RN (FLEX) - Critical Care - The Brookdale Hospital Medical Center

Under the supervision of the Nurse Manager, Critical care Nurses provide direct and individualized nursing care to patients based on the application of scientific nursing principles. In addition to general nursing care, responsibilities of Critical care Nurses include (but are not limited to):

Assessment: Conducts ongoing focused physical, psychosocial, and pain assessments; includes assessment of patient education needs.

Planning: Utilizes the assessment, identifies problems, and makes nursing diagnoses, formulate goals, teaching plans and outcomes to create an individualized plan of care.  Identifies individual patient goals, readiness to learn, and incorporates family into the plan of care.

Implementation: Prioritizes and implements an efficient nursing plan of care.

Evaluation/Reassessment: Consistently conducts timely evaluations, recognizes changes in patient conditions, determines when reassessments are needed, and adjusts the plan of care as necessary. Compares expected and achieved outcomes of nursing care utilizing the plan of care.

Evaluate patient’s response to interventions and communicates with other healthcare team members the need to revise or maintain plan of care.

• Utilizes the nursing process in taking care of the patient.
• Assesses condition of the patient and documents findings in EHR.
• Utilizes principles of Infection Control in the delivery of care.
• Implements appropriate nursing interventions to facilitate recovery of patient and prevent complications.
• Evaluate patient’s response to interventions and communicates with other healthcare team members the need to revise or maintain plan of care.
• Implements discharge planning based on patient care needs.
• Initiates and documents patient education based on treatment plan in the language that the patient understands.
• Documents assessment, interventions, changes in the patient’s condition and response to interventions based on hospital policy on documentation.
• Initiates appropriate actions effectively in an emergent situation.
• Prioritizes tasks and adjusts priorities, maintain orderly, efficient, and timely flow of patients.
• Recognizes and reports errors or unusual occurrences, and initiates corrective action when appropriate.
• Makes accurate, complete, and timely entries into the patient medical record addressing all steps of the nursing process.
• Actively communicate with all members of the healthcare team, patient, and patient family and then assess, plan, implement and evaluate patient care.
• Know how to start standard interventions to stabilize the patient.
• Communicates with colleagues and interdisciplinary team about the prevention, treatment and patient care needs of the patient that has pressure injuries (reports, dietary consults, communicates with physicians).
• Basic cardiac rhythm monitoring techniques, interpretation, and treatment. 
• Recognizes lethal arrhythmias and acts appropriately. Initiates corrective action whenever information from monitoring equipment shows adverse symptomatology.
• Recognize the signs and symptoms of cardiopulmonary and respiratory emergencies and knowing how to start standard interventions to stabilize the patient.
• Prepares and administers (orally, subcutaneously, through an IV) and records prescribed medications. Reports adverse reactions to medications or treatments in accordance with the policy.
• Calculate drug dosage, administering continuous medication infusion, and monitoring patients for effects of medication. 
• IV pump setup. Use of Doppler. Phlebotomy /IV start.
• Cardio pulmonary monitoring/ Arrhythmia recognition & treatments.
• Medication Indication, dosage, action, side effects of anti-platelets/ coagulants.
• Blood and blood product transfusions and assists with Massive  blood transfusion.
• Care of mechanically ventilated.
• Assisting with Emergency Management.
• Urinary Catheterization – Male and Female.
• Start standard interventions to stabilize the patient.
• Communicates with colleagues and interdisciplinary team about the treatment and patient care needs of the patient that has pressure ulcers (reports, dietary consults, communicates with physicians).
• Management patient post neuro procedure, or Neuro patient transferring from Surgical intensive care unit. 
• Have knowledge of all vasoactive Drugs such as Vasopressors, Inotropes, Catecholamine, and Adrenergic. Calculate and administer according to the guideline.
• Monitors and adjusts specialized equipment used on patients, and interprets and records electronic displays, such as intracranial pressures, arterial line pressures, central venous pressures, pulmonary artery pressures, Balloon Pump, Hypo/Hyperthermia machine, CVVHD, Peritoneal Dialysis.  
• Initiates patient education plan, as prescribed by physician. Teach patients and significant others how to manage their illness/injury, by explaining: post-treatment home care needs, diet/nutrition/exercise programs, self-administration of medication and rehabilitation.
• Demonstrates efforts in the prevention of hospital acquired conditions (HAC) CAUTI, CLABSI, Pressure injuries and Falls.
• Records all patients’ medical information concisely, accurately and completely, in a timely manner, in the appropriate format and on the appropriate forms.
• Prepares equipment and assists physician during examination and treatment/procedures of patient at the bedside.
• Participates in the formulation, review and or revision of departmental policies.
• Proactively participates in performance improvement initiatives to continuously improve the quality of patient care.
• Uses hospital resources effectively in providing patient care. Follows the process of reporting broken equipment.
• Recovering patient after sedation analgesia.
• Transferring patient  to floor after  verbal report/electronic report using Hand-off.
• Involves Patient and family in discharge teaching. Discharge patients safely if out patients.
• Performs other duties as assigned within the RN scope of practice.

Education:

Internal & 1199 SEIU:

• Graduate of accredited nursing program(s).
• Bachelor's degree in Nursing preferred.

Non 1199 SEIU Candidates:

• Bachelor’s degree in Nursing or equivalent to BSN program.
• Master's degree in Nursing, preferred. 

Experience:

• Minimum two (2) years' Telemetry experience required.
• Minimum one (1) year Critical Care nursing or equivalent experience preferred.

Knowledge and Skills:

• Knowledge of Neuro assessment, and documentation, NIHSS scale.
• Knowledge of critical lab values. 
• Critical thinking, math, and computer skills; Works as a team player. 
• Demonstrates respect and professionalism in all interactions.
• Excellent oral and communication skills. 
• Decision making and problem solving. 
• Able to read, write, see and hear English.

Licenses, Certifications:

• Current NY State RN License required.
• Basic Life Support (BLS) required.
• Advanced Cardiovascular (ACLS) required.
• CCRN (required within one (1) year of hire).
• Basic Arrhythmia Class with Certificate required.
• Stroke Certification required.
• Trauma Care After Resuscitation (TCAR) required.

Physical Requirements:

• Physically demanding, high-stress environment requiring prolonged periods of standing, reaching, walking throughout the working day. 
• Position will be required to stoops, bends, lifts, carry items weighing up to 35 pounds for routine performance of essential functions.
• An individual in this position may be exposed to: Adverse indoor environmental conditions, Blood borne pathogens, Blood and body fluids, Physical hazards (e.g., needle pricks, etc.), communicable diseases, chemical hazards, radiation, and repetitive motions.
• Full range of body motion, able to lift up to 100 pounds, if necessary, to assist lifting and moving patients.
• Manual and finger dexterity, as well as hand and eye coordination.
• Corrected vision and hearing to within normal range
• Frequently sitting at desk working on computer
• Ability to flex working hours.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The statements herein are intended to describe the general nature and level of work being performed by employees, and are not to be construed as an exhaustive list of responsibilities, duties, and skills required of personnel so classified. Furthermore, they do not establish a contract for employment and are subject to change at the discretion of The Brookdale Hospital Medical Center.

BHMC is an equal opportunity employer, it is our policy to provide equal opportunity to all employees and applicants for employment without regard to race, color, religion, national origin, marital status, military status, age, gender, sexual orientation, disability or handicap or other characteristics protected by applicable federal, state, or local laws.