Registered Nurse (RN) Per Diem - Labor & Delivery
This unit is comprised of L&D and a separate L&D triage area. We have 24 hour perinatologists, neonatologists, and anesthesiologists (dedicated to OB) along with obstetric physicians and 2 sets of midwives. We are a 28 bed high risk antepartum and intrapartum unit including 14 LDR beds, 10 antepartum outpatient beds, and 4 pre-op and post-op beds. We have 3 dedicated L&D OR’s for scheduled C-Sections and unscheduled cases such as cerclage placement or removal. We also do emergent cases such as a laboring patient who needs a C-Section for arrest of dilation or descent or fetal intolerance of labor, hysterectomy or D&C for hemorrhage. Our nurses are unique in that they are trained to be the pre-op nurse, intraoperative nurse (circulator), and PACU nurse for all OR cases, along with the nurse for the newborn after delivery. We care for triage patients; ante-partum patients (both outpatient and inpatient if high risk or unstable); intrapartum, and preop and postop patients. Our triage nurses see pregnant women over 20 weeks of gestation for obstetrical concerns. They also take care of patients with scheduled procedures such as non-stress tests and versions. We currently do over 5,500 deliveries a year. We currently have 14 nurses certified in Inpatient Obstetrics through NCC. Several nurses also have a subspecialty certification in electronic fetal monitoring. All nurses in L&D are certified in NRP and ACLS.
Coordinates patient care planning with other disciplines utilizing the principles of the nursing process and critical thinking skills in order to maintain patient safety and well-being. (Some positions might be assigned to critical care areas requiring specialized training.)
Provides direct patient care, evaluates outcomes, consults with other specialists as required and adjusts nursing care processes as indicated to ensure safe patient care.
Writes or obtains initial nursing histories, assesses patients' conditions and develops individual care plans; maintains patient documentation.
Receives and reviews preceding shift reports and floor nurse reports; makes complete rounds of all units, and notes patients' condition.
Notifies appropriate physician regarding any unusual or unexpected events or problems requiring direct physician consultation.
Works with other members of the interdisciplinary patient care team, implements and reinforces patient instructional needs with patient and family offering informational material and pointing out special areas of concern.
Evaluates outcomes of patient care, consults with other specialists as needed and adjusts nursing care processes as necessary to ensure optimal patient care.
Identifies and resolves workplace health and safety issues.
Provides appropriate, direct patient care utilizing appropriate aseptic techniques.
May manage IV lines, ensure that sterile techniques are adhered to, and oversee patient movement and positioning to ensure that the patient is handled in a medically safe manner.
May perform the administration of pharmacological vasodilator medications for the purpose of nuclear myocardial perfusion imaging; complies with examination competency as defined in the Imaging Services Practice Standards.
Complies with policies, procedures, regulations, and standards and takes corrective action when violations occur.
Orients, instructs, and educates assigned personnel.
Adheres to and supports team members in exhibiting TMCH values of integrity, community, compassion, and dedication.
Adheres to TMC organizational and department-specific safety, confidentiality, values, policies and standards.
Performs related duties as assigned.
EDUCATION: Graduation from a qualified, nationally-accredited nursing program. (Some positions may require additional training related to specific skill area, such as EP, which requires instructional programs in intra-cardio echocardiogram and electrophysiology, which includes 30 ablation procedures.)
EXPERIENCE: One year of nursing experience in an acute care setting preferred. (Positions assigned to EP: require two (2) years of EP experience or demonstrated competency in all areas of EP Lab procedures).
LICENSURE OR CERTIFICATION: Current RN licensure permitting work in the State of Arizona and Basic Life Support (BLS) certification required. Some departments such as OR, Ambulatory Surgery, Pediatrics/PICU, PACU, and GI Lab will require advanced life support certification (ACLS and PALS). (Additional certification may be required for some specialties, such as EP certification from International Board of Heart Rhythm Examiners for Special Competency in Cardiac Electrophysiology for the Associated Professional or equivalent certification.) For Hospice & Pediatrics areas, valid Arizona Fingerprint Clearance Card within 6 months of hire and for Mental Health only Crisis Prevention Instruction (CPI) required.
KNOWLEDGE, SKILLS AND ABILITIES:
Knowledge of direct patient care and critical care procedures and techniques, tools, and responses required to ensure optimal patient care.
Knowledge of exam indicators, contraindications and patient preparation.
Skill in communicating in a clear and concise manner with staff involved in critical care, and physicians to ensure the proper care of patients.
Skill in reading 12-lead EKG.
Skill demonstrated in assigned disciplines such as EP, directly involved in patient care.
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.
Ability to complete routine reports and correspondence.
Ability to listen and accurately interpret others’ communication or instructions to take appropriate action.
Ability to speak and communicate effectively.
Ability to define problems, collect data, establish facts, and draw valid conclusions.
Ability to interpret an extensive variety of instructions and deal with several abstract and concrete variables.