Registered Nurse Observation

To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

As an integral member of the Yale New Haven Health System (YNHHS) healthcare team, the Registered Professional Nurse (RN) upholds the YNHHS mission, vision, values and strategic initiatives to provide the highest level of patient centered care. The RN practices professional nursing as a registered nurse within the legal and ethical framework established by the Connecticut Nurse Practice Act, American Nurses Association Scope and Standards for Nursing Practice, ANA Code of Ethics for Nurses and the YNHHS Professional Practice Model. The professional role of the RN is exemplified by the qualities of leadership, delegation, collaboration, effective communication, ensuring quality outcomes. YNHHS nurses practice in a framework outlined in our professional practice model, which states, "Achieving outcomes through Autonomy and Accountability". We value Nursing Professional Governance, and use evidence and data to support our practice with the patient and family at the center, always. The RN provides care that: * Establishes and maintains a therapeutic relationship with the patient and family encompasses an understanding and integration of cultural and diversity into practice * Includes communicating and working collaboratively with the patient, family and health care team members * Includes respecting the patient's values, preferences, expressed needs and knowledge of the healthcare situation in holistic data collection, in formulating health care outcomes and in the evaluation process.

EEO/AA/Disability/Veteran

• Unit: Celentano 2 Yale New Haven Hospital, Saint Raphael Campus Observation RN Observation nursing lies between emergency nursing and inpatient nursing- it is fast-paced and assessment-focused. Observation nurses care for patients who are not sick enough to be admitted as full inpatients but are not well enough to go home yet. These patients usually stay in the hospital 12-48 hours while doctors determine whether they need an inpatient admission or can be safely discharged. Observation nurses often have patients with conditions such as: * Chest pain * Heart failure * Stroke-like symptoms * Asthma exacerbation * Syncope * Dehydration * Abdominal Pain Nursing Duties: * Head-to-toe assessments * Vital sign checks * Reviews cardiac monitoring * Evaluates pain levels and symptoms * Thorough documentation Because observation patients are often being evaluated for possible discharge, our nurses spend time: * Medication teaching * Reviewing discharge instructions * Ensuring follow-up appointments are arranged Unlike inpatient units where patients may stay several days, observation units frequently admit and discharge patients on the same shift. An observation nurse may care for multiple admissions and discharges in a shift.

• 1. STANDARDS OF PRACTICE RN practice is guided by the ANA Scope and Standards of Practice (2015). The Standards of Practice describe a competent level of nursing care as demonstrated by utilizing the nursing process components of assessment, diagnosis, outcomes identification, planning, implementation and evaluation. Assessment: The registered nurse collects pertinent data and information relative to the healthcare consumer's health or situation Diagnosis: The RN analyzes the assessment data to determine the actual and potential diagnoses or the issues. Outcomes Identification: The RN identifies expected outcomes for a plan individualized to the healthcare consumer or the situation. Planning: The RN develops and modifies a plan of care that prescribes strategies and alternatives to attain expected outcomes. Implementation: The RN implements the identified plan. Coordination of Care: The RN coordinates care delivery and transitions in care. Health Teaching and Health Promotion: The RN employs strategies to promote health and a safe environment. Evaluation: The RN evaluates progress toward attainment of outcomes.
• 2. STANDARDS OF PROFESSIONAL PERFORMANCE The ANA Standards of Professional Performance (2015) describe a competent level of behavior in the professional role, including activities related to: ethics, culturally congruent practice, communication, collaboration, leadership, education, evidence-based practice and research, quality of practice professional practice evaluation, resource utilization and environmental health. The RN is expected to engage in professional role activities, including leadership, appropriate to their education and position. The RN is accountable to for their professional actions to themselves, their healthcare consumers, their peers and ultimately to society. Ethics: The RN practices ethically. Culturally congruent practice: The RN practices in a manner that is congruent with cultural diversity and inclusion principles. Communication: The RN communicates effectively in all areas of practice Collaboration: The RN collaborates with healthcare consumer and other key stakeholders in the conduct of nursing practice. Leadership: The RN leads within the professional practice setting and the profession. Education: the RN seeks knowledge and competence that reflects current nursing practice and promotes futuristic thinking. Evidence-Based Practice and Research: The RN integrates evidence and research findings into practice Quality of Practice: The RN contributes to quality nursing practice. Professional Practice Evaluation: The RN evaluates owns' and others' nursing practice. Resource Utilization: The RN utilizes appropriate resources to plan provide and sustain evidence-based nursing services that are safe, effective and fiscally responsible Environmental Health: The RN practices in an environmentally safe and healthy manner.

EDUCATION

Graduation from an accredited school of nursing. BSN preferred. All newly hired registered nurses must have current BCLS certification or must obtain within one month of hire.

EXPERIENCE

Registered Nurse is the foundational job description for all RNs. All RNs are encouraged to advance through the SPIRE clinical advancement program.

LICENSURE

Licensed and a currently registered nurse in the State of Connecticut. Clinical specialty certification highly encouraged.

SPECIAL SKILLS

Registered Nurse is the foundational job description for all RNs. All RNs are encouraged to advance through the SPIRE clinical advancement program.

PHYSICAL DEMAND

Requires prolonged standing; walking; use of sight, hearing, and touch. May be exposed to infectious diseases. Will be exposed to physical, mental and emotional illness as well as end of life conditions and death. Moderate stress and risk of injury from patient care. Standing/walking for more than half of the day. Frequently bending, reaching, pushing, pulling, twisting and lifting. Must be able to assist pushing/pulling/lifting patients ranging from five (5) to three hundred (300) pounds.