; quality and clinical risk issues; and documentation of medical record completeness. Performs other related duties as assigned. Qualifications Associate's Degree Registered Nurse (licensed in state of employment) from an accredited school for nursing Preferred Bachelor's Degree Nurisng; Must be obtained within 5 years Preferred 4-6 years 5 Years of nursing experience may be considered with demonstration of skills required for the position. Preferred Advanced knowledge of problem solving and decision making skills. Strong multi-tasking abilities with the ability to handle competing deadlines; flexible and adaptable. Ability to deal tactfully with customers and community. Advanced communication skills used to lead a team. Advanced execution and delivery (planning, delivering, and supporting) skills. Ability to consider the relative costs and benefits of potential actions to choose the most appropriate one. Ability to function in clinical setting with diverse cultural dynamics of clinical staff and patients. Mastery knowledge of phases of care transitions and resources available for patients. Mastery of digital literacy skills. Ability to handle sensitive information ethically and responsibly. RN Preferred LPN Required