GENERAL PURPOSE:

The Nurse Apprentice (NAP) in the Medical /Surgical Unit performs total patient care services under the direction of the Registered Nurse practicing within the guidelines of the Boulder City Hospital policies and procedures. Measures, evaluates, administers, and documents patient care. Contributes to patient care plans in collaboration with the Registered Nurse when appropriate and within the scope of the Nevada Board of Nursing [Nevada Administrative Codes (NAC) 632.252 and 632.253] of the Nurse Practice Act. Actively responds to patient, physician, and family requests.

ESSENTIAL FUNCTIONS:

The NAP works as a member of the interdisciplinary team providing nursing care following the Nevada State Board of Nursing approved skills list. As the NAP progresses through their nursing programs, their ability to perform more of the approved skills increases. These skills include assisting with physical examinations, diagnostic procedures/treatments; passing and administering medications via the following routes: oral, intramuscular, subcutaneous, otic, ophthalmic, nasal, or feeding tube; patient education; and report any abnormal findings or observations to supervising RN (see skills list section).

· Efficiency and effectiveness, including quantity and quality of desired work, as well as organization skills necessary to perform successfully.

· Adherence to all relevant policies, procedures, and guidelines affecting the work environment, including maintenance of required competencies and communication skills.

· Adaptability to include teamwork and flexibility needed to fulfill job responsibilities including adapting to changes in work environment and accepting supervisory feedback

· Ability to respond to internal and external customer needs and expectations in a positive and timely manner.

· Must comply with the Boulder City Hospital’s Privacy and Security policies as reflected in the Health Insurance Portability and Accountability Act (HIPAA).

DUTIES AND RESPONSIBILITIES:

1. Oversees patient care in collaboration with the Registered Nurse and within the scope of the Nevada Board of Nursing [Nevada Administrative Codes (NAC) 632.252 and 632.253] of the Nurse Practice Act.

2. Works directly with other staff to assure provision of highest standards of care.

3. Ability to organize and prioritize work to maintain harmonious daily workflow.

4. Administer and document medications at appropriate times. Monitors effects and side effects of medications.

5. Works with intravenous medications and administer all routes of medications allowed per Nevada State Board of Nursing criteria.

6. Administers and records treatments as ordered. Monitors progress toward expected outcomes of treatments.

7. Admits, transfers and discharges patients as required.

8. Reports changes in condition, laboratory results, unexpected occurrences to the Registered Nurse and the physician.

9. Accurate documentation, reporting and in-depth nursing observation to assure continuity of patient care. Every shift: documentation, summarizing, and updating patient care plans as needed.

10. Every shift evaluates patient care needs and condition changes, and implements changes in care delivery as warranted. Consults with the Registered Nurse in implementing such changes.

11. Assures that Patient Rights are upheld.

12. Assures that Labs, X-rays, etc., are completed and notifies attending physician of abnormal results.

13. Assists as necessary with patient care.

14. Maintains cleanliness and order on unit.

15. Participates in and satisfactorily completes the Orientation process and annual reviews.

16. Attends inservices and meetings as required.

17. Completes annual hospital education requirements

18. Reports deviations in quality of care to House Supervisor as outlined by current nursing standards.

19. Actively participates in Quality Improvement activities.

20. Maintains working knowledge of hospital electronic medical record system.

SKILLS AND ABILITIES REQUIRED:

Demonstrates knowledge of disease process and therapeutics by recognizing changes in patient status, and reports pertinent information to the Registered Nurse or Physician.

Recognizes and follows through with nursing interventions.

Demonstrates knowledge of various age-related groups and applies appropriate interventions.

Utilizes appropriate teaching methods related to growth and development, and age specific factors evidenced by documentation in the patient’s medical record.

Maintains complete and up to date documentation.

Performs patient and/or family teaching as needed under the supervision of the Registered Nurse.

Effective and professional communication skills, both verbal and written

Proficient with computer skills to navigate and enter data into electronic medical records

The Nevada State Board of Nursing approved Apprentice Nurse Skills are:

* indicates skills expected at NAP II level

SKILL

APPRENTICE RN

*Advanced Directives

Documentation and teaching

AM Care/Activities of Daily Living

Includes shaving

Ambulation of Patients

Performs

*Admission and ongoing assessments

Assists in data collection

Back Rubs

Performs

Bathing Patients

Bed, assist, sponge, tub, shower, whirlpool

Bathroom

Assist with commode, bedpans, urinals

Bed making

Performs

*Bili-lights

Assist RN with care of infants under light

*Breast feeding

Reinforcement education

Bowel and Bladder

Assist with retraining

Call lights

Answer

*Cast Care

Routine cast care with assist

*Care Planning

Contributes to the plan of care established for a patient by recording and reporting to the appropriate person his or her observations by conducting a focused assessment.

*Catheters, Foley

Insertion, site care, care of patient with, emptying drainage bag, discontinuation, retention

*Catheters, Intermittent

Insertion, site care, care of patient

*Catheters, Suprapubic

Site care, care of patient, empty drainage bag

*Charting, flowsheets

Graphic/vital signs record, profile, admission database, I & O, outpatient, pre-op

*Circulation, movement, sensation assessment

Performs

Code

As appropriate with basic CPR

*Croup tent

Care of patient in

*Discharge of Patients

Performs

*Douche

Administration

Dressing and undressing

Performs

*Dressing changes (sterile and unsterile)

Surgical, simple (uncomplicated), moist, non-sterile, wet to dry

*Education, patient

Reinforcement of established written teaching plan

*EKG, 12-lead

Task only, no interpretation

*Enema

Fleets, Harris Flush, oil retention, soap suds

Errands as directed

Supplies and equipment

*Elastic stockings

Measuring and application

HS and PM care

Performs

Hair care

Shampoo, brush, and comb

I & O

Adult/pediatric

Impaired mobility management

Positioning and transferring

*Intravenous therapy

Start and remove peripheral line or peripheral access device, administer IV fluids w/o additives or medications, peripheral and central venous IV site care, flush lock

Isolation

Technique following guidelines (Standard Precautions, Body Substance Isolation)

*Jejunostomy

Gavage of existing tube

*K-pad

Administration and monitoring

Linen

Emptying

*Medications

Administration or oral, intramuscular, subcutaneous, otic, ophthalmic, nasal or tube

*Medications NOT ALLOWED

IV medications (PCA, push, piggyback, additives) or epidural

Nutrition

Appropriate for age and diagnosis, feed patient, verifying diet, feed with regular or thumb-controlled syringe, assist with menus, pass trays

*Nutrition, GT/PEG feeding

Care of patient, administer tube feeding

*Nutrition, nasogastric tube

Care of patient, insertion. gavage with existing tube, gastric suctioning

Observe condition or change in condition

Performs

Oral hygiene (conscious and unconscious patient)

Brush, floss, denture care

*Orthopedic devices

Care of patient with knee immobilizer, cervical collar, sling, crutches, CPM

*Ostomy

Change bag and skin care

Orientation of patients to room/unit

Performs

*Oxygen therapy

Care of patient and application of mask, nasal cannula, hood, blow-by

Perineal care

Performs

Positioning patient in bed

Performs

Post-mortem care

Assist with care, consent forms, required requests

*Pre-procedure shave/skin prep

Performs

*Pulse oximetry

Performs

Range of Motion exercises

Simple

*Rectal digital stimulation (not on a new paraplegics or quadriplegics)

Performs

*Restraints/safety devices

Apply, release, care of patient

Safety

Fall prevention, care of patient, patient education and documentation, reporting

*Seizure care

Precautions and management

*Sequential compression stocking

Application and care of patient

Skin care

Pressure ulcer prevention, turning, collecting skin-care related data

Specialty beds

Care of patient

*Specimen collection and handling (non-manipulated)

Respiratory secretions and sputum, throat, rectal, stool, urine, diaper

*Specimen collection and handling (manipulated)

Wound drainage, indwelling catheter

*Staples/sutures

Removal only

*Steri-strips

Application and removal

*Suction and care of patient

Tracheal, oral, and nasal

*Suctioning, bulb (infants)

Only with OB/RN instruction

*Surgical drains

Care of Jackson Pratt, J-vac, JT-tube

*Tracheotomy

Care and suctioning

*Traction equipment

Set up (trapeze only), assist RN/LPN/PT with initial application and care of patient, may reapply traction

Transportation of patients and equipment

Performs

*Transcription of orders

Limited to provider order processing-e.g., transfer of order to MAR; MAY NOT ACCEPT TELEPHONE AND/OR VERBAL ORDERS

*Vaporizer-cool mist

Performs

Valuables

Appropriate care and documentation

Vital Signs

Performs

Weights/heights

May measure and weigh patient (standing/chair/bed, scale/sling)

EDUCATION AND EXPERIENCE REQUIRED:

High School Graduate or GED

Current / Proof required that applicant is a student enrolled in an accredited Nursing program

Basic Life Support (BLS) Certified

Telemetry certification within one (1) year of hire

Job Type: Full-time

Pay: $22.75 - $35.50 per hour

Benefits:

• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Pet insurance
• Tuition reimbursement
• Vision insurance

Healthcare setting:

• Acute care

Medical specialties:

• Medical-Surgical

Schedule:

• 12 hour shift

Application Question(s):

• This position requires you to be currently enrolled in an accredited nursing program, do you meet this requirement?

Experience:

• Currently enrolled in a Nursing program: 1 year (Required)

Work Location: In person