Registered Nurse - Med/Surg

At Waterbury Hospital we offer our RN’s with scheduled hours:

• Employer paid pension plan
• Sign on bonuses for experienced RN’s
• Employee Referrals
• Opportunity for training in specialty areas
• Generous student loan forgiveness
• Education reimbursement
• Shift incentives
• Clinical Ladders

SCOPE OF POSITION:

The Registered Nurse in the Med./Surg. unit utilizes the nursing process, diagnoses to treat human responses to actual or potential problems and is accountable to the patient, family and peers for the totality of work performed in order that the organization can fulfill its primary mission of providing quality health care within the community.

Population serviced includes adult, geriatric patients and upon occasion, adolescents. Reports to the Assistant Director.

RESPONSIBILITIES:

Develop and implement a plan of care and demonstrate leadership to ensure all patient/family needs are met. Monitor patients before, during and after surgery and /or procedures to provide safe, efficient care. Evaluate the plan of care and the patient's responses:

reassess and revise the plan based upon changing needs and priorities.

Demonstrate the skill and judgment necessary to implement Physician's orders, nursing interventions and procedures as necessary for the care of the patient.

Maintain up to date and accurate documentation of nursing care provided to insure the integration of information for use by the health care team and to insure the totality of quality care.

Promote effective working relationships and work cooperatively as part of the department team to facilitate the department's ability to meet its goal and objectives. Contributes to Quality Improvement activities and participates in the departmental Quality Improvement Program.

Responsible for own professional development to insure appropriate knowledge of advances in practice to provide state of the art treatment for patient population serviced.

Perform other related duties as required.

REQUIREMENTS:

Licensed Registered Nurse in the State of Connecticut

Medical/Surgical experience preferred.

Intravenous therapy experience preferred (included starting IV's)

Good communication skills.

Ability to work as a member of an interdisciplinary team

Ability to work in a time oriented environment including exposure to all patient elements, i.e. blood borne pathogens, physical requirements; lifting and pulling of patients, pushing stretchers, standing and walking for extended periods of time wearing a lead apron.

Ability to demonstrate and perform strengthening and toning exercises.

Ability to interact with patients with tact and confidentiality.

Graduate of an accredited Nursing ( RN ) Program

Must have basic computer skills and ability to access internet and other programs applicable to Waterbury Hospital procedures.

Perform automated functions that fall within job responsibility.

Date:

07/01/2018

1.0 Introduction

This assessment documents the physical demands and essential job functions of the Med Surgery RN position.

2.0 Physical Job Description

Med Surgery RNs frequently push and pull patients and equipment that requires between 5 lbs to 35 lbs of force. Moving, lifting or transferring of patients may involve lifting of up to 50 lbs., individually, or more as part of a team-lift. Med Surgery RNs are regularly required to stand and talk or hear, frequently required to walk, use hands to finger, handle, or feel; and reach forward with hands and arms.

Med Surgery RNs are occasionally required to sit and stoop, kneel, or crouch.

They frequently lift and/or move items and materials up to 20 lbs. and only occasionally lift or move materials up to 50 lbs.

Standing and walking are constant during nursing. Med Surgery RNs are seated when charting and writing reports for about 15 minutes at a time for a total of up to 2 hours per shift.

The job of a Med Surgery RN may be classified as "Medium." Medium work indicates that the job involves handling 20 to 50 lbs Occasionally (O) or handling 10 to 20 lbs Frequently (F).

3.0 Operational Overview

The Med Surgery RN is responsible for the following job tasks.

Assessing Patients

Developing Individualized Plans of Care

Following of Five Medication Rights

Performing Patient Care

Documenting Nursing Process

Communicating with the Physician

Med Surgery RNs will deliver care to patients utilizing the nursing process of assessment, planning, intervention, implementation and evaluation. Med Surgery RNs will effectively interact with patients, family and other health team members while maintaining all standards of professional nursing.

Med Surgery RNs coordinate patient care by working collaboratively with the interdisciplinary team, patients and families. Med Surgery RNs communicate, as appropriate, the patient's clinical condition, responding quickly and accurately to changes in condition or response to treatment.

Their day can vary from assessments, using IV skills or EKG, giving Meds and evaluations, to utilizing Combative Patient Skills training, including de-escalation. RNs must possess current AHA health care provider training (BCLS) certification.

3.1 Work Hours/Shifts:

Work shifts can be 8 or 12 hrs.

3.2 Working Environment:

The vast majority of work is performed indoors.

May on occasion accompany patient to outside facility for appointment/transfer or discharge

The areas of work are the temperature-controlled hospital facilities.

The flooring is primarily hard surfaces with some office areas that may be carpeted, both of which support ease of push/pull tasks.

3.3 Tools, Equipment, Work Aids:

Nurses wear a uniform.

Tools include a stethoscope, pen, watch with a second hand, penlight, bandage scissors and hemostat.

Equipment can include portable diagnostic and assessment equipment, portable glucometer, portable pulse oximeter, a rolling vital sign kit that includes a thermometer and an automatic blood pressure monitoring cuff that also assesses heartbeat.

Work aids include carts for laundry linens and stepstools for optimal positioning when giving CPR.

Personal Protective Equipment includes Eye Protection, Gown, Lab Coat or Apron, Mask, Non-Sterile Medical Gloves, Protective Gloves and Sterile Medical Gloves.

4.0 Physical Demands Analysis

The following tables detail the individual physical demands using the following six categories:

Mobility, Strength, Upper Extremity Postural Activity, Sensory/Perceptual, Work Environment, and Conditions of Work.

Key1: Exposure Time & Strength Rating

Rating of Exposure Time

Definition (Hrs of time)

Not Observed (N/O)

Not Observed

Infrequent (I)

< 1 Hr

Occasional (O)

1 – 3 Hrs

Frequent (F)

3 – 6 Hrs

Constant (C)

6 – 8 Hrs

Key1: Exposure Time & Strength Rating (continued)

Strength Rating

DOT Definitions

Sedentary

0 to 10 lbs performed Occasionally (O)

Very Light

0 to 20 lbs performed Infrequently (I)

Light

0 to 20 lbs performed Frequently (F) or Significant Walking or Standing

Medium

20 to 50 lbs performed Occasionally (O) Or 10 to 20 lbs performed Frequently (F) or 10 lbs performed Constantly (C)

Heavy

50 to 100 lbs performed Occasionally (O) or 25 to 50 lbs performed Frequently (F) or 10 to 20 lbs performed Constantly (C)

*Based in part on US Department of Labor's Dictionary of Occupational Titles (DOT), Physical Demands Strength Rating, 1991

Key2 : Essential Function Tasks

Task #

Task Description

1

Occasionally pushing/pulling bed, stretcher, gurney, with and without a patient; force will vary from 5 lbs to 35 lbs; infrequent, slight but repetitive pushing during CPR, duration can be from a few minutes to several hours. Occasionally pushing carts for laundry linens, and infrequently pushing specialized storeroom shelves.

2

Frequently lifting/carrying items ranging from 2 lbs to 10 lbs and above; occasionally lifting as part of a team an adult patient weighing up to 200 lbs. plus.

3

Reaching up to 65" frequently to review monitoring equipment, administer oxygen and meds, operate nursing equipment, and to access supplies.

4

Frequently bending, stooping, crouching and kneeling to care for patient.

5

Visually identifying labels, charts, supplies, displays, and controls to properly care for patients, take vital signs and write reports.

6

Standing and walking to assess and care for patients.

Table 1: Mobility

Activity

Duration

Essential

Function Task

Example

Sitting

O

3,5

Standing

C

1,2,3,4,5,6

Walking

C

1,2,3,4,5,6

Running

I

6

Climbing

N/O

1,3

Plugging in compression boots & special beds, IV poles, PCA pump, CPAP, respiratory treatments, pulse-oximeter

Table 1: Mobility (continued)

Activity

Duration

Essential

Function Task

Example

Bending/Stooping

F

3,4

Emptying Foley, working with chest tube, cleaning up, Plugging in compression boots, IV poles, PCA pump, CPAP, respiratory treatments, special bed needs plugging in, pulse-oximeter

Crouching

O

3,4

Kneeling

O

3,4

Crawling

N/O

Twisting

F

1,2,3,5,6

Putting in IVs, getting patient in and out of bed, putting in Foley, changing central line dressing

Balancing

O

1,2,3,4,5,6

Table 2: Strength

Activity

Duration

Essential

Function Task

Example

Lift 0-10 lbs

F

2,3,4,5,6

Med supplies, IV basket, medicines

Lift 11-20 lbs

O

2,3,5,6

SCD's, aka compression boot, IV pumps, commodes

Lift 21-50 lbs

O

2,3,5,6

Scale, linen bags

Trapeze bar (24 lbs)

Lift >50 lbs

O

2,6

Patients (all sizes, all weights)

Carry 0-10 lbs

O

2,3,4,5,6

Supplies and linens

Carry 11-20 lbs

O

2

Cooler, furniture, trapeze, two scales

Carry 21-50 lbs

O

2,3,5,6

Scale, bags

Carry >50 lbs

I

2

Pushing 0-10 lbs

F

1,6

Med supplies, IV basket, medicines, bladder scanner, EKG machine

Pushing 11-20 lbs

F

1,6

Monitors, standing scale (11 lbs starting force)

Pushing 21-50 lbs

O

1,6

Beds, non-motorized and bariatric beds (40 lbs force)

Table 2: Strength (continued)

Activity

Duration

Essential

Function Task

Example

Pulling

F

1,6

Pull patient up to sit up in bed Pull patient onto a stretcher

Cooler, furniture, code cart (10 lbs force), trapeze, two scales

Table 3: Upper Extremity Postural

Activity

Activity

Duration

Essential

Function Task

Example

Reaching above shoulder

O

1,3,4,5

Up to 65", Medications, IV AB's, IV fluids, continuous pulse oximeter, supply closet, to reboot computer, to reach light switch above bed in patient room

Reaching to side

O

1,2,3,4,5,6

Patient care, changing clothing, linens, giving baths

Wrist Movements

F

1,2,3,4,5,6

Giving meds, placing IV's, and others

Finger Movement

F

1,2,3,4,5,6

Power grips on handles and carts Open/close latches on cabinets

Striking Hand

N/O

1,6

Throwing

N/O

Table 4: Sensory/Perceptual

Activity

Duration

Essential

Function Task

Example

Talking/Speech

F

1,2,3,4,5,6

Communicating with co-workers, patient, visitors

Hearing/Listening

F

1,2,3,4,5,6

Communicating with co-workers, patient, visitors

Seeing/Vision

C

1,2,3,4,5,6

Reading

F

3,5

Meds, charts

Writing

O

3,5

Keying/Mousing

O

3,5

Table 5: Work Environment

Activity

Duration

Essential

Function Task

Example

Inside Work

F

1,2,3,4,5,6

Outside Work

O

6

Hot

N/O

6

Cold

N/O

6

Humid

N/O

6

Dry

N/O

Dust

N/O

Moving Objects

O

1,2,6

Beds, code cart, W.

O.W., C.

O.W.

Hazardous Machines

O

1,2,6

Bariatric bed

Electrical

O

3,4,5,6

Sharp Tools

F

1,2,3,4,5,6

Scissors, needles

Radiant/Thermal Energy

N/O

Bear-hugger or K-Pad

Congested Work

F

1,2,3,4,5,6

Patient rooms can occasionally get busy and congested

Table 6: Conditions of Work

Activity

Duration

Essential

Function Task

Comments

Traveling

N/O

Work Alone

N/O

Work Independent but in a Group

C

1,2,3,4,5,6

Deadline Pressures

F

1,2,3,4,5,6

Interact with Public on the telephone

N/O

4,5

Family and other caregivers, prisons

Operate Equipment /Machinery

F

3,4,5,6

Completed with:

Ms. Morgan Cook, RN, and Mr. Eric Diehl, Clinical Director