Staff Nurse- Operating Room

Position Purpose

The Registered Nurse is responsible for the delivery of safe, effective and quality patient-family centered care in the Operating Room for all patient population by utilizing Nursing Care Plans. Collaborates with Physicians, Medical Professionals and other Staff to ensure that the unique, physical and psychosocial needs of the patient are met. The Registered Nurse involves appropriate parties (i.e., patient's family or guardian, outside agencies) in the assessment, treatment and continuing care of the patient as needed. Supports the Mission, Vision, and Values of Doctors Community Hospital.

Role Specific Competencies

1. Adheres to professionalism standards.

• Serves as a role model/resource for other team members and exhibits flexibility and adaptability to change in department practices.
• Identifies strengths and development needs of self.
• Identifies active/potential problems and seeks appropriate solutions to those problems, and assumes responsibility and accountability for "judgments" and actions.
• Appearance consistently complies with department policy.
• Participates in orientation and training of new personnel.
• Utilizes work time productively.
• Willingness to cover varying shifts as requested.

2. Delivers quality nursing care to surgical patients in the pre, intra and immediate post-operative phase of surgical intervention that is consistent with published standards for nursing practice

• Plans for patient care needs by reviewing assigned scheduled cases / procedures against the surgeon's preference cards.
• Demonstrates competence and knowledge in the assessment, treatment and care of pediatric, adult and geriatric patients within the perioperative setting.
• Asses the physiological health of the patient and psychosocial health status of the patient/family.
• Participates in patient/family/significant other education.
• Provides equipment and supplies based on patient needs and surgeon's preference.
• Provides appropriate positioning devices and assists with positioning the patient safely.
• Appropriately admits and transfers patients per DC H standard/policies and complies with Advanced directive requirements.
• Observes standard precautions and practices aseptic technique in caring for the patient.
• Observes safe practices and maintains a safe environment while caring for the patient.
• Performs nursing actions that demonstrate accountability.
• Orchestrates the services of operating room personnel to provide rapid progression from cleaning to preparing room (OR) for the next case.
• Delegates effectively in daily operations and utilizes critical thinking skills in crisis situations in a calm and professional manner.
• Assists in maintaining surgeon's preference cards for accuracy.
• Enforces and maintains intraoperative standards of care.
• Maintains accurate documentation of nursing care provided to patients during surgery, this includes accurate implant logs and charge supplies.

3. Demonstrates skills and knowledge necessary to provide quality care services for patients.

• Clinical competency skills checklist is maintained and completed prior to annual evaluation.
• Assumes responsibility and accountability for professional development by attending and completing required annual in-services.
• Attends and participates in monthly staff meetings and department specific in-services.
• Initiates and adheres to infection control practices consistent with department and hospital standards.

4. Demonstrates skills and knowledge necessary to provide quality care services for patients.

• Clinical competency skills checklist is maintained and completed prior to annual evaluation.
• Assumes responsibility and accountability for professional development by attending and completing required annual in-services.
• Attends and participates in monthly staff meetings and department specific in-services.
• Participates in on-going evaluation of job performance and identifies personal & professional goals and objectives during each appraisal session.
• Initiates and adheres to infection control practices consistent with department and hospital standards.

5. Develops and implements a plan of care based on nursing diagnosis and subsequent patient outcome goals by using the following interventions:

• Protect patient from injury caused by chemical, electrical, laser, positioning, thermal sources, and extraneous objects.
• Perform sponge, sharp, and instrument counts according to DC H standards to protect patient from unintended retained foreign objects.
• Perform Universal Time-Out Protocol during the surgery to ensure correct site, side and level. The debriefing part of the Time-out ensures that the correct specimen, procedure and any concerns regarding the care of the patient has been addressed.
• Handle patient's specimen according to established DC H protocols.
• Communicate patient's current status throughout the continuum of care.
• Perform interventions to maintain the status of the patient's organ systems at or above baseline levels.
• Perform interventions to ensure the patient is at or returned to normothermia at the conclusion of the immediate postoperative period.
• Creates and maintains a sterile field; monitors the traffic in and out of the OR.
• Administers drugs and solutions as prescribed to the patient / sterile field per DC H standards in compliance with the Maryland Nurse Practice Act.
• Physiologically monitors the patient during surgery.

6. Perform activities that support Nursing Staff and facilitates patient care.

• Assists with room tum-over and clean up after each case.
• Assists with environmental services support such as linen management, trash removal and cleaning of equipment when needed.
• Assists with returning unused instruments, equipments and supplies after each case, as appropriate.
• Assists with the transfer and positioning of patients on and off the OR table, stretcher, bed, etc.
• Saves all used supply wrappers for charge purposes.
• Reports to Operations C oordinator seeking additional responsibility when assignments are completed.
• Demonstrates ability to react quickly and confidently to changing priorities and stressful emergency or conflict situations.

7. Performs professional development activities. Participates in orientation and training of new personnel.

• Participates in the development of unit and hospital based standards of practice.
• Demonstrates willingness to pursue leadership roles with increasing levels of accountability, comfort with decision-making
• responsibilities, coaching, teaching and counseling skills, and the ability to inspire and build confidence in others.

8. Performs special department assignments and stocking functions in the Surgical Suite within established time frames while following department policies and procedures, Infection Control practices, Blood Borne Pathogen procedures, OSHA Standards, and Universal Precautions.

• Assists with restocking OR rooms at the end of shift in accordance with established PAR levels, as needed.
• Assists with checking supply outdates.
• Demonstrates knowledge of techniques, procedures, and correct use of personal protective equipment (PPE).
• Reports malfunction of equipment/instrumentation to Operations Coordinator and lor IPS Manager and / or Equipment Manager immediately upon completion of procedure.
• Tags and removes malfunctioning equipment in need of repair from use.
• Assists with clearing the hallways and returning equipments and supplies to proper storage throughout the day.
• Assists in docking the Neptune machine at the end of shift.
• Performs other duties as assigned.

Qualifications and Experience

• CNOR Preferred.
• Current ACLS is required.
• Current CPR/BLS is required.
• Graduate of an accredited nursing program, BSN preferred.
• Knowledgeable of AORN standards.
• Knowledgeable of Universal Precautions.
• Maintains current licensure by the state of Maryland or a compact state license for Registered Nurse.
• Minimum of two (2) years of O.R. experience is desirable; experience in all service specialties is preferred.
• Technical skills/knowledge necessary to function in O.R. environments.

Physical Requirements

• Concentrates on moderate to fine detail for extended periods of time with irregular telephone and other interruptions.
• Full range of body motion including handling and lifting patients; manual and finger dexterity; hand/eye coordination.
• Lifting and carrying items weighing up to 50 pounds.
• Remembers schedules, tasks to be completed, where activities left off, etc.
• Sitting, standing and walking for extensive periods of time.
• Understands and can operate from the conceptual basis of tasks and activities.