Job Summary: 

The Registered Nurse provides direct care in the Perioperative settings. The Perioperative RN is directly responsible to the Team Lead Operating Room Manager and Director of Surgical Services and indirectly to the House Supervisor. Communicates with physicians/Nurse Manager/ Team Lead/coworkers, as appropriate, about changes in the patients’ clinical condition including results of diagnostic studies and symptomatology and act as a patient advocate. The Registered Nurse is responsible for the delivery of patient care through the nursing process of assessment, planning, implementation, and evaluation. The Registered Nurse is able to respond quickly and accurately to changes in condition or response to treatment. They will need to perform general nursing duties as appropriate for level of care. Additionally, they will participate in performance improvement, quality and service excellence activities.

Responsibilities: 

• Assess the health status of assigned patients by data collection through interview, observation, inspection, auscultation, palpation, reports, and records
• Consistently completes an accurate initial assessment and reassessments on all patients requiring Perioperative care
• Adjusts frequency of assessment as appropriate for patient’s condition and reassess nursing action for effectiveness in achieving desired outcome. Accurately documents patients’ physical assessments and report abnormalities to the practitioner
• Follows guidelines for perioperative patients according to hospital policy (I.e., history and physical, consent, site mark, PACU discharge criteria, etc.)
• Monitor hemodynamic status of the patient and correctly interpret the results and communicate to the physician any abnormal results
• Assist physicians with special tests and procedures in the unit using time out for bedside procedures (Universal Protocol policy)
• Works with other departments to provide a continuum of care and co-workers to provide continuous, quality patient care, efficient patient flow and unit maintenance and organization.
• Responsible for adherence to regulations, standards and hospital or unit policies and procedures. Responsible for participation in Performance Improvement activities, unit meetings and in services.
• Ensure crash cart, defibrillation function have been checked per protocol and after each code, appropriate items are immediately replaced and indicated by signature on crash cart check list.
• RN conducts timely and accurate assessments, initiates appropriate interventions, and communicates with surgeon and anesthesia.
• RN evaluates and anticipates changes in patient condition or surgical course. Is able to manage and/or prevent emergencies or adverse events.
• Completes all work in organized and timely manner ensuring that all orders written are carried out within the appropriate time frame and documentation is performed in “real time” in the current operating room module.
• RN adheres to the current Patient safety standards, OSHA bloodborne pathogens standards and CDC guidelines, such as proper hand washing and using two patient identifiers (MAR’S, SBAR, Hand off communication).
• RN demonstrates knowledge and environmental awareness by maintaining clean/unobstructed work area. Communication style (verbal and nonverbal) is professional, courteous, polite, and respectful to all customers.
• Makes clear and logical decisions while using resources appropriately (including self).
• Demonstrates flexibility to assignment, schedules, and staffing.
• Prepares surgical suite for the operation. Demonstrates appropriate counting of instruments, sponges, and sharps per departmental protocol/policy. Exhibits knowledge of appropriate protocol for an incorrect count.
• Ensures that all proper documents are on the chart and completed within the designated time frame prior to leaving the Holding Room. (Anesthesia consent, surgical consent, H&P, etc.). Ensures the patient is marked by the appropriate staff per policy if undergoing a procedure with a predetermined laterality.
• Monitors sterile field until released by anesthesia, reports and corrects any break in sterile technique.
• Monitors all instrumentation and equipment during use, (i.e. electrocautery instruments, electric & pneumatic drills, light sources, insufflation devices, etc.) for placement, settings and functioning, paying attention to any and all audible alarms.
• Verifies medication name, route, dosage, and expiration date with surgical tech before medication is placed on surgical field. Ensures medication on the field has been labeled appropriately by the surgical tech.
• Demonstrates appropriate handling/labeling of surgical specimens.
• Consistently and appropriately performs “time out” according to facility policy.
• Independently recognizes and performs duties which need to be done without being directly assigned. Establishes priorities: organizes work and time to meet them.
• Willing to scrub procedures as needed.
• Recognizes and understands that as a member of an interdependent group, collaboration and compromise is required in order to maintain the effectiveness of the group as a whole to effectively resolve problems.
• Timely notification to Director of Surgical Services of potential problems or concerns. When faced with a problem or concern, is proactive by presenting suggested solutions at the time that the Director of Surgical Services is made aware of the problem.
• Is knowledgeable and adheres to JACH/CMS standards specific to the position.
• Attends schedules in-service and mandatory in-services. Communicates ideas to Director for a safer layout of equipment, tools, and/or processes.
• Adheres to procedures for the disposal of waste – household waste and biohazard waste as well as the proper disposal of sharps.
• Administer medications using Rights of Medication Administration. Initiates, titrates and safely monitors all IV medications and blood components. Consistently uses two patient identifiers when drawing labs, medicating, or performing any procedure on a patient and administering blood components
• Adheres to procedures for the disposal of waste—household waste and biohazard waste as well as the proper disposal of sharps
• Follow medication reconciliation policy
• Adequately assess and reassess pain, after giving pain medication and upon discharge. Accurately documents information on the patient record
• Document concise, timely and complete nursing care in EMR, using only appropriate abbreviations.
• Reviews and implements new orders and keeps physician informed of changes in patients’ clinical status. Consistently follows policy regarding telephone/verbal orders and the using of “read back”. Accurately records and/or processes orders in a timely manner
• Initiates and updates patients plan of care
• Initiate discharge and patient/family education planning with proper documentation in the EMR
• Gives thorough, detailed and efficient change of shift report using the SBAR format to ensure consistency in the plan of care
• Demonstrates empathy and respect for patients by explaining all procedures and care while providing privacy and allowing patients to express emotional needs. Understands, respects, and displays sensitivity to culture, age and persons with disabilities
• Ensures crash cart and defibrillation function have been checked per protocol and after each code, appropriate items are immediately replaced and indicated by signature on crash cart checklist
• Knowledge of National Patient Safety Goals. Comply with federal, state, and local laws that govern business practices. Comply with all Department of Health Services requirements for CMS and The Joint Commission standards that apply to the position
• Is in compliance with information contained in the Infection Control policies (OSHA Bloodborne pathogen standards, CDC Guidelines), and demonstrates appropriate use of personal protective equipment (I.e. gloves, gowns, masks, goggles) and hand washing techniques
• Uses proper body mechanics at all times. Seeks assistance when necessary to move heavy objects or to transport/transfer a heavy patient
• Complies with all hospital safety and injury prevention policies and regulations (hospital safety policies and procedures)
• Recognize signs of child and elder abuse and report appropriately to Social Services and/or Child/Adult Protective Services
• Consistently ensure that all clinical alarms are set with the appropriate parameters for the patient and are audible at all times
• Independently recognizes and performs duties which need to be done without being directly assigned. Establishes priorities; organizes work and time to meet them
• Recognize and respond to priorities, accept new ideas, have insight into problems, and the ability to develop workable alternatives
• Uses time effectively and constructively. Does not abuse supplies, equipment and services
• Accepts constructive criticism in a positive manner
• Adheres to attendance and punctuality requirements per hospital policy. Provides proper notification for absences and tardiness. Takes corrective action to prevent recurring absences or tardiness
• Observes dress code policy and wears hospital identification as required by our policies and procedures
• Observes all hospital and departmental policies governing conduct while at work (e.g., telephone and computer use, electronic messaging, smoking regulations, parking, breaks and other related policies)
• Conducts business in an ethical and trustworthy manner at all times when dealing with patients, visitors, physicians and fellow employees
• Participates actively and positively affects the outcomes of customer service activities
• Demonstrates a positive professional image; performs responsibilities in a professional manner and works within the goals regarding hiring policies and procedures
• Understands and abides by all departmental policies and procedures as well as the Codes of Ethics, HIPAA requirements and patient rights
• Complies with federal, state, local laws that govern business practices. Complies with all Ohio Department of Health Services requirements and standards that apply to the position
• Is knowledgeable of all emergency codes and emergency preparedness procedures and understands his/her role in response to each of the emergency codes (Code Blue, Code Pink, Code Green, Code Stroke, Code Orange, Code Yellow, Code Gray, Code Silver, Code Violet, etc.)
• Displays honesty and respect for others, and respect for the organization as evidenced by: 
• Treating internal and external customers as the most important part of the job 
• Being sensitive to customers’ emotions, thoughts and feelings 
• Refraining from negative comments of any kind where the public or other customers can hear 
• Taking appropriate actions to resolve concerns 
• Interacts with coworkers, other hospital staff, physicians, and the public in a courteous, professional and efficient manner 
• Is a team player and communicates effectively at all times
• Facilitates and enhances communication as evidenced by: 
• Effective and timely processing of customers' requests according to hospital and departmental policies
• Utilizing verbal communication methods, which enable others to clearly understand what is being said
• Utilizing verbal and nonverbal behaviors without being defensive, manipulative, aggressive or controlling
• Using written communication that is legible, timely and at a level based on the position specific requirements
• Listening attentively to ensure effective two-way communication 
• Expressing and accepting feedback in a professional manner 
• Answering the telephone with stating department, name and greeting 
• Uses effective collaborative strategies as evidenced to include: 
• Developing peer relationships that enable the work group to accomplish the daily workload within the allotted time frame and achieve departmental goals 
• Recognizing and understanding that as a member of an interdependent group, collaboration and compromise is required in order to maintain the effectiveness of the group as a whole to effectively resolve problems
• Timely notification to Department Manager of potential problems or concerns. When faced with a problem or concern, is proactive by presenting suggested solutions at the time that the Department Manager is made aware of the problem or concern
• Displaying teamwork ability to promote cooperation and collaboration; gaining support for programs and goals
• Continually strives for self-improvement in areas of responsibility by attending continuing education classes
• Seeks out educational opportunities to promote management growth and current knowledge in areas relating to Patient Satisfaction surveys
• Attends scheduled in-services and mandatory in-services  
• Understands the Continuous Quality Improvement process and apply it in performing everyday tasks/duties and actively participate as necessary
• Understands performance improvement concepts and demonstrates understanding by defining performance improvement, and verbalizing at least one major goal of the performance improvement program within the hospital setting; ability to describe a quality improvement problem solving process using the Plan, Do, Check, Act (PDCA) model and how its use assists in reaching improving patient outcomes and/or organizational quality improvement goals
• Performs other duties as assigned, or required

Education and Experience:

• Current and valid RN license in the State of Ohio
• BLS and ACLS upon hire and maintain current
• PALS within 6 months of hire and maintain current
• Previous Acute Care hospital experience preferred
• Minimum of 2 years of experience in an acute care operating room preferred.

Required Skills/Abilities:

• Must possess strong computer skills to include EMR and Microsoft Outlook
• Must be able to handle stress of working efficiently with frequent interruptions and distractions
• Must be highly motivated and willing to work additional jobs and duties as needed
• Must be able to prioritize tasks 
• Strong computer skills to include Microsoft Word, Excel, PowerPoint, EMR and database products.
• Hours must be flexible to accommodate for needs during call shifts, Accreditation surveys or other unscheduled events.
• Use of telephones, fax/copy machines
• Hours must be flexible to meet the needs of the department
• Must be willing to take call on nights, weekends and holidays.
• Must be willing to float to other departments to meet patient care needs

Physical Requirements:

• Frequent Sitting, standing and walking 
• Occasionally reaching, bending, pulling, pushing, twisting and squatting 
• Occasional hand and wrist deviation 
• Occasionally lift/carry up to 50 pounds  
• Occasionally be exposed to hazardous chemicals or infections and Ionizing radiation 
• Occasionally required to wear Personal Protective Equipment

The above statements reflect the general duties considered necessary to describe the principal functions of the job as identified and shall not be considered as a detailed description of all the work assignments that may be inherent in the job. This document is not an exhaustive list of all responsibilities, skills, duties, requirements or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.