Registered Nurse - Surgical Services - Circulator

Registered Nurse

A Registered Nurse with basic knowledge of perioperative patient care. Coordinates and initiates patient care within the operating room. Acts as a patient advocate during the perioperative process to promote safety and the highest quality of care. Provides direction for other members of the surgical team, sterile and non-sterile. Provides direct patient care and educates patients and family members as needed.

Primarily interacts with: administration, physicians, employees, clinical and non-clinical departments, patients, visitors, and volunteers.

Primary functions:

• Responsible for safely transporting patients to the operating room.
• Check the chart prior to procedure to verify that proper documentation is on the chart and that abnormal diagnostic studies are addressed prior to the transfer of patient to the OR.
• Work closely with the ASU in assuring that prophylactic antibiotics are: appropriate for the procedure, and administered timely via the proper route.
• Responsible for monitoring compliance with core measures.
• Verify integrity of sterile packages and verify expiration dates of all items introduced into the sterile field.
• Open sterile instrument packs, drapes, solutions, and supplies while maintaining sterility during transfer into the sterile field.
• Coordinate personnel within the operating suite verifying that the surgeon, anesthesia provider, and other team members are present.
• Stand by the patient during the induction of anesthesia to promote safety of the patient and assist the anesthetist if needed.
• Properly connect sterile devices and equipment from sterile field to non-sterile sources (suction, bovie, camera, light, etc.).
• Safely handle and prepare medications used in the sterile field.
• Identify, prepare, and pass suture to surgeon when needed.
• Participate in counting of sponges, needles, and instruments according to departmental policy.
• Recognize and verbalize breaks in sterile technique by self and others.
• Help prepare the Operating suites and readies equipment for procedures, including housekeeping needs, instruments, and equipment when needed.
• Properly care for tissue specimens, including packaging.
• Apply sterile dressings at the end of procedure without contamination of the dressing or the operative site.
• Properly prep the operative site prior to incision.
• Count sponges and sharps with the scrub member per policy.
• Assist with daily housekeeping duties within the surgical department as needed (including break room, sterile supply, endoscopy, scrub areas, anesthesia room, etc.)
• Initiate timeouts prior to procedure to avoid wrong site surgery.
• Keep an ongoing assessment of supplies needed versus supplies in the room.
• Remain in the operating room at all times unless relieved by another RN.
• Dispense medications needed on the back table, checking labels for correct medication and expiration dates.
• Communicate procedure status when necessary to the ASU to facilitate coordination of procedures and to update family members.
• Prepare specimens to be sent to that lab (enter in log book, verify proper packaging)
• Assist the anesthetist post-operatively during emergence from anesthesia and stands by the patient to promote safety.
• Accompany the patient and anesthetist to the PACU and give appropriate report to the receiving nurse.
• Assist staff in the cleaning and preparation of the operating room for subsequent procedures.
• Check narcotic sheet against stock per policy to be sure all narcotics have been signed for.
• Enter charges from the procedure and medications/drugs used into the computer in a timely manner to assure proper capturing of charges.
• Participate in annual peer competency review process.
• Provide exemplary customer service.
• Maintain confidentiality and compliance with HIPAA.
• Cooperate with other personnel to achieve departmental objectives and maintain good employee relations, inter-departmental objectives and infection control policies.
• Cordially demonstrate timeliness and professionalism in appearance, communications, and actions during all interactions and with all individuals and entities.
• Solve practical problems, dealing with a variety of issues, and interpret a variety of instructions furnished in written and oral form.
• Attend meetings as required.
• Perform other duties as requested or assigned.

Requirements:

Ability to use equipment, tools, materials, machines:

• Computer, telephone, facsimile machine, copier, scanner, printer, calculator and other standard office equipment.
• Blood Pressure Cuffs, stethoscope, syringes, IV pumps, feeding pumps, beds, scales, lifts, hyper/hypothermia units, glucose monitors, PCA pumps, suction equipment, ventilators, crash cart, miscellaneous medical equipment and DME.

Education/Experience/Skills/Abilities:

Education:

• Associate degree in nursing required; bachelor degree in nursing preferred
• Valid RN license in Texas
• BLS/ACLS required.

Experience:

• One year nursing experience preferred.
• 4-6 weeks preceptor training required.

Personal job-related skills / abilities:

• Must be committed to quality and patient safety at all times.
• Excellent command / highly proficient in spoken and written English; bilingual in Spanish preferred.
• Basic computer skills, including but not limited to: Microsoft Office, electronic medical documentation, and email.
• Must be effective at adjusting to change, prioritizing duties, handling stress and effectively communicating face-to-face and/or over the telephone.
• Must be able to work independently, and flexibly, and as a part of a multidisciplinary team.
• Must be able to manage several interruptions throughout the shift.
• Must have strong interpersonal and communication skills, verbal and written.
• Must have strong time management skills.
• Must be able to work under pressure while interacting in a helpful, courteous manner with a high degree of patient contact.
• Sufficient hearing, vision and dexterity to perform duties safely.

Physical and Mental Requirements:

Physical:

• Walking: 80
• Squatting: 40
• Standing: 80
• Pulling: 25
• Kneeling: 50
• Reaching: 50
• Sitting: 20
• Lifting up to 50 lbs: 25
• Pushing: 25
• Wrist/Finger Movements: 90
• Bending: 50
• Climbing: 1

Mental:

• Stress Level Moderate to High

Individual position core competencies:

• Quality
• Service Excellence
• Compassion
• Professionalism
• Fiscal Responsibility

Required education within first 60 days (if employee is from outside organization):

• GrahamRMC Orientation
• Department Orientation

Continuing/Annual Education and Training:

• As needed to maintain certification/licensure of position
• BLS/ACLS Falling Star Program
• Safety Storm Program

Supervision:

Employees Supervised: __No__

ADA Requirements:

Each category is grouped under a percentage rating based on the frequency the condition is expected to occur.

Frequency of Condition 1-33% 34-66% 67%+

1-33%

• Extreme Heat
• Extreme Cold
• Extreme Swings in Temperature</