Job: Nurse Tech / Nurse Intern

POSITION: UNLICENSED NURSING PERSONNEL (NURSE TECH AND NURSE INTERN)

DEPARTMENT: NURSING SERVICE, HOSPITAL SETTING

FLSA STATUS: NON-EXEMPT

PROGRAM SUMMARY:

Under the direction and supervision of a registered or advanced practice nurse; continuously responsible for assisting professional nursing personnel in providing non-complex patient care tasks.

*Nurse Interns and Techs perform duties of unlicensed assistive personnel.

POSITION RELATIONSHIPS:

• Responsible to the supervisor, charge nurse, department director
• Positions directly supervised: none
• Regular contact with all hospital departments, physicians, patients and their families/caregivers, and the public

MISSION STATEMENT:

As an integral part of our community, Franklin Medical Center’s mission is to provide the highest quality health care and customer satisfaction to all those we serve. We are committed to delivering compassionate, capable, and personalized treatment to our patients and their families, always keeping in mind that our responsibility is to the health needs of the people.

UNIFORM COLOR:

Ceil Blue (Nurse Tech)

Hydrogreen (Nurse Intern)

NURSE TECH AND NURSE INTERN RESPONSIBILITIES AND PRIVILEGES:

A NT or NI must be currently enrolled in an accredited licensed practical or a registered nursing program and have completed (at least) the first clinical semester or term of the nursing program.

The Nurse Tech and Nurse Intern:

• Understands the rules, regulations of Franklin Medical Center; complies with established departmental policies & procedures and dress codes standards (See Human Resources Policy Manual)
• Follows patient safety-related policies, procedures, and protocols
• Maintains a good attendance record and current health record
• Always notifies director/supervisor if ill or cannot come in; understands repeated absenteeism is reason for dismissal
• Enhances professional growth and development by attending in-services and department meetings
• Interact well with the public
• Must present a positive and pleasant attitude
• Understands and considers the patients’ needs
• Has good communication and professional phone skills
• Possess the ability to be flexible
• Is a team player
• Reports potential or actual patient safety concerns, unsafe/hazardous conditions, defective equipment, medical errors and/or near misses in a timely manner
• Maintains confidentiality of all information regarding employees, patients, medical staff, hospital business, etc.
• Follows infection control protocols
• Performs various functions on computer as necessary (limited documentation in Cerner)
• Perform all other duties as assigned with promptness
• In addition to following hospital policies and procedures, internally motivated, considers the legal, ethical, and moral aspects of patient care and interaction

Contingent upon the RN’s evaluation of each patient’s condition and also upon the RN’s evaluation of competency of each unlicensed assistive personnel (UAP), an RN may delegate non-complex tasks to an UAP. A non-complex task is one that can safely be performed according to exact directions, with no need to alter the standard procedure, and the results are predictable. When the above criteria have been met, the following interventions may be delegated when non-complex:

NUTRITION/HYDRATION

Permanent gastrostomy tube (PEG) feeding

One touch glucose monitoring

Deliver and/or warm patient meals (cannot feed patients)

Pass out ice, filling water pitchers (must know patient’s diet, if NPO)

ELIMINATION

Foley catheter insertion (RN supervision immediately available)

• Emergency Department Only

(EXCEPTION: patient with a history of BPH, hematuria, stricture(s), any form of obstruction or malformation of the GU system)

Empty & measure drains

Collect urine (voided or by indwelling urinary catheter port), stool, or sputum specimens

Intake & Output measurements

CARDIOVASCULAR

ECG, placing of leads and probes

Phlebotomy

SAFETY

             May ambulate with patients, transfer in wheelchair

Alert the nurse regarding alarms, electrodes displaced

Fall prevention (placement of non-slip socks, bed in low position, rails up with egress, hourly rounding (evaluation of the 4 Ps: potty, pain, personal belongings, need for repositioning)

Helps to maintain a safe, comfortable, and therapeutic environment for patients/families in accordance with hospitals standards

Clean patient care rooms, equipment and instruments

SKIN

             Wound taping (e.g., steristrips)

Dressing removal and application (Stage I)

Stage I: Nonblanchable erythema of intact skin, the heralding lesion of skin ulceration. In individuals with darker skin, discoloration of the skin, warmth, edema, induration, or hardness may also be indicators.

Removal of sutures and staples

Patient personal hygiene care (bathing, brushing teeth, turning, bed making, incontinence care, replacing spoiled garments or briefs

The following wound care interventions may be delegated when non-complex: topical application of anti-infective medications, protective ointments, wound cleansers, skin sealants, gauze, transparent films, hydrocolloids, and hydrogels and the cleansing of the skin of a mature, healed PEG tube site with soap and water. For example, the application of a transparent film to an area of redness over a bony prominence in a stable patient is a non-complex task; however, the application of a transparent film and hydrocolloid agent for the purpose of autolytic debridement of the wound is a complex task and may not be delegated to UAP.

COMMUNICATIONS

             Transport patient to another department

Act as Ward Clerk (answer phones, clean equipment, stock carts, etc.).

Report patient requests, report and changes in condition or behavior of patients or unusual incidents

Report equipment problems, order and store supplies, maintain appropriate PAR levels

Assist and accompany patients during the admission, transfer, and discharge process

Encourage patients to actively participate in their own care by asking questions and reporting treatment or situations that they don’t understand

Reinforce patient education that has already been provided

Makes an introduction to the patient, includes name, discloses discipline. Explains all tasks and procedures to the patient. Asks permission to provide care or complete patient specific task. Asks the patient if they have any questions before beginning. Reports to the charge nurse any issues or concerns.

Reinforce discharge plan

Assist with pre-op preparation of the patient to include the preoperative checklist

Assist provider with medical procedures

Assist in change of shift report

NURSE TECHS AND NURSE INTERNS MAY NOT PERFORM (COMPLEX TASK):

• A task is defined as complex if it requires the consideration of a number of factors in order to perform the procedure, or if it requires judgment to determine how to proceed from one step to the next (listed but not limited to):
• Document physical assessments
• Assess age specific tasks
• Oral feedings (patients with dysphagia are high risk for aspiration; therefore, oral feedings cannot be delegated to a certified nurse’s assistant or UNP)
• Nasogastric (NGT) feeding
• Document ongoing assessment and evaluation of the patient’s response
• Evaluation of lab results, intervention other than reporting to charge nurse
• Evaluate patient’s response to interventions
• Formulate teaching or discharge plans or provide the initial patient education
• Formulate, initiate, or revise nursing diagnoses or nursing/interdisciplinary care plan
• Review/sign off on physician’s orders and perform 24-hour chart checks
• Delegate tasks to other team members
• Administer by medications by any route
• Handle narcotics
• Prepare or medications for administration
• IV Therapy (starting PIV)
• Initiate or change flow rates
• Administer IV medications or solutions – including saline flush solutions and parenteral feedings
• Calculate IV rates or adjust IV rates
• Removal of fecal impaction
• Irrigation of a colostomy
• Draw from any central venous access devices (PICCs, Hickmans, Groshong, Porta-cath, etc.)
• Administer blood or check blood out of the blood bank
• Groin and pulse checks
• Cardiac monitors: setting up, and placing
• Hemodynamic monitoring
• Diathermy or other deep heat
• Betadine & phisohex douches
• Terramycin ointment to wounds
• Cleansing wounds with peroxide, betadine, physohex, or cara klenz

MINIMUM QUALIFICATIONS:

• Active enrollment in an accredited (LPN or RN) nursing program
• Completion of at least the first semester or term of clinical experience from an accredited nursing program
• Student in good standing of a nationally accredited nursing program with completion of their first semester or second term
• At least two (2) professional references

LICENSES/CERTIFICATIONS:

Basic Life Support Certification (preferably by the American Heart Association) or must obtain within 30 calendar days of date of position

TESTING REQUIREMENTS:

Tuberculin Skin Test, TB questionnaire; random drug and alcohol screening; COVID vaccination or exemption records.

Individuals who are not fully vaccinated shall be subjected to random COVID-19 testing on a weekly basis until they are fully vaccinated. The number of individuals tested will be subject to the availability of tests.

In addition, exempted or otherwise unvaccinated individuals should report any new health and/or individual condition, as well as, monitor and report any symptoms that may indicate COVID-19 infection to their immediate supervisor as soon as possible (e.g., fever, cough, shortness of breath, irregular temperature, etc.).

ADDITIONAL STANDARDS OF PERFORMANCE:

 Positive Attitude:

We are here to serve our customers by meeting their needs with utmost care and courtesy. Our attitude represents the hospital’s commitment to excellence. This commitment is reflected by providing a positive and caring experience with every interaction.

Professionalism:

We consider our customer’s expectations in how we present our facility and ourselves. We have only one opportunity to make a positive first impression. This commitment is reflected in our ethics, appearance, manner, expressions, and concern.

Service:

Communication: We are committed to listening attentively to our co-workers, patients and customers in order to fully understand and meet their needs. This commitment is reflected by our verbal, non-verbal, and written communications being delivered with courtesy, clarity, care, and a smile.

 Dignity and Respect:

We recognize, value, and respect the diversity of our co-workers, patients, and customers by honoring their perspectives, choices, and differences. This commitment is reflected in our conduct by ensuring their knowledge, values, beliefs, and cultural backgrounds are incorporated into staff interactions, care planning, and decision-making.

 Privacy:

We are committed to the protection of our co-workers’ and patients’ rights to personal and medical privacy. We treat the patient, patient information and/or property with confidentiality and respect and strive to create a secure and trusting environment. This commitment is reflected by ensuring that rights to privacy and modesty are honored.

 Knowledge and Expertise:

We believe our patients deserve to have people caring for them who are knowledgeable and technically proficient in what they do. This commitment is reflected through preceptorships, mentorships, continuing education, and ongoing competency evaluations.

Safety Awareness:

We all share in the responsibility of maintaining a safe environment for our co-workers, patients and customers. This commitment is reflected by our safety conscious attitudes, actions, and continuous safety training.

Sense of Ownership:

We take pride in what we do, taking responsibility for the outcomes of our efforts. This commitment is reflected by our ongoing effort to complete our work promptly and accurately the first time.

Finances:

Fiscal Responsibility: As a public hospital, we are accountable to the community to ensure responsible use of resources to provide the needed services for all those we serve. This commitment is reflected by our actions and attitudes toward expense and time management.

 Integrity:

We believe in complying with all government rules and regulations relative to receiving compensation for our services. This commitment is reflected by exercising ethical and accurate billing and financial practices.

Growth:

Customer Service: We believe in the importance of growth and on-going public support. This commitment is reflected by providing exceptional customer service to all we serve and by responding quickly to resolve problems.

 Recruitment and Retention:

We believe our patients deserve to have the very best providers and staff available to provide their care. This commitment is reflected in our organization by continually attracting, developing, and retaining staff with exceptional skills.

PHYSICAL REQUIREMENTS:

• Must be professional and well-groomed (Physical Appearance and Dress Code)
• Able to work efficiently and effectively
• Lift weight over 25 lbs. (e.g., lifting and moving or helping to lift patients of awkward weights, moving and carrying equipment)
• Repeated bending, stooping, squatting, and occasional pushing and pulling movements
• Prolonged walking and standing
• Frequent interruptions
• Visual and hearing acuity as well as cognitive function to make observations and communicate these to other staff

The above physical requirements are intended to describe the general nature and level of work to be performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.

WORKING/ENVIRONMENTAL CONDITIONS:

Significant hazard exposure: risk exposure to biohazardous materials requiring extensive safety precautions and may include the use of personal protective equipment.

OSHA EXPOSURE CATEGORY:  A – has the potential to be exposed to bloodborne pathogens.