Registered Nurse - Operating Room - Day/Evening

Registered Nurse - Surgical Services

• 10 OR Suites including Cystoscopy and Obstetrics Suites.
• The schedule is based on opening seven to eight operating rooms Monday - Friday from 7am - 3:30pm or 7am - 5:30 pm.
• Minimal staffing for each OR is one RN and one or two scrub persons, either RN's or Surgical Technicians.
• Call: Seven days a week: on RN and two Surgical Technicians, 3:30pm - 7am. Saturday: one RN and two Surgical Technicians, 3:30pm - 7am working for urgent cases. One RN and on Surgical Technician on call from 7am - 7am, second call.
• Unit provides a wide variety of surgical specialties including orthopedics, general, vascular, neurology, ENT, plastics, OB/GYN, urology and Robotics. The unit is also responsible for urgent/emergent cases and cesarean sections 24 hours a day, seven days a week.
• RN orientation includes a comprehensive AORN Perioperative Nursing 101 training program.
• Advanced robotic surgery (Da Vinci SI Surgical System)

The Registered Nurse is responsible and accountable for implementing, directing and coordinating the care of patients through the use of the nursing process: assessment, planning implementation and evaluation. Included is recognition and treatment of the physical and psychosocial changes unique to the age/population group served on the specific unit.

Essential Functions and Responsibilities

Core Values: Service, Integrity, Compassion
1. Demonstrates service excellence and patient and family centered care by showing respect, honesty, fairness and a positive attitude toward all customers.
2. Maintains confidentiality.
3. Demonstrates dependability, to include attendance and punctuality.
4. Is accountable - takes initiative and ownership of issues.
5. Displays a professional demeanor. Represents hospital in a positive way. Has a compassionate working relationship with patients and families.
6. Assumes personal responsibility for 2-way communication. Communicates and listens effectively with patients, families, coworkers, other departments, physicians/providers and community.
7. Supports coworkers, initiatives and a patient and family centered philosophy; pitches in; does own part and helps others.
8. Works to continuously improve work environment/processes (Performance Improvement). Demonstrates a patient and family centered focus when considering/developing improvement solutions.
9. Represents willingness/enthusiasm to create, embrace and facilitate change.
10. Develops self and others; supports a learning environment; leads by example. Encourages patients and families to give feedback and suggestions for improvement.
11. Develops working relationships critical to the organization including patients, families, coworkers, other departments, physicians/providers and community.
12. Encourages others by providing recognition and support.

Technical Excellence
1. Thinks critically; utilizes sound judgment; promptly reports potential risks.
2. Maintains state of art knowledge of area of specialty, healthcare trends and practice, and populations served.
3. Maintains a level of computer literacy appropriate to their role.
4. Meets and maintains current all unit specific and organizational skills/competencies, certifications/licensures, as required.
5. Completes hospital-required reviews, e.g. HIPAA, safety, health screening, care concerns, and others as assigned.
6. Adheres to National Patient Safety Goals.

Job Class Specifics
1. Demonstrates safe medication practice.
2. Maintains a professional image that reflects the employee's role in health care, with confidence and a positive impression.
3. Completes chart check to ensure no missed orders.
4. Accurately transcribes physician's orders.
5. Demonstrates therapeutic communication skills.
6. Demonstrates ability to assess patient education needs and use of patient education resources.
7. Demonstrates involvement in unit by attending 50% of staff/committee meetings and in-services for area.
8. Demonstrates leadership through the nursing process and supervision while maintaining accountability for treatment and patient outcomes.
9. Acts as a resource person regarding patient care, specialty area, orientation and teaching of staff.
10. Responds to delays in a calm manner. Apologizes for inconveniences and gives alternatives.
11. Analyzes assessment data, identifies priority problems and documents on Plan of Care in PCS for patients and families and significant others.
12. Uses effective problem-solving skills to plan patient care.
13. Identifies critical factors evidencing changes in patient condition and responds appropriately.
14. Completes and documents discharge assessment against plan of care goals.
15. Initiates and maintains Intravenous Therapy according to IV standards.
16. Responds appropriately to emergency situations.
17. Utilizes proper body mechanics to prevent injury to self and others. Safely positions, transfers and transports patients.

General Requirements

The following requirements are expected of all employees:
Core Values: Integrity, Compassion, Excellence, Service
Annual Health Screening with Infection Control and Blood Borne Pathogens Education
Safety Awareness: Hospital Fire, Safety, and Disaster Procedures
Confidentiality: Maintains Employee and Patient Confidentiality.
Attendance: Regular attendance is an essential function of the position
Leadership Standards:
Character: Attitude, Integrity, Role Modeling
Job Performance: Results Orientation, Customer Focus, Decision Making, Awareness
Interpersonal Skills: Communication, Relationship-building, Team Player, Celebration
Innovation: Breakthrough Thinking, Knowledge-Building/Sharing, Coaching/Empowering, System Vision & Management

Physical and Mental Requirements: Classified as medium work by Dictionary of Occupational Titles: May exert 20-50 pounds of force occasionally, and/or 10-20 pounds of force frequently/and/or greater than negligible (up to 10 pounds) force constantly in order to move objects.
- Stands frequently during a normal shift.
- Walks frequently within the department.
- Sits occasionally.
- Lifts up to 50 pounds laterally to and from waist level.
- Pulls/pushes up to 125 pounds.
- Carries up to 15 pounds.
- Frequent bending, kneeling and squatting from an upright position to lower levels.
- Reaches to heights of up to 2 feet.
- Occasional twisting from upper torso.
- Ability to move rapidly in response to unpredictable emergencies/patient behaviors.
- Ability to physically restrain average person (weighing 155 pounds) by assisting in a 2-person lift.
- Near-visual acuity with color perception in order to view computer screen, decipher fine print and colors of medications and solutions; also must be able to observe specific actions and from a distance. Assessment of patients including the ability to perform the following: Recognition of body color changes including but not limited to pallor, flushing, cyanosis, and jaundice; evaluation of skin rashes, erythema, and wounds, including color and quality of wound bed and exudate if present; and detection of visible blood or bile in urine, stool, sputum, and vomit. Use of area-specific monitoring equipment, potentially including color-coded information.
- Auditory acuity; able to hear phone conversation, overhead pagers, alarms and call bells, heart and lung and bowel sounds (differentiating the quality of each), normal voice tones when not facing the individual, and able to hear as well as see blood pressure reading with accuracy.
- Ability to occasionally operate hand/arm and foot/leg controls on beds, stretchers, bed scales, wheelchairs and lifts.
- Manual dexterity, digital sensitivity, and flexibility (i.e. ability to program equipment, start IV's, give injections, check pulses and temperatures of patient, adjust flow rates, open medications and utilize a keyboard).
- Good hand/eye coordination.
Mental Requirements: Must possess good general mental health; ability to work under pressure; ability to communicate effectively in both written and verbal form. Must establish priorities among essential functions of the job and coordinate these functions with others; ability to speak, read, and write the English language.

Working Environment: Work is performed in a clean well-ventilated, indoor area. Possible exposure to patients with infectious diseases or to bodily fluids, which may contain infectious agents. Some risk of harm through dealing with patients who may pose a danger to self, others or property. Interfaces with a diversity of customers. Exposure [occupational level] to ionizing radiotion while utilizing protective shielding. Possible exposure to patients with infectious diseases or to bodily fluids which may contain infectious agents. Exposure to high magnetic fields and high radio frequency waves created by superconductive magnet.
Reporting Structure:
A. Formal Reporting and Chain of Command - Patient Services: Reports to the Clinical Manager of the assigned unit or their designee. In his/her absence, reports to Nurse Manager, Administrative Resource Coordinator, Director of Patient Services and/or Vice President of Patient Services.
Cardiovascular Services: Reports to the Manager with oversight from the Director of Patient Services. In their absence, reports to another designated Nurse Manager and/or to the Vice President for Patient Services.
Physical Medicine: Wound Care Center reports to the appropriate Clinical Manager and Cardiac Rehab reports to the Cardiac Rehab Coordinator. In their absence, reports to another designated Clinical Manager or the Administrative Director of Wound Care Services and Outpatient Physical Medicine and Rehabilitation. In the Directors absence reports to the VP for Administration.
B. Informal Reporting and Relationships - Establishes and maintains harmonious, productive relationships with all levels of nursing personnel,
other hospital personnel, management, physicians, patients and the general public.

Disclaimer: These essential job functions are requirements of the position which must be performed either with or without reasonable accommodation. The essential job function list is intended to be a guide rather than a limitation. The Chambersburg Hospital possesses the right to add new responsibilities to the list as business demands dictate. Some of the essential job functions may exclude individuals who pose a direct threat/significant risk to the health and safety of themselves or others.
By identifying essential job functions, we are in no way stating or implying that these required tasks are the only activities that are to be performed by the employee occupying this position. In addition, employees will also be expected to follow any other job-related instructions and to perform any other job-related duties that are included in the job description. The preceding requirements represent only the minimum acceptable levels of knowledge, skills, and/or abilities that a job incumbent must possess; in order to perform the job successfully, the incumbent will possess additional aptitudes so as to perform the other duties that the job description entails.

Revised Date: 10/06/2023

In the section below, you will find the Registered Nurse department specifics.

Surgical Services - OR:
1. Identifies the patient prior to admission to the OR, assesses and identifies operative site.
2. Assesses the H&P and Anesthesia Assessment forms for information which will require adjustment to the standard protocol such as obesity, deafness, diabetes, etc.
3. Completes continuous patient assessment during surgery, reporting abnormalities to the surgeon or Anesthesiology personnel immediately.
4. Reports all pertinent intraoperative information to PACU personnel.
5. Plans for appropriate and proper functioning of equipment and supplies based on the individual surgery and physician's preference, assisting with radiological procedures and equipment needs of the surgeon which includes but is not limited to stepping on the pedal.
6. Obtains and maintains equipment needed to implement standards of care.
7. Maintains proper position and draping of the patient in accord with physician protocols to prevent patient exposure, and damage to muscles, nerves, and blood vessels.
8. Prepares skin according to physician protocols in order to prevent infection and skin damage.
9. Creates and maintains a sterile field according to policy and procedure in order to prevent infection.
10. Obtains and accounts for needles, sponges, sutures, instruments, and other supplies following established policies as evidenced by proper documentation on OR Count Sheet, Implant Records, and count board.
11. Correctly handles surgical specimens per policy and procedure.
12. Prepares the patient for transfer to PACU under the direction of the surgeon and Anesthesia personnel.
13. Completes the Unit-based Electrosurgical Unit Competency.
14. Completes the Unit-based Procedural Counts Competency.
15. Completes the Unit-based Orthopat-Zimmer Competency.
16. Documents appropriately and accurately in the ORM portion of Meditech.
17. Maintains appropriate safety measures in surgical areas, i.e., strict compliance with all surgical initiatives including but not limited to all steps of Universal Protocol process, parallel processing, sharps safety, no pass zone, PPE protection in the surgical areas, medication labeling and specimen handling.
18. Is cognizant and monitors SCIPS information as it pertains to their practice and hospital protocols.
19. Achieves accurate SBAR hand off communication between levels of care.
20. Prepares the operating room for cases by setting up table, instruments and supplies according to the type of cases.
21. Prepares rooms between procedures and after terminal cleaning. Monitors and restocks supplies.
22. Drapes patients for surgical procedures.
23. Assists the surgical team during operative procedures.
24. Assist in the maintaining correct count of instruments, sutures, and sponges.
25. Prepares patient skin for surgery in accordance with hospital standards.
26. Maintains aseptic techniques; actively monitors situations which could lead to breaches in aseptic techniques.
27. Assists surgeons during operations by retracting tissues under direction.
28. Identifies and cares for specimen.

Qualifications and Standards

Education:
- Graduate of an accredited School of Nursing required; Bachelor of Science in Nursing is preferred.
- Evidence of participation in educational programs to update and maintain current knowledge and clinical skills.

Experience:
- Experience applying customer service behaviors and communication skills required.
- Previous nursing experience in specialty area preferred.
- For Cath Lab, one year of acute carenursing experience (ED, Cath Lab, CCU, IMCU, Tele-Observation) preferred.
- For Cardiac Rehab, two years experience in Critical Care and/or Progressive Care required.
- For Cardiovascular Services, two years of experience reading cardiac monitors and be self directed in responding to abnormalities or cardiac arrests codes as a team member.
- For Device Clinic, at least one year of device management services required. Successful completion of EKG course required. At least two years of acute care nursing required (Tele-Observation, IMCU, CCU, Cath Lab, ED).
- For Emergency Department, at least one year of RN experience in ED or Critical Care required.
- For Family Birthing Services, a minimum of 1 year Labor and Delivery experience (within the last five years); For Family Birthing position posted as a trainee position, requirement of at least 1 year of experience as an RN with preferred areas of ICU, CCU, IMCU, EDor internal nurse intern upon successfully completing accredited nursing program. Experience requirement does not apply to an RN in the Family Birthing Services Fellowship Program (FBSFP)
- For Infusion Services, 6 months of infusion nursing experience required, and 6 months Midline and PICC experience required.
- For Wound Care Center, two years experience and expertise in the nursing process related to wound care required. Experience in advanced wound care initiatives preferred.
- For Outpatient Behavioral Health Services, two years experience in Behavioral/Psychiatric nursing is required. Previous experience in a Behavioral Health Outpatient setting preferred. Child Abuse Recognition and Reporting Training in accordance with Act31 of 2014 required. Federal Bureau of Investigation (FBI) Clearance and finger printing required.
- For Rapid Admission, requires one year acute care experience and successful completion of EKG course within six months of hire.
- For SDS / PACU, must have experience with, and be familiar with, reading cardiac monitors and be self directed in responding to abnormalities or cardiac arrest as a team member. Must have recent clinical experience with cardiopulmonary resuscitation and have the ability to lead a Code Blue in the absence of a higher level professional.
- For Medical Surgical (Renal, Oncology and Pediatrics), pediatric experience is preferred.
- For Level II NICU, a minimum of one year NICU experience (within the last five years); For Level II NICU position posted as a trainee position, requirement of at least 2 years of experience in: NICU Level 1, Labor and Delivery, Post-Partum, Nursery, PICU, ICU, ED, or CCU. Or, for Level II NICU position posted as a trainee position, requirement of a new graduate RN with (A) practicum/capstone in Labor and Delivery, Nursery, or NICU, or (B) experience as Tech/Aide in Labor and Delivery, Post-Partum Nursery, or NICU.

Certifications/Licensure:
- Eligible for or currently licensed as a Registered Professional Nurse in Pennsylvania.
- Certification in specialty preferred.
- CPR certification required.
- ACLS required for Cardiovascular Services, CCU, Device Clinic, Emergency, IMCU, FBS, Tele Observation, PACU/SDS, or achieved within one year of start date.
- ACLS required for Cardiac Rehab or achieved within 3 months of hire/transfer.
- Proficiency in cardiac monitor interpretation, conscious sedation, and ACLS required for Cath Lab or achieved within 6 months of hire/transfer.
- ACLS required for Float Pool.
- PALS required for Emergency, PACU, and Pediatric trained staff within one year from start date.
- PALS and Conscious Sedation is required for SDS, or must be achieved within four months of hire/transfer.
- CNOR preferred for OR.
- CPAN/CAPA preferred for PACU/SDS.
- CRRN preferred for Rehabilitation Medicine.
- NRP required for Level II NICU.
- NRP and Fetal Monitoring Pathway required for Family Birthing Services within one year from start date.
- STABLE required for FBS, Level II NICU within 12 months from start date.
- PMH-BC preferred for BHS (IP and OP).
- Proficiency in cardiac monitor interpretation required for PACU/SDS, IMCU, Tele Observation, CCU, Cardiac Rehab, Cardiovascular Services, Cath Lab, and Emergency.
- Temporarily reassigned personnel will work in a limited scope of practice consistent with credentials and be surpervised by appropriately credentialed staff.
- WOCNCB or CWCN preferred for Wound Care Center.