Primary Function

The incumbent performs nursing procedures to patients of all ages independently within the framework of established policy within the Emergency Department (ED) at the Cherokee Indian Hospital, Cherokee North Carolina. The Registered Nurse is a licensed professional nurse responsible for assessment of patients, development, implementation and evaluation of a patient plan of care; administration of therapeutic measures; teaching and counseling of patients and families; and participating in the development of nursing policies and procedures and quality assurance standards.  The Registered Nurse is responsible for the delivery of comprehensive health care to patients of all ages, utilizing standards of care and practice, policies, protocols, and procedures. The purpose of the work is to perform the full range of the nursing process from assessment to evaluation.  The work affects the physical and psychosocial well being of the patients and their families.

Job Description

• Provides nursing care in accordance with established nursing care standards. Performs nursing care to patients presenting to the ED with urgent or emergent health conditions. Participates in curative, rehabilitative, and preventive nursing care.The nurse will function in the ED under the supervision of the Emergency Department Nurse Manager or his/her designee to insure patient care is provided in a safe and efficient quality manner.
• Demonstrates ability and willingness to adapt to special circumstances, such as patient emergencies, fluctuations in census and acuity level of patients, and disasters.
• May be required to rotate between nursing departments including Primary Care and Inpatient departments. Participates in cross training of services within the nursing department.The Emergency Department Nurse Manager or his/her designee will schedule cross training.
• Works on a regularly assigned or rotational basis to provide continuity of services during

evenings, nights, weekends, and holidays.  May be required to rotate shifts and be subject to on-call and callback.

• The Nurse will be evaluated annually on his/her ability to identify, assess, analyze, and evaluate data and solve problems.
• Performs ongoing assessment by actively participating in the determination of meeting the nursing care needs based upon collection and interpretation of data relevant to the health status of the client.
• Collects data from relevant sources regarding the biological, psychological, social and cultural factors and determines the influences these factors have on the health status of the individual.
• Collects data through observations of appearance and behavior, measurements of physical structure and physiological function, and information regarding available resources.
• Interprets data and recognizes existing relationships between data collected and the client’s health status and treatment regimen and determines the client’s need for immediate nursing interventions.
• Reviews the patient’s health records and health summary, interviewing patients and family members, documenting the chief complaints, medical history, physical and clinical findings, identifying learning needs of the patient and family, and determining priority of care required.Assessment for health prevention, health promotion, restorative, and health maintenance needs is emphasized.
• The nurse will plan patient care according to individual assessed patient needs and established hospital policies and procedures.
• Functions as Team Leader when assigned by the Emergency Department Nurse Manager or his/her designee; assigns nursing staff according to staff competency and patient complexity and provides technical supervision for staff members, including reviewing procedures; anticipates problems and acts to resolve problems.
• Initiates plan of care based on assessment of the patient for specific illnesses, injuries, and diseases and human behavior and appropriate standards of care.
• Develops expected patient outcomes that are observable and within an adequate time frame, and are congruent with the patient’s present and potential physical capabilities and behavioral patterns.
• Plans for care to provide for the basic needs of patients including health prevention, health promotion, protection, comfort, nutritional, fluid and electrolyte balance, physiological functions, activity, rest, and sleep, hygiene, oxygenation, management of health, growth and development, and coping.
• Implements nursing care according to the established health care plan.

  Performs nursing interventions including, but not limited to

• Detects changes in the patient’s condition and takes appropriate action.
• Recognizes, identifies and interprets serious situations and immediately decides proper action.
• Initiates appropriate resuscitative measures in an emergency situation.
• Initiates appropriate action when safety measures are required to protect patients.
• Documents observations, nursing interventions, patient progress, needs, treatments, diagnoses, possible side effects of treatment, teaching, patient response, effectiveness, complications and communicates information to the physician, co-workers and other health personnel.
• Administers and documents medications per manufacturer guidelines, hospital policy and established protocols and according to State Board of Nursing regulations.Documents all known drug allergies on the medical record and according to protocol.
• Assures that all medications, treatments and tests are done appropriately and in a timely manner, detects, and reports medication errors.
• Provides counseling, teaching, and anticipatory guidance to patients and families on preventive, curative and rehabilitation measures involved in health care.Documents all patient education activities within the patients/family’s level of understanding.
• Provides guidance, leadership, and training to other nursing personnel.
• Coordinates health care needs through referrals to support services, community, and tribal resources to promote continuity of care.
• Maintains a safe environment through the practice of Universal Precautions and Body Substance Isolation, medical waste/chemical management and containment.Isolates infected patients.Cleans patient contact areas and equipment according to policies and OSHA regulations.
• Participates in the development and implementation of performance improvement activities.Identifies and reports risk management issues.
• Assumes responsibility for the adequacy and appropriateness of supplies and ensures proper functioning of all medical equipment.Maintains cleanliness and orderliness of work areas.
• Promotes patient advocacy and confidentiality.
• Serves on Committees as appointed.
• Maintains and promotes positive and constructive communications and activities within Nursing services, other departments, tribal, and community agencies for purposes of coordinating and understanding of goals and objectives relevant to the population served.
• Functions appropriately during disasters.
• Updates and maintains currency/competency in nursing practices and standards by attending training and in-services.

• Evaluates patient care provided.
• Directly observes and evaluates patient care.
• Revises nursing care to reflect changes in patient needs.
• Documents nursing care and patient progress according to hospital policy.
• Participates in ongoing nursing quality assurance program.
• May be necessary to work when Administrative leave is granted if patient care would be compromised.

Education/Experience

• Graduated from an accredited Bachelor or Associate Degree program in nursing with 1 year recent critical care experience.
• Applicant must have an unrestricted valid Registered Nurse license within the state of North Carolina or a state that is accepted as reciprocity.

• Current Basic Life Support (BLS) minimally required upon hire, must obtain Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) which can be acquired through the facility following appointment to position. ACLS and PALS must be acquired within 6 months of date entering on duty. TNCC and ENPC preferred, but not required.

• Proficiency rated at 1 year for an RN with one year clinical nursing experience.