REGISTERED PROFESSIONAL NURSE JOB DESCRIPTION
ADULT CRITICAL CARE
Job Summary:
The Adult Critical Care RN is responsible for managing the care of the adult or elderly patient experiencing life-threatening problems requiring complex assessment, high intensity therapies and interventions, and continuous nursing vigilance. The Adult Critical Care RN is responsible to the Clinical Manager for assigned ICU or Emergency Department.
Qualifications:
· Current licensure in good standing in the state of practice
· Evidence of 1 year of adult critical care nursing experience within the past two years
· Evidence of BLS credential mandatory; additionally, the RN may have resuscitation credentials, including but not limited to ACLS (Advanced Cardiac Life Support) or TNCC (Trauma Nursing Core Course)
· Additionally, the RN may have professional certifications, including but not limited to CCRN, CEN (Certified Emergency Nurse) or CNRN (Certified Neuroscience Registered Nurse)
Responsibilities:
· Conducts an individualized patient assessment, prioritizing the data collection based on the adult or elderly patient’s immediate condition or needs within timeframe specified by client facility’s policies, procedures or protocols.
· Conducts ongoing assessments as determined by the adult or elderly patient’s condition and/or the client facility’s policies, procedures or protocols and reprioritizes care accordingly.
· Develops plan of care that is individualized for the adult or elderly patient reflecting collaboration with other members of the healthcare team.
· Performs appropriate treatments as ordered by physician in an accurate and timely manner.
· Performs therapeutic nursing interventions as established by individualized plan of care for the adult or elderly patient and his/her family.
· Provides individualized patient/family education customized to the adult or elderly patient and his/her family.
· Documents patient assessment findings, physical/psychosocial responses to nursing intervention and progress towards problem resolution.
· Initiates emergency resuscitative measures according to adult resuscitation and advanced life support protocols.
· Maintains confidentiality in matters related to patient, family and client facility staff.
· Provides care in a non-judgmental, non-discriminatory manner that is sensitive to the adult or elderly patient’s and family’s diversity, preserving their autonomy, dignity and rights.
· Reports patient condition to appropriate personnel during each shift.
· Maintains current competency in adult critical care nursing.
KNOWLEDGE & SKILLS CHECKLIST
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ASSESSMENT & CARE OF PATIENT W/ OR REQUIRING:
1. Abdominal Aortic Aneurysm Repair
2. Acute MI
3. Acute Pneumonia
4. Acute Renal Failure
5. Adrenal Disorders
6. Angioplasty
7. ARDS
8. Bacterial Endocarditis
9. Basal Skull Fracture
10. Blunt Trauma
11. Bone Marrow Transplant
12. Bowel Obstruction
13. Brain Death/Organ Procurement
14. Burns
a) First degree
b) Second degree
c) Third degree
15. Cardiac Arrest
16. Cardiac Catheterization
17. Cardiac Tamponade
18. Cardiac Transplant
19. Cardiomyopathy
20. Cerebral Vascular Accident (CVA)
21. Chest Trauma
22. Coma
23. Congestive Heart Failure (CHF)
24. COPD
25. Cor Pulmonale
26. Cranial Aneurysm
27. Delirium Tremens
28. Diabetic Ketoacidosis
29. Diabetes Mellitus
30. Disseminated Intravascular
Coagulopathy (DIC)
31. Drug Overdose
32. Electrocution Injury
33. Encephalitis
34. ERCP
35. Esophageal Bleeding
36. Externalized VP Shunt/Reservoir
37. GI Bleeding
38. Gun shot/Stab Wound
a) Abdomen
b) Chest
c) Head
39. Hazardous Material Exposure
40. Head Trauma
41. Heat Exhaustion/Stroke
42. Hepatic Failure
43. Hepatitis
44. HIV/AIDS
45. Hyperthyroidism
46. Hypothermia
47. Hypothyroidism
48. Infective Endocarditis
49. Inflammatory Bowel Disease
50. Ileal Conduit Nephrostomy
51. Insulin Shock
52. Intracoronary Stent Placement
53. Leukemia
54. Liver Transplant
55. Lung Transplant
56. Malignant Tumors
57. Meningitis
58. Multiple Sclerosis
59. Multiple Trauma
60. Multi-System Organ Failure
61. Myocardial Contusion
62. Near Drowning
63. Neuromuscular Disease
64. Pancreatitis
65. Orthopedic Injury
66. Paralytic Ileus
67. Pericarditis
68. Penetrating Trauma
69. Pituitary Disorders
70. Post-Operative Care
a) Cardiothoracic Surgery
b) GI Surgery
c) Neurosurgery
d) Ostomy
e) Tracheostomy
f) Vertebral Surgery
g) Vascular Surgery
71. Pulmonary Edema/Hypertension
72. Pulmonary Embolism
73. Radiation Exposure
74. Renal Rejection Syndrome
75. Renal Trauma
76. Renal Transplant
77. Seizures
78. Shock
a) Anaphylactic
b) Cardiogenic
c) Hypovolemic
d) Neurogenic
e) Septic
79. Spinal Cord Injury
80. Status Asthmaticus
81. Traumatic Amputation
82. Tension Pneumothorax
83. Tuberculosis
84. TURP
85. Thyroid Dysfunction
86. Urinary Tract Infection
87. Additional patient types seen in ED:
a) Bites
i. Animal
ii. Human
iii. Venomous snake
iv. Venomous spider
b) Eye Injuries
c) Precipitous Delivery
d) Spontaneous Abortion
SKILLS
1. Admission Process
2. AMA Procedure (ED Skill)
3. A-V Fistula Care
4. Brace/Splint Application
5. Bronchoscopy (assist)
6. Catheter insertion & care
a) Bladder Irrigation
b) Foley
v. Female
vi. Male
c) Straight
i. Female
ii. Male
d) Suprapubic
7. Cardioversion
8. Cast Placement (assist) & Care
9. Charge Nurse Routine
10. Chemotherapy – Adult Protocols
11. Chest Physiotherapy
12. Chest tube & drainage system
a) Care & maintenance
b) Insertion (assist)
c) Removal
d) Set-up
13. Continuous AV Hemodialysis (CAVH)
14. EKG Interpretation
a) 12 Lead
b) Arrhythmia
c) Lead placement:
i. 5 electrode placement
ii. I, III, V-leads
iii. Lead II & MCL
15. Emergency Tracheostomy (assist)
16. Extubation
17. Feedings
a) Continuous tube feeding
b) Gavage, intermittent
18. Femoral Artery Sheath Removal
19. Forensic Evidence Collection (ex. Rape
Kit) (ED Skill)
20. Gastric Lavage, Iced Saline
21. Gastric Suction
22. Glascow Coma Scale
23. Halo Traction/Cervical Tongs
24. Hemodialysis
25. Hemodynamic Monitoring, Invasive
a) Mean Arterial (MAP)
b) Central venous (CVP)
c) Pulmonary Artery/Capillary Wedge
d) Radial Arterial
e) Specific Measurements
i. Cardiac index
ii. Cardiac output
iii. SVO2
26. Hemodynamic Monitoring, Noninvasive
a) Auscultation
b) Doppler
c) Electronic
d) Palpation
27. Hyperbaric Skills Monitoring
28. Interpretation of Lab Results
a) Blood Gases
b) Blood Chemistry
c) Cardiac enzymes & isoenzymes
d) CBC
e) Coagulation studies
f) Cultures
g) Electrolytes
h) Urine dipstick
29. Intestinal Tract Tubes, Placement &
Care
a) Gastrostomy
b) Jejunostomy
c) Nasogastric
d) Orogastric
e) T-tube
30. Intra Aortic Balloon Pump
31. Intracranial Pressure Monitoring
32. Intravenous Infusion Therapy
a) Blood & blood products infusion
i. Albumin
ii. Auto transfusion
iii. Cryoprecipitate
iv. FFP
v. Packed RBCs
vi. Whole blood
b) Central line site maintenance
i. Broviac
ii. Groshong
iii. Hickman
iv. Peripheral arterial line
v. PICC
vi. Portacath
vii. Quinton
c) Heparin lock
d) Nutritional Infusions
viii. Hyperalimentation
ix. Intralipids
e) Peripheral IV insertion &
maintenance
i. Angiocath
ii. Butterfly
33. Intubation (assist)
34. Isolation Procedures
35. Lumbar Puncture (assist)
36. Nerve Stimulators
37. Neurological Assessment
38. Nursing Assessment Care Planning
39. Oral Airway Insertion
40. Oxygen Therapy Administration
a) Bag & mask
b) ET tube
c) External CPAP
d) Face mask
e) Nasal cannula
f) Trach Collar
41. Pacemaker
a) External
b) Permanent
c) Temporary
d) Transthoracic
42. Peritoneal Dialysis
a) Automatic cycler
b) Manual
43. Peritoneal Lavage
44. Physical Assessment
45. Restraints
46. Specimen Collection
a) Blood
i. Arterial stick, femoral
ii. Arterial stick, radial
iii. Central line
iv. Venous stick
b) Cultures
c) Sputum
d) Urine
i. Catheter
47. Suctioning
a) ET Tube - Closed
b) ET Tube - Open
c) Nasal-pharyngeal
d) Oral-pharyngeal
e) Tracheostomy
48. Suicide Precautions
49. Temperature
a) Axillary
b) Oral
c) Tympanic
50. Thoracentesis (assist)
51. Ventricular Assist Device (RVAD,
LVAD)
52. Vital Signs
53. Wound/Ostomy Care
a) Colostomy site care/bag change
b) Decubitus ulcers
c) Ileostomy site care/bag change
d) Irrigations
e) Staple insertion (assist)
f) Sterile Dressing Changes
g) Steristrip application
h) Surgical wounds with drains
i) Suturing (assist)
MEDICATIONS
1. Adenosine
2. Albuterol (Ventolin)
3. Aminophylline
4. Amiodarone (Cardarone)
5. Amrinone (Inocor)
6. Aquamephyton
7. Atropine
8. Bretylium
9. Charcoal
10. Chemotherapeutic agents
11. Corticosteroids
12. Dobutamine
13. Dopamine
14. Diazepam (Valium)
15. Digoxin
16. Diltiazem
17. Epinephrine
18. Esmolol
19. Insulin
20. Ipecac
21. Isoetharine (Bronkosol)
22. Kayexelate
23. Lactulose
24. Lasix
25. Lidocaine
26. Mannitol
27. Meraproteranol (Alupent)
28. Metoprolol (Lopressor)
29. Nitroprusside
30. Nitroglycerine
31. Phenobarbital
32. Phenytoin (Dilantin)
33. Procainamide (Pronestyl)
34. Propranolol (Inderal)
35. Sodium Bicarbonate
36. Streptokinase
37. Terbutaline
38. TPA
39. Thyroid Replacement
40. Vasopressin
41. Verapamil
42. Delivery Methods
a) Continuous IV infusion
b) Eye/ear instillations
c) IM injections
d) Insulin pump
e) IV Push
f) Meter dosed inhalers
g) Nebulizer
h) Rectal infusion/suppository
i) SQ injections
j) Z track injections
PAIN MANAGEMENT
1. Pain Level Assessment
2. Care of patient w/:
a) Epidural analgesia
b) IV conscious sedation
c) Patient controlled analgesia (PCA)
d) Narcotic agents
e) Non-narcotic agents
EQUIPMENT
1. BP transducer
2. Cardiac Monitor
3. Centrifuge
4. Defibrillator
5. Glucometer
6. Hemodialysis Machine
7. Hypo/Hyperthermia mattress
8. Infusion Delivery Systems (Specify
manufacturer)
a) IV pump:
b) IV pump
c) IV pump
9. Oxygen Analyzer
10. Oxygen Blender
11. Pulse Oximeter
12. Specialty beds
a) Air fluidized
b) Low air loss
c) Rotating
13. Stryker Frame
14. Ventilator
a) CPAP
b) High frequency jet
c) Pressure
d) T-Piece
e) Volume
Age Specific Experiences
Adolescent (13-18 yrs)
Young Adult (19-39 yrs)
Middle Adults (40-64 yrs)
Older Adult (65+ yrs)
1. Understands the normal growth and development for each age group and adapts care accordingly
2. Understands the different communication needs for each age group and changes communication methods and terminology accordingly.
3. Understands the different safety risks for each age group and alters the environment accordingly
4. Understands the different medications, dosages and possible side effects for each age group and administers medications appropriately.
The information I have provided in this knowledge and skills checklist is true and accurate to the best of my knowledge.
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