Nurse Practitioner
4 weeks ago
Assessment:
- Conduct thorough nursing histories and physical assessments upon admission and ongoing.
- Collect and document patient data, including vital signs and medical history.
- Interview patients and significant others to gather information for the patient's care plan.
- Identify and document signs and symptoms indicating potential problems.
- Incorporate information from families/significant others and healthcare team members into the written assessment.
- Assess the safety of the patient care environment.
Planning:
- Develop individualized patient care plans in collaboration with patients and families.
- Identify short and long-term goals, including discharge planning, consistent with established patient care.
- Document patient problems and goals requiring intervention, including teaching needs and discharge planning.
- Communicate the plan of care and diagnostic data through shift reports, adhering to unit guidelines.
- Involve family members and other healthcare team members in the development of the plan of care as able and appropriate.
- Revises the initial patient care plan to accommodate changing patient needs.
Implementation:
- Provide direct nursing care based on the plan of care and established priorities.
- Set priorities and deliver nursing care based on patient needs.
- Implement medical care plans as delegated.
- Follow through with care plans established by other healthcare team members.
- Write patient discharge plans and make appropriate referrals.
- Delegate and guide aspects of care to appropriate personnel based on acuity and individual patient needs.
- Coordinate activities of other disciplines to implement individual care plans.
Evaluation:
- Evaluate and document patient/family response to nursing interventions related to stated goals and overall effectiveness of the care plan.
- Revises plan of care based on evaluation.
- Document patient response to medical care plans.
- Document patient response to nursing interventions.
- Recognize alterations in physiological and psychosocial status.
- Collaborate with other healthcare team members to revise patient care plans according to changing patient needs.
- Document revision of goals and plan of care to meet changing patient needs.
Customer Service:
- Strive to implement unit customer service standards and exceed expectations of patients, families, physicians, and visitors.
- Unit surveys consistently meet or exceed hospital benchmarks.
- Maintain flexibility in relation to patient assignment, shift assignment, and work schedule.
- Conduct all interactions in a professional manner.
- Verbal and written feedback from patients, families, medical staff, visitors, and coworkers indicates behavior conducive to positive guest relations.
- Exhibit appropriate phone protocol, answering phones promptly and professionally, and being courteous and helpful.
- Interact with other departments for problem resolution and quality patient care.
- Maintain a quiet, therapeutic environment in patient care areas, including the nursing station.
- Makes rounds to assigned patients, anticipating patient needs, and responding to patient call lights or paging promptly.
Professional Conduct:
- Perform additional duties and responsibilities in different areas of the department or as needed, as determined by management.
- Follow attendance and all other established hospital and department policies.
- Demonstrate the philosophy of the team concept.
- Participate in staff meetings with suggestions to enhance the work environment and increase productivity.
- Communicate well with supervisors, reporting problems with equipment, supplies, or procedures.
- Request assistance as appropriate.
- Comply with all safety and infection control standards.
- Maintain confidentiality related to job responsibilities.
- Exhibit willingness to resolve problems as they arise.
- Project a positive professional image through appearance and behavior.
- Attend 75% of staff meetings or read and initial minutes.
- Complete assigned work within the shift.
- Comply with time and attendance policy (i.e., Kronos).
Performance Improvement:
- Demonstrate WHMC's commitment to quality through individual effort.
- Work to improve identified unit-specific problems.
- Work to improve identified hospital-wide system problems.
- Use established systems to document occurrences.
Professional Growth and Development:
- Complete Annual Updates and Ethics Training within established time frames.
- Complete general and departmental orientation within established time frames.
- Attend 80% of inservice programs.
- Maintain licensure/certification as appropriate.
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