Registered Nurse III

Job Description:
Registered Nurse III performs highly complex (senior-level) bedside nursing work in a 75-bed hospital. Performs duties of Patient Care Coordinator (charge nurse) on one to two nursing units when needed. Ability to provide patient care; to prepare and maintain records; to interpret and explain health laws and regulations: to organize, coordinate, and evaluate nursing activities and the delivery of health services; to interpret policies and procedures; to interpret health care regulations; to recognize patterns of medical necessity treatment; to communicate effectively; and to serve as a lead worker providing direction to others. Work involves planning, developing, coordinating, and evaluating nursing activities and providing for the care and treatment of inpatients. Work may include serving as a resource on nursing practices and education programs by performing consultative and administrative work. May serve as a lead worker providing direction to others. Works under limited supervision, with considerable latitude for the use of initiative and independent judgment. Provides leadership in the coordination and delivery of quality compassionate patient care. Utilizes the nursing process of assessment, planning, implementation, and evaluation, to provide, delegate, supervise and document care and teaching of patients and family. Work involves preparing, administering, and recording prescribed medications and also assessing, planning, implementing, and evaluating patient care plans in consultation with healthcare professionals. Experience in evaluating medical information, as well as providing direct and individualized bedside nursing care to pre and post-surgery patients and Infectious Disease patients. Demonstrates clinical expertise in caring for population served and in developing performance improvement measures and participates in competency assessments. Participates in emergency preparedness, safety functions and infection control activities for the unit. Assists with patient rehabilitative care and patient or patient related transportation needs when necessary. May serve as Nurse Manager in their absence. Adheres to the policies and procedures of Department of Health and State Services (DSHS), Texas Center for Infectious Disease (TCID) and the Department of Nursing. Essential Job Functions:
1. Patient-Centric Care: Establishes a compassionate environment by providing emotional, psychological, and spiritual support to patients, friends, and families. Maintain clear and respectful communication with patients and their caregivers. Tailor care activities to suit the specific age and needs of each patient. Adhere to best nursing practices, standards, and protocols.
Patient Personal Care Needs: Administer personal care tasks such as bathing, bed baths, shaving, and hygiene maintenance. Assist patients with essential tasks including lifting, feeding, and using commodes and bedpans.
Medications: Administers medications, immunizations, and treatment; and observes patients for unusual symptoms and reactions. Adhere to in medication administration and storage procedures, and controlled substance regulations.
Documentation/Assessment: Documents patient care services by charting in patient and department records. Conducts physical, developmental, and psychosocial assessments per policy standards an obtains and documents nursing history from patients and/or significant others that is comprehensive of present condition and prior problems. Performs basic assessment of patients, indicating adequate knowledge of anatomy, physiology, and pathology. Records vital signs, notes changes, and pursues more-specific investigations as needed. Identifies abnormal diagnostic data and shows a fundamental understanding of its implications by reporting information to the physician and others caring for the patient, and by incorporating information in the nursing care plan. Implements and monitors care plans. Uses care plans as a basis for providing safe and therapeutic care to patients. Communicates with the patient and his or her family and other members of the health care team in carrying out the goals of the care plan. Maintains continuity among nursing teams by documenting and communicating actions, irregularities, and continuing needs.
Discharge Planning: Collaborate on discharge planning with the healthcare team.
Patient/Family Education: Instructs, counsels, and assists patients in meeting their health care needs. Prepares, maintains, and reviews patient records, program reports, and patient assessments. Resolves patient problems and needs by utilizing multidisciplinary team strategies.
HIPAA Compliance: Maintains patient confidence and protects operations by keeping information confidential. (20%)

2. Patient Room Preparation and Vital Signs: Assist with the readiness of patient rooms for new admissions. Take patients' vital signs and accurately record the results. Collect and transport lab specimens as necessary. Utilize glucometers to measure and monitor blood glucose levels for diabetic patients. Respond to patient call lights promptly and make regular patient rounds. (5%)

3. Rehabilitation Assistance: Prepare and organize materials and equipment required for therapeutic activities. Operate therapeutic equipment as needed and provide guidance during rehabilitative therapies.
Collaborate with patients to support and encourage their participation in rehabilitative exercises. Aid patients in mobility and positioning, providing assistance during ambulation and transfers. (5%)

4. Support to Medical and Other Staff: Assist medical provider during patient examinations and procedures. Collaborates with medical provider and multidisciplinary team members. Works, in cooperation with medical providers to ensure the quality of patient care. Maintains a cooperative relationship among health care teams by communicating information and participating in team problem-solving methods. Contributes to team effort by accomplishing related results as needed. (5%)

5. Equipment Maintenance: Thoroughly clean and sanitize patient care equipment, including IV pumps, wheelchairs, and bedside commodes. Facilitate patient transportation to different departments, ensuring a safe and comfortable experience. Assists in maintaining a safe and clean environment. Ensures operation of equipment by completing preventive maintenance requirements; calling for repairs; and evaluating new equipment and techniques. (5%)

6. Efficient Resource Utilization: Follow efficient supply usage practices to minimize waste. Ensure proper handling, storage, and distribution of medical supplies and equipment. Dispose of medical waste according to established guidelines. Answers telephones, files, greets customers, and performs some data entry. Maintains nursing supplies inventory by checking stock to determine inventory level. (5%)

7. Infection Control and Safety Measures: Emphasize respiratory precautions and unit rules during patient education sessions. Strictly adhere to infection control policies to create a safe healthcare environment.
Maintain hand hygiene and follow proper personal protective equipment (PPE) usage. Reinforce respiratory precautions and unit rules during patient teaching sessions. Thoroughly sanitize and maintain patient care equipment, including IV pumps, wheelchairs, and bedside commodes. Adhere to infection control policies to maintain a safe environment. Environmental conditions that apply to this job: Human blood, body fluids, tissue or wastes, biomedical waste, and biological agents. Maintains safe and clean working environment by complying with procedures, rules, and regulations. (5%)

8. Patient Engagement and Recreational Activities: Engage with patients in diversional activities, both indoors and outdoors. Actively encourage patient participation in recreational pursuits. Accompany patients on field trips outside the facility. (5%)

9. Transportation of Patients: Safe Transport: Safely transport patients to and from medical appointments, tests, and procedures within the healthcare facility, ensuring their comfort and security during transit. Assistant with vehicle maintenance by regularly inspecting and maintaining the cleanliness and functionality of the vehicle used for patient transportation. Report any mechanical issues promptly to the appropriate department. Assist patients in entering and exiting the vehicle, ensuring their safety and comfort throughout the transportation process. Adhere to schedules and ensure timely arrival at destinations, taking into consideration potential delays and adjusting routes as necessary. Drives state owned vehicles to transport patients, passengers, or supplies. Transport patients to and from scheduled appointments. Adjusts work schedule to carry out long distance driving, these duties may require traveling long distance throughout the state to transport patients. Which includes working extra hours after shift normally ends. Determines the most practical route to be traveled while considering the safety of the patient. Adjusts transportation schedule as needed to have patients arrive at scheduled appointments in a timely manner, adapts schedule to meet patient special needs (age related or medical need). Properly identifies patient to be transported and safeguards the medical record. (5%)

10. Educational Requirements: Maintain up-to-date certifications related to the job role, renewing them as required. Regularly review and refresh knowledge acquired during training to ensure continued competence. Adhere to company policies and industry standards as learned during training sessions. Ensure facility trainings and certifications are not delinquent. Attend nurse staff meetings. Develops and conducts community outreach and health education presentations. May serve as a resource on nursing practices and education programs by performing consultative and administrative work. Participates in peer review as appropriate. May provide consultation, training, and technical assistance to agency staff, care recipients, provider agencies, and the medical community. Maintains professional and technical knowledge by attending educational workshops and participating in professional societies. (5%)

11. Regulatory Compliance: Ensure strict adherence to guidelines set by The Joint Commission (TJC), Centers for Medicare & Medicaid Services (CMS), and other relevant regulatory bodies. Conduct regular internal audits to identify potential areas of non-compliance and work proactively to address any discrepancies. Prepare for and participate in external audits and surveys by regulatory agencies, providing accurate documentation and responses as needed. Foster a proactive approach to regulatory compliance, encouraging all team members to actively participate in maintaining a compliant environment. Evaluates nursing services through the analysis of statistical studies and performance evaluation reports. Participates in quality assurance programs and processes. May conduct inspections, certifications, surveys, and investigations of health care facilities to determine compliance with state and federal laws, regulations, and rules. (5%)

12. Patient Care Coordinator (charge nurse): Create nursing assignments, management of throughput, staffing to matrix, and responding to patient and staff needs. Provides supervision for the support staff in accordance with their level of training and the patient’s acuity and is responsible for ensuring staff meet patient care centric needs. per policy and protocols. Liaise with doctors and administrators and communicate any protocol changes to staff during huddles. Coordinating daily administrative duties, including staffing schedules as needed, daily nursing assignments and patient care. Manages a patient care assignment as indicated by patient care needs. Instructs staff and ensures compliance with standards through daily on-going monitoring and performance management. Reviews medical records and patient assessments to determine compliance with policies and procedures, correctness of assessment, standard of care, and quality of service. Motivates staff to maintain a high level of patient care. Responsibility for assigned unit performance improvement activities and outcomes, complete assigned audits. Assists with developing in-service training and educational programs. (20%)

13. Fill-in Nurse Manager: Recognize and assist in solving clinical and administrative problems
Supervise care delivery systems to ensure accuracy and consistency. Assists in providing clinical expertise in medical, behavioral, and crisis management. Coordinate with the Chief Nurse Executive to accomplish facility and patient-care goals. Assist with develop and implement nursing policies and procedures. (5%)

14. Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location. (5%) Knowledge Skills Abilities:
1. Knowledge of Department of State Health Services (DSHS) and Texas Center for Infectious Disease (TCID) policies and procedures.
2. Knowledge of principles of adult learning.
3. Knowledge of current treatment for tuberculosis.
4. Knowledge of Joint Commission, CMS and state and federal regulations pertaining to health care and accreditation standards. Skill in teaching these requirements to others.
5. Knowledge of applicable safety, infection control and emergency preparedness activities relating to TCID.
6. Knowledge of human development to the extent that teaching techniques may be adapted to care of young adults, adults and geriatric individuals.
7. Skill in conducting small and large teaching sessions.
8. Skill in performing Cardiopulmonary Resuscitation (CPR).
9. Skill in performing clinical nursing functions and the ability to teach such functions.
10. Skill in assessing learning needs.
11. Skill in the care and treatment of patients, and in the operation of computers and applicable computer software.
12. Ability to provide meaningful participation in Performance Improvement activities.
13. Ability to develop and maintain competency records for clinical knowledge and skills for TCID clinical staff.
14. Ability to communicate clearly and positively with patients and staff.
15. Ability to read, write, and speak English.

In addition to the above knowledge, skills and abilities must be able to meet the following physical tasks:

Repeated bending, simple grasping, finger/manual dexterity, vision, hearing, reach above shoulder, simultaneous grasping, twist upper body, and can move approximately lbs with or without assistance.

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