Description

At Bristol Health, we begin each day caring today for your tomorrow. We have been an integral part of our community for the past 100 years. We are dedicated to providing the best possible care and service to our patients, residents and families. We are committed to provide compassionate, quality care at all times and to uphold our values of Communication, Accountability, Respect and Empathy (C.A.R.E.). We are Magnet ® and received the 2020 Press Ganey Leading Innovator award for our rapid adoption and implementation of healthcare solutions during the COVID-19 pandemic. Use your expertise, compassion, and kindness to transform the patient experience. Make a difference. Make Bristol Health your choice.

Essential Job Functions and Responsibilities:

Plans and provides for the care of the surgical patient using the nursing process.

• Contributes to the admission assessment and ongoing intraoperative reassessment of the surgical patient.
• Verifies the Surgical Consent and reviews the procedure and surgical site.
• Individualizes care plan to specific patient needs.
• Interventions are evaluated for effectiveness.
• Uses nursing diagnosis appropriately.
• Evaluates outcomes and modifies plan of care appropriately.
• Utilizes a multidisciplinary decision making process to provide care.
• Communicates specific needs to multidisciplinary team members.
• Demonstrates leadership role in multidisciplinary team as RNFA.

Adheres to the Standards of Practice outlined by AORN and in Unit Specific policies and procedures to ensure high quality, safe perioperative care is provided to the surgical patient.

• Verifies patient identification.
• Checks consent form for surgical procedure and surgical site.
• Reviews with physician pertinent patient information including X-rays, CT Scan, MRI, etc. prior to surgery.
• Actively engages multidisciplinary team members in correct surgical site verification.
• Ensures the equipment is functioning correctly before its use.
• Ensures aseptic technique and sterility is maintained.
• Positions patient and provides padding, safety belts.
• Performs instrument, sponge, needle/sharp counts with the scrub nurse visually and audibly together.
• Physiologically monitors patient intraoperatively, and intervenes to improve outcomes.
• Monitors and controls intraoperative environment (temp/humidity/visitors).
• Safety (e.g. electrical cords, equipment). Reports problems to BME.
• Advocates for patient by acting as a clinical resource for staff in patient care management.

Acts as a patient advocate.

• Assesses, identifies, and prioritizes learning needs and barriers to learning.
• Implements, evaluates, and modifies teaching plan using multidisciplinary team members as needed.

Documentation/Competencies.

• Performance Appraisal: Completed, attaches goals.
• Education log of inservice, seminar, conferences attended; records inservice provided for others.
• Ensures his/her credentials are maintained within the Medical Staffing Office
• Provides documentation of credentials as they are updated to the Director of Surgical Services and Human Resources
• Reviews and revises preference cards and sends a copy to the Booking Coordinator.

Maintains responsibility for professional and continued learning and development.

• Identifies strengths and weaknesses within specialties.
• Takes active steps to strengthen identified weaknesses as evidenced by a written plan.
• Develops plan to strengthen weaknesses with O.R. Operations Manager and O.R. Educator to meet learning needs and to attain/maintain competency.
• Attends available workshops and seminars to enhance clinical competency.
• Attends unit specific inservices.
• Completes all mandatory inservices (CPR, Safety & Infection Control, Workplace Violence).
• Attends staff meetings and actively participates in problem solving rather than blaming/complaining.
• Participates in hospital committees to improve processes.
• Maintains certification as a CNOR.
• Attends professional meetings and provides inservices to staff. Minimum one per year.
• Establishes goals annually as part of Performance Appraisal.
• Attends formal educational programs and continuing education of 120 CEU’s every four years.
• Attains/maintains certification as RNFA and maintains specialty certification as CNOR or CRNFA.

Acts as a Preceptor for the novice or new employee by Role Modeling Professional Nursing Practices in the perioperative area.

• Works with O.R. Clinical Coordinator to identify learning opportunities for new or current staff (not constrained by a room assignment) to gain competency.
• Continuously provides support and feedback to learner
  • immediately after a case
  • written progress report weekly
  • communication with O.R. Educator weekly.
• Monitors preceptor attainment of competency using standard tools
• Seeks feedback from preceptee about what is helpful; quality of preceptor process in the spirit of always seeking to improve a process. Non-threatening.

RNFA intraoperative behaviors/skills under direction and supervision of operating surgeon

• Drapes patient according to procedure and asepsis.
• Handles tissue as directed.
• Provides hemostasis (coagulation, ligation).
• Provides exposure via retraction.
• Performs wound closure (deep and superficial structures).
• Inserts and secures drains.
• Applies dressings.
• Role models behaviors of problem solving in clinical and logistical processes to manage cases in O.R.
• Choose communication styles that embrace professional, cooperative, collaborative interpersonal relationships with all stakeholders (staff, surgeon, anesthesiologist, and other departments.
• Demonstrates knowledge of surgical anatomy, physiological and operative technique relative to operative procedures where the RNFA assists.

RNFA post-operative nursing behaviors include:

• Accompanying patient to PACU.

Additional Responsibilities:

• Works collaboratively with OR Clinical Coordinator to ensure efficient use of resources and to provide assistance as needed to ensure appropriate care delivery including adequate staffing assignments within their scope of practice
• Acts as a leader and resource person amongst his/her peers regarding the use of products, equipment and supplies for the best interests of the patient, hospital and environment
• May function as a liaison as needed to the Value Analysis Committee to provide clinical knowledge support when making decisions regarding the use of products within Perioperative Services
• Provides adjunct support as needed including assisting with audits, charging, inventory management
• Makes recommendations to staff to ensure efficient and safe delivery of care
• Works with Medical Director of BHMG to develop onboarding plan for Surgical Pas
• Onboarding plan to include Robot use training
• Onboarding plan to include training of Surgical PAs to assist with OBGYN cases

Qualifications

Educational / Minimum Requirements:

Graduation from an accredited nursing school (minimum two years post-secondary level). Successful completion of an RNFA program that meets the AORN recommended education standards for RNFA programs. Minimum of 2 years perioperative nursing experience.

State/Federal Mandated Licensure or Certification Requirements:

Current State of Connecticut registration as a registered nurse. Certification as CNOR, RNFA required. CRNFA preferred. BCLS required; ACLS preferred.

Bristol Hospital Mandated Educational Requirements:

General orientation at time of hire. Fire/Safety/Infection Control annually. Other programs as mandated by Hospital.

Special Requirements:

The role of RNFA includes the handling of tissue, providing wound exposure, the use of instruments and suturing and providing hemostasis.

Physical Requirements:

Physical and mental stamina is required for long or difficult cases and emergency call. Physical agility with repetitive occurrence including but not limited to; walking, running, bending, stooping, climbing stairs and ladders, kneeling, crouching, crawling, balancing, reaching, standing, sitting, and twisting. Lifting greater than 50 lbs. repeatedly throughout the work day. Looking at a computer monitor up to two hours daily. Vision acuity correctable to normal with normal color perception. Hearing acuity correctable to normal. Acute sense of smell for normal perception. 

Ability to verbalize so that the average person can comprehend. Must be flexible, have excellent manual dexterity, good hand/eye coordination.

Work Environment:

Regular exposure to patient elements, occasional stress. Long hours of standing may be required. Exposure to occasional radiation and anesthetic gases is possible.

Cognitive Requirements:

Provides direct care according to the established patient plan for care, and delegates care to be given by other staff. Carries out a wide variety of complete and involved treatments, procedures and examinations requiring professional judgment and initiative; as well as other more routine nursing care tasks. Such activities include, but are not limited to performing irrigations, catheterization, suctioning of tracheotomies, respiratory and other treatments/procedures. Allowing for reasonable mathematics ability administers prescribed drugs and medications intravenously, orally, subcutaneously, intramuscularly, etc., as appropriate. The RNFA under the supervision and direction of the operating surgeon, is responsible for providing perioperative nursing interventions for a given population. The RNFA collaborates with the surgeon and the health care team in performing a safe operation with optimal outcomes for the patient.

Disclaimer

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed.