RN REACH

As a member of the Resource Team, it is expected that the REACH Nurse / RN will strive to achieve the highest standards of excellence every day, demonstrating

• Exemplary Covenant Values

• Outstanding Clinical Skills

• Amazing Flexibility

The REACH / RN demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant and the commitment to Extraordinary Care for Every Generation. The REACH Nurse is responsible and accountable for assisting with the delivery of care and patient to move safely and effectively through the hospitalization. The REACH Nurse responsibilities include leadership, direction and feedback to care team members; assessment, collaboration and coordination regarding plan of care; patient and family education; pain management; patient safety; and planning for patient discharge. The REACH Nurse is a supportive role assisting the care givers and patients through critical events in their hospitalization such as Code Blue, Code 180, REACH Calls and other patient clinical needs.

Contributes to the organization success targets for net operating margin.

Models Covenant’s Mission, Vision and Values of keeping our commitment to Extraordinary Care for Every Generation.

Contributes to organizational success for patient satisfaction.

Demonstrates excellent customer service in all contacts with internal and external customers.

Communicates with patients and families in a professional, therapeutic, and courteous manner.

Intervenes with problematic issues with patients, families, visitors, employees and physicians as needed, involving managers appropriately.

Demonstrate outstanding communication methods and skills, using lines of authority appropriately.

Effectively relates to and interacts with patients, families, visitors and other staff.

Records observations and care interventions on all appropriate forms.

Demonstrate thorough knowledge of hospital policies, procedures and guidelines.

Role Models the adherence to all policies

Collaboratively interacts with other hospital employees to increase their knowledge and adherence to policies

Displays professional responsibilities

Demonstrates an awareness of self-responsibility and accountability for own professional practice. Seeks validation of knowledge base, skill level, decision making as necessary and assertively seeks guidance in area of question.

Provides leadership, direction, encouragement , and feedback on unacceptable performance and exemplary performance.

Serves as a role model / mentor for staff

Maintains professional standards by actively participating in continuing education activities, quality management activities inservices related to area of practice and age(s) of patient population.

Maintains specific PICC and Med Port Certifications

Adheres to Unit, Department and Hospital budgetary practices

Attends and participates in Staff Meetings

Demonstrates critical thinking skills as evidenced by ability to perform efficiently in emergent patient situations following established standards.

Assist with bedside emergencies, including REACH calls, Code Blues, and Code 180 Calls

Demonstrate ability to make critical independent decisions

Demonstrates ability to be flexible based on priority, as determined by an assessment and triage of situations and individual crisis.

Demonstrates ability to care for a variety of patient age, acuity and clinical presentation.

Assist with bedside procedures and monitoring of critical patients

Assist with the Admission Process and subsequent EMR documentation in the Admission Navigator

Assist with Transporting and monitoring critically ill patients to X-rays and other procedures.

Provides patient care as directed:

Performs assessment and synthesizes data collected by self and others in an ongoing and systematic manner, focusing on the patient's physiologic, psychologic, and cognitive status.

Formulates and coordinates a goal directed plan of care which is prioritized and based on determined nursing diagnoses and/or identified patient care concerns.

Delegates, supervises and implements care in a knowledgeable, skillful, consistent and continuous manner by utilization of/adherence to standards which define the process.

Collaborates effectively with all health care disciplines to facilitate patient outcomes, assess readiness for discharge and anticipate discharge needs.

Identifies patient/significant other learning needs and their ability to follow through, including discharge instructions, while implementing appropriate measures to meet these needs.

Administers medications as outlined by Patient Service guidelines and policies.

Assist with peripheral intravenous catheter insertions, med-port access, and trouble shooting of PICC lines for patient care areas.

Assist with application/maintenance of wound vac dressings.

Performs as a role model and mentor for all staff during patient care delivery.

Demonstrates Staffing Flexibility:

Remains flexible in staffing patterns.

Participates in temporary staffing assignments

Demonstrates professionalism and flexibility with the resolution of staffing conflicts

Supports Patient rights/safety/legal issues:

Demonstrates awareness and sensitivity to patient/significant other rights, as identified within the organization.

Functions with an awareness and application of safety as identified within the organization

Demonstrates awareness of legal issues in all aspects of patient care, unit function and strive to manage situations in a reduced-risk manner

Maintains Patient confidentiality

Promptly reports actual or potential medication errors and adverse drug events

Primary Responsibilities – Center around Patient Safety

1.Respond to ALL Code Blue calls

Includes Code Blue to Critical Care Units / Select / Ancillary Areas

2.Respond to REACH calls, paged and unpaged

If patient condition necessitates, act immediately for patient safety

All other calls, talk with the primary care RN.

Should be a mentoring/learning opportunity for the primary RN

DO NOT take over the patient care

Review the assessment and interventions with the RN

Contact the patient’s physician PRN

Ask the RN / Charge Nurse “How would you like me to help?”

Document the REACH call in the patient’s EMR using the .exprn phrase

Document REACH call in REACH Database

3.Activate a Code 180 when appropriate.

Prefer to have a AST (Acute Stroke Team) member respond

If you are not a AST member, report to 4E (Neuro ICU)

Cover the floor so one of them can respond

Code 180 calls in the ECC are initiated by the ECC Physician

Express RNs do NOT need to respond to these.

Code 180 calls in the CDU are handled by the Express RNs

All Code 180s use the appropriate flowsheets / order sets in Epic

4.Check Crash Cart in Cooper Admitting every shift

Secondary Responsibilities –Center around Patient / Staff Support

Experienced resource to novice RN

Staff Mentoring / Nurturing / Education

Transport patients from general floors to ICU, when asked

Lower to higher acuity

Cover Critical Care Unit when RN leaves floor with patient for a procedure

Approved in advance by Shift Administrator or Resource Team / Staffing Coordinator

Assist RN in Critical Care with transport of unstable patient to procedure

Approved in advance by Shift Administrator or Resource Team / Staffing Coordinator. Will be the 2nd RN on transport

Tertiary Responsibilities – Done as time permits

Hard to Start IVs

It is expected that an experienced RN attempt initially

Unit Rounds

Visual check monitors for rhythm/rate issues, talk with primary RN

Ask the Charge Nurse if there are any questions/needs

PICC trouble shooting and dressing changes

If have specialized training by PICC Team

If PICC team not available.

Supply retrieval

Wound care/Dressing supplies in ET Offices

Other supplies: Materials Management

Cooper basement- between Main elevators and Room 63

Harrison 1st floor- just past Room 63

Wound photography If the ET RN is not available, you may be asked to take pictures of wounds

If  the ET RN is not available, you may be asked to take pictures of wounds

EDUCATION/EXPERIENCE

Current Michigan licensure to practice as a Registered Nurse

BLS and ACLS certification

PALS Preferred TNCC within 1 year of acceptance into position

Specialty training in Acute Stroke Management required

Minimum of 3years clinical experience required

Minimum of 1 year Critical Care experience required

Minimum of 1 year Emergency Care experience preferred

KNOWLEDGE/SKILL/ABILITIES

Experienced in clinical area

Demonstrated understanding of communication and customer service principles

Demonstrated understanding of patient’s rights, legal issues, and policies related to confidentiality

Demonstrated ability to make critical independent decisions

Strong clinical assessment skills

Excellent communication, and critical thinking skills

Strong interpersonal and customer service skills

Strong computer skills, including EPIC

Strong organizational and time management skills

Demonstrate ability to care for various patient population

Functions as a RN III with the ability to care for patients in all identified clusters

Demonstrate ability to be flexible based on priority

Demonstrate ability to perform and prioritize independently

WORKING CONDITIONS/PHYSICAL DEMANDS

Ability to maintain punctual attendance consistent with the ADA, FMLA, and other federal, state, and local standards

Constant talking, hearing, tasting/smelling, near vision, midrange vision, far vision, depth perception, visual accommodation, color vision and field of vision

Frequent lifting 0-25 lbs.

Frequent standing, walking and sitting

Occasional lifting 26-100 lbs. or more

Occasional reclining, lifting, carrying, pushing, pulling, climbing, balancing, stooping, kneeling, crouching, squatting, crawling, twisting, reaching, handling and feeling