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II. POSITION SUMMARY:

Under the direct supervision of the Nurse Manager, Surgery Department, the Registered Nurse in the Surgery Department is responsible for the provision of safe and effective care of the Peri-operative patient both the out-patient and the in-patient inclusive of the immediate pre-operative period, during operative procedures, and immediately following surgery in the Post anesthesia care unit. The Registered Nurse assigned to the Surgery Department may also provide direct patient care for patients admitted for endoscopy procedure.

III. ESSENTIAL FUNCTIONS

A. Administrative Functions

• Assists in the scheduling of surgical and endoscopy procedures for both inpatients and out patients. Ensures that all practitioners requesting to perform procedures have delineated clinical privileges for specific procedure(s). Ensures availability of space, personnel and equipment for requested procedures. Ensures proper distribution of schedule to different departments requiring them. Maintains appropriate charges for individual procedures/ surgeries performed in the department.

• Ensures that standard precautions and required protective apparel is utilized by all practitioners in the performance of procedures in the department. Helps in updating the logbook on surgical procedures, endoscopy and PACU logbook. In collaboration with the Nurse Manager, assists in developing and maintaining operational standards unique to the department. Teaches, supervises and serves as a resource person for nursing and other staff in the department with reinforcement of correct principles, procedures and techniques of patient care.

• Assumes responsibility for the smooth function of the department in collaboration with the Nurse Manager. Ensures that required diagnostic and therapeutic interventions are completed and documented for each patient being served by the department. Ensures implementation of operational standard, which promote the maintenance of patient rights including right to confidentiality, explanation of treatment processes, ethical and privacy consideration and handling of patient complaints. Delegates nursing care activities to members of the nursing team based on patient care needs and competencies of available nursing staff.

• Communicates information appropriately with medical staff and other members of the health care team to promote continuity of care and attainment of patient expected outcome. Checks daily the crash carts in surgery, PACU and endoscopy. Maintains medication availability in the unit, inclusive of narcotics with thorough knowledge of usual dosage, side effects, compatibilities and indication for use of each medication. Assist in monthly medication check and outdates with pharmacy, when needed.

• Participates in rotational call system as needed to provide for continuous availability of service. Acts as patient advocate in obtaining care with questioning of orders or other practices as indicated using appropriate channels of communication. Maintains current knowledge of developments and trends in the provision of perioperative nursing care through the use of in-services, professional organizations and other self-directed learning activities. Maintains awareness of current hospital and departmental operational standards, which impact on position responsibilities. Assists in housekeeping chores of the department when needed.

C. Registered Nurse in the Intra-operative Area

• Assumes responsibility for the efficient management of preoperative patients admitted to the Holding Area, preparing them for the operative procedure that they require. Possesses comprehensive knowledge of clinical components of care required in the immediate preoperative and intraoperative period to provide for direct patient care in a circulating position in the operating room. Possesses comprehensive knowledge of medicolegal responsibilities in completing documentation and checking for the presence of required consents and preoperative documents, including chart review and surgical checklist, verification of surgical site, appropriate operative orders and consent.
• Applies principles of surgical asepsis required for the surveillance of the operating room suite environment. Assumes responsibility as circulator on assigned cases, assisting both the anesthesiologist and the sterile surgical team when needed, or as surgical scrub nurse if competencies are appropriate. Care for specimens according to standards ensuring proper identification, proper handling and delivery to lab with appropriate documentation. Proficient in the utilization of specialized equipments and gadgets to provide care to patient applying principles of surgical asepsis and care to prevent burns and injury.

• Provides direct supervision to other personnel ensuring that patient care is provided by staff with identified competencies in meeting individual patient needs. Possesses comprehensive knowledge of clinical components of care required from the time of completion of the procedure until transport to the Post Anesthesia Care unit or the Intensive Care Unit. Provides appropriate information to nursing personnel regarding the patient’s status on transfer of patients to the Post Anesthesia Care Unit or the Intensive Care unit or other designated area.

E. Registered Nurse in the Endoscopy Unit

• Assumes responsibility for the overall functioning of Endoscopy when applicable in collaboration with the Nurse Manager. Communicates information appropriately with the Medical staff and other members of the health care team to promote continuity of care and attainment of patient expected outcomes. Ensures implementation of operational standards which promote the maintenance of patient rights including informed consent, explanation of patient expectations, treatment processes, maintenance of patient privacy, maintenance of confidentiality of patient information. 

• Performs technical skills proficiently in accordance with standards of care, including monitoring the patient during the procedure with documentation of data, monitoring and verifying accuracy of medication orders and administration with knowledge of usual dosage, side effects, compatibilities and indications for use of each medication. Provides guidelines for pre-procedure and post-procedure care of inpatients undergoing endoscopic procedures to nursing personnel involved in their care. Maintains environmental control through constant surveillance of patient temperature and physiological responses.

• Assesses patients appropriately for discharge based on approved discharge criteria. Applies principles of body mechanics in the provision of direct patient care activities and in the supervision of other personnel in the Endoscopy unit, including during transport of patient to other patient care units. Provides appropriate information to nursing personnel regarding the patient’s status on transfer of patients from the Endoscopy unit to other patient care units. Provides health care teachings to the patient, family or significant other with documentation.

IV. EDUCATION AND EXPERIENCE REQUIREMENTS

Current licensure in California as a Registered Nurse. Previous clinical nursing experience in Peri-operative services or endoscopy environment desired. Current verification of competency in cardiopulmonary resuscitation including and ACLS.

V. PHYSICAL DEMANDS

Physical activity – exerting up to 50 pounds of force occasionally, and or up to 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects. Physical demand requirements are in excess of those for light to medium work.

Working hazards or risks – routine hazards and risks involved in performing nursing activities, including potential exposure to infectious processes, potential exposure to hazardous substances, potential musculoskeletal injuries.

OSHA Blood Borne Risk Category I.