The Medical Intensive Care Unit (M.I.C.U.) staff nurse provides inpatient nursing care with a primary focus on cardiology, cardiovascular surgery, pulmonary, renal and general medicine. The M.I.C.U. registered nurse will provide care to critically ill medical patients, many of whom have multi-system failure, requiring the staff nurse to be proficient in hemodynamic monitoring, ECG interpretation, titration of multiple critical infusions, ventilator management, etc.. The staff nurse provides care frequently to patients withcomplex psychosocial issues including dual diagnosis and complex family issues. Renal failure patients require the M.I.C.U. nurse to be proficient in managing peritoneal dialysis, ensuring patency of hemodialysis access, and implementing and managing patients requiring CVVH.
Registered Nurses are responsible and accountable for all elements of the nursing process when providing and/or supervising direct patient care. He/she administers medications and procedures per established policies and guidelines. The staff nurse considers all characteristics of the individual, including sex and sex role identification, age and life stage, state of health, race and culture, socio-economic status, values and previous experience with similar events, in order to assist each patient to identify and meet basic health needs and improve his/her health status to the individuals maximum potential.
The staff nurse consistently demonstrates sound clinical judgment and the ability to effectively provide and/or direct the care provided by team members for patients on an assigned tour of duty and modifies and updates the plans of care/treatment plans for patients on an assigned tour or duty. Documentation consistently reflects the use of the nursing process in recording patient responses/outcomes and revising and modifying the plan of care and/or treatment plans. The incumbent appropriately and consistently revises and modifies the plan of care or treatment plan for patients with complex nursing care needs, based on nursing assessment. He/She identifies significant patient care problems and sets priorities for their management. In the role of charge nurse, provides and directs nursing care for clients with complex nursing care needs; i.e. multi-system health care issues, complex psychosocial issues, etc. The staff nurse demonstrates leadership qualities through collaboration with others. The incumbent participates in studying, identifying, evaluating and implementing creative process and system improvements that facilitate the Mission of the Medical Center at the program or service level and which can be documented through demonstrated outcomes. He/She demonstrates understanding of patient rights, policies relating to patient rights (i.e. Advanced Directives, DNR, patient confidentiality) and understanding of ethics for the Federal employee. The incumbent acts as a patient advocate, guides, directs or supports co-workers regarding ethical issues and makes appropriate referrals when issues are suspected or identified; i.e. knowledgeable regarding the chain-of command and ensures referrals are made to the Medical Ethics Committee when appropriate.
The staff nurse completes assignments in a timely and effective manner and follows safety protocols designed to reduce/eliminate employee risk of injury. The incumbent guides and ensures that other health team members follow established safety protocols that have been designed to reduce/eliminate the risk of injury and when in charge, makes assignments in a manner that appropriately utilizes and optimizes the resources available for the shift. He/She consistently demonstrates consideration and/or utilization of restraint alternative and/or utilizes the least restrictive form of restraint possible. He/She supports and enhances client self-determination.
The MICU staff nurse demonstrates creativity in meeting patient needs and demonstrates initiative in discharge planning and reducing patient length of stay. The incumbent identifies risk areas and analyzes resources available in the use of patient care equipment and body mechanics, while evaluating options available and selecting a course of action resulting in favorable patient/organizational outcomes. The staff nurse verbalizes understanding of the process for advancement utilizing the Nursing Professional Standards Board process, the Nurse Qualification Standards and functional statements. He/She demonstrates knowledge of VA policies, procedures and clinical protocols andtakes initiative in developing and evaluating unit level and/or disease specific standards of care, policies, procedures and nursing programs that guide nursing practice an/or measure performance. The incumbent demonstrates leadership by developing, revising, evaluating and communicating standards of nursing practice related to his/her area of nursing practice.
The staff nurse will complete unit-based competency education and maintain the proficiency in all required unit-based procedures, skills and competencies and is self-directed in communicating progress to manager and identifying additional education needs. In collaboration with nurse manager or supervisor, he/she develops and implements a personal education/career development plan, which might include conducting a literature review on an appropriate topic area and sharing information with peers, matriculating towards an advance degree, attending management and leadership conference, identify and utilizing an appropriate mentor. Formally and informally the incumbent coaches and/or mentors staff by identifying learning needs and sharing information related to new or unfamiliar technology, procedures, medications, trends, practices, etc. and participates in clinical orientation of new personnel.
The staff nurse will communicate effectively with co-workers and participate in staff meetings and unit in-services. He/she will maintain effective communication with intra-department staff and demonstrate professional behavior by role-modeling, respect for others, collegiality, ability to accept constructive criticism and participate on ad hoc, nursing or medical center/health care system committees or task forces. The staff nurse will utilize effective channels of communication to report information, demonstrate effective team work and customer service skills with professional and supportive personnel providing care. The staff nurse will collaborate with other health professionals as a member of the multi-discipliniary team to ensure continuity of patient care by evaluating patient needs and identifying continuum of care strategies. Leadership is evidenced through effective interdisciplinary problem solving and consultation with others.