Location: Hopkinsville,KY, USA
The RN working in L/D is responsible for promoting and maintaining quality patient care on all patients presenting to the L/D area. They will function with minimal supervision and exercise sound judgment when conducting medical screens on patients presenting to L/D for monitoring/observation. The RN has knowledge of the admission, discharge, transfer and fetal monitoring of all patients presenting to L/D. Assures Hourly Rounding with Intention is done on all labor patients Q 30 minutes-1 hour for safety of the patient utilizing Aidet . RN will conduct herself in a professional manner at all times and will adhere to unit specific/JSMC policies/procedures and function within the scope of her practice.The RN in L/D area is responsible for admitting and caring for a patient in labor throughout her delivery and recovery. This includes taking vital signs, starting IV and drawing blood, vaginal exams, pain management and obtaining pertinent information and able to document in McKesson/OB Trace Vue. RN is knowledgeable about EFM which includes interpretation and treating strips, notification of physician in a timely manner and providing them with needed information such as dilation, effacement, station, presentation and reactivity of the baby. Has understanding of all policies and protocols related to labor and delivery such as: Cytotec, Pitocin, Magnesium Sulfate, Fetal Distress, Prolapsed Cord, Shoulder Dystocia, Uterine Rupture, Abruption, Preparation for Emergency C/Section/Delivery and Fetal Demise.The RN in L/D is aware of the chain of command process, Emtala regulations, transfer process, and notification of on-call anesthesia/physician. RN will provide the on-coming shift with report utilizing hand-off communication at bedside. The RN will adhere to AWHONN/AGOG standards with much emphasis on EED/Healthy Babies 39 weeks or greater.Identifying patient care requirements by establishing personal rapport with potential and actual patients and other persons in a position to understand care requirements.Establishing a compassionate environment by providing emotional, psychological, and spiritual support to patients, friends, and families.Promoting patient's independence by establishing patient care goals by teaching patient, friends, and family to understand condition, medications, and self-care skills; answering questions.Assuring quality of care by adhering to therapeutic standards; measuring health outcomes against patient care goals and standards; making or recommending necessary adjustments; following hospital and nursing division's philosophies and standards of care set by state board of nursing, state nurse practice act, and other governing agency regulations.Resolving patient problems and needs by utilizing multidisciplinary team strategies.Maintaining safe and clean working environment by complying with procedures, rules, and regulations; calling for assistance from health care support personnel.Protecting patients and employees by adhering to infection-control policies and protocols, medication administration and storage procedures, and controlled substance regulations.Documenting patient care services by charting in patient and department records.Maintaining continuity among nursing teams by documenting and communicating actions, irregularities, and continuing needs.Maintaining patient confidence and protecting operations by keeping information confidential.Ensuring operation of equipment by completing preventive maintenance requirements; following manufacturer's instructions; troubleshooting malfunctions; calling for repairs; maintaining equipment inventories; evaluating new equipment and techniques.Maintaining professional and technical knowledge by attending educational workshop; reviewing professional publications; establishing personal networks; participating in professional societies.Completes Nursing History and Assessment accurately within the 24 hours of admissionDetermines and delivers age appropriate careDelegates duties based on complexity of patient needsUtilization of critical thinking skills in prioritization of careDevelops, prioritizes, updates and maintains individualized plan of careCoordinates and collaborates Plan of Care with health care teamIncorporates Discharge planning needs on the Plan of CareDocuments interventions that are accurate, pertinent, timely and legibleAdministers medications observing the 6 rights Maintains Barcode Override rate