Position Description.pdf

POSITION DESCRIPTION (Please read Instructions on the back) 1. Agency PD Number 1 8741 0 2a. Reason for Submission 3. Service

4. Employing Office Location 5. Duty Station UpdateSuperviaor

Redescription i:i New Ciflatisn Headquarters IE Field

Window Rock. AZ NNMC-Sh)prock, NM Q Rnesrabiiiitment i:i Other Q Reorganization

6. Fair Labor Standards Act 7, Financial Statements Required 8. SubJect to iA 2b. Position information iComplete xii that apply)

Exempt Nonexempt OGE-278 OGE-450 N/A Yes No Drug Physical Exam Required

9. Position Status 11, PositIon is: 12. Position sensitivityTesting

13. Comp Levei Code

I Cyber Sec Acq Code: 1776 00 D FPL J Competitive Supervisor/Manager (Code 2)

1-Nonsensitive NURO r-, Seiect Agent [] incumbency r Commissioned L..J Access Oniy Li Corps Q Excepted (Specify in remarks) C Supervisor-CSRA (Code 4) 2-Noncritical

Sensitive 2c, Explanation iShow any cositions reolacedi Q SE$ (GEN) C SES (CR) Management Offlciai )C.SRA) 14. Job Code Replaces Operating Room Nurse, GS-061 0-10, PD (Code 5) C 3-Critical Sensitive

137070, dated 09/070/17. New 0600 series standard lOs. Administrative Code applied dated Sept. 2017. GFJJ28 C Work Leader (Code 6) C 4-Speciai Sensitive

S-Pubiic Trust/

C Limited Term C Limited Emergency lob. Job Requisition/Position Number C Team Leader (Code 7) Moderate 15. OPM Certiflcetion No.

6-Public Trust/High NTE Date: I1 Neither (Code 8) Risk

16. Classified/Graded by: Official Title of Position Pay Plan Occupational Grade initials DateSeries Code

a. U.S. Office of Personnel Management

b. Department Agency or Nurse (Operating Room) GS 0610 10 RC 06/01/2018 Establishment

c. Recommended by Supervisor or initiating Office

17. OrganIzational Title of Position (ifdifferent from official title) 18. Name of Employee (Ifvacant, specify)

Perioperative Nurse

c. Third subdivision

19. DEPARTMENT OF HEALTH AND HUMAN SERVICES Northern Navajo Medical Center

a. First Subdivision d. Fourth subdivision

IHS/NAIHS Division of Nursing Services

b. Second subdivision e. Fifth subdivision

Shiprock Service Unit Surgical Specialty Rooms Branch

20. Supervisory Certification. I certify that thIs is art Occufate statement ofthe major duties and responsIbilities of this position and its organizationalrelationships, and that the position Is necessar, to corny our Government functions for which I am responsible. This certification is made with the knowledge that this information Is to be used for statutorypurposes relating to appointment and payment ofpublic funds, and that false or misleading statements may constitute violations ofsuch statutes or their Implementing regulations.

a. Typed Name/Title/Employee ID ofimmediate Supervisor 0, Typed NarnefritieIEmpioyee ID of Higher LeveiSupervisor or Manager (optional)

Vickle Morez-Waiser, RN, Supervisory Nurse Lavenla L. Diswood, RN, CNE, Supervisory Nurse

Signature Date Signs ure Date

Li2’L (( ( 24C assiflcation”21. ClaealflcatlonlJob Grading Certification. I certify that thin position has been classifIed/graded 22. Pa tandards used in Classifying/Grading Position as required by the Titles, U.S. Code, in conformance with standards published by the U.S. Office of PersonnelManagementor, ifno published standards apply directly, consistently with the mast USOPM, Job Family PCS for Professional Work In the Medical and Heaithcare Group, appilco ble published standards. 0600 September 2017.

Typed Name and T7tl of Official Taking Action

Roberta Clyde, Human Resources Specialist (Classification)

Date Intavmation for Employ.ea. The standards andinfa.’matinn an rlreitappiicatisn are available In tile truman rise sirceaSignatur

Management, info.tnation on clossificallonflxb grading appeals, and complaints an exemption from P15411 available

23. UFM5VesNs office. The clasaiftcailon of rile position may be reviewed and corrected by the agency or tire US. Office efPerrsnnei

(rare the human resources office of tire 1)5. Office of Pert onnei Manogemenc incumbentrnrusi be suitable for Federal employment as determined by fingerprint check results and appropriate background investigation. An incumbent lound not suitable after rime will be removed (Tom this position.

Position list the (uli performance ievei Functional code. Si Position it covered under P.L 101-630 and Pt.. tOi-64?.

24 DescriptIon o(MaJs.Duses undAespo.sslbii:lies end tealeotion Srsre,nent 15cc Attache di OF-a lR.vtsid Augast 2014i Department o114.iith and Human 5.retcla

187410 Nurse (Operating Room)

GS-0610-1O

I. INTRODUCTION:

This position is located at Shiprock Service Unit, Northern Navajo Medical Center, Division of Nursing Services, Surgical Specialty Rooms Branch, in the Operating Room (OR), which has four (4) suites and an Endoscopy Room. The Perioperative nurse is responsible for the delivery of comprehensive patient care within the preoperative, intraoperative, and postoperative periods of patient’s experience during operative and other invasive procedure, using the framework of the nursing process. The Perioperative Phase includes the following: Preadmission, Day of Surgery/Procedure, and the Post Anesthesia Phase II.

This department provides 24/7 service of scheduled or emergency procedures. Services consist of General Surgery, Podiatry, Ear, Nose, Throat (ENT), Orthopedic, Pediatric Dental, Endoscopy, Urology, Oral Maxillo-facial and OB/GYN.

II. MAJOR DUTIES AND RESPONSIBILITIES:

A. Clinical Nursing Duties (85%):

Observes and assesses patient’s health status and critically ill emergency patients by physical assessment and examination, interviewing patient and family members and patient’s health history.

Independently assesses and interprets the data, patient’s condition and recognizes normal/abnormal parameters for appropriate nursing action to be taken.

Develops, implements, and evaluates an individualized plan of care and will coordinate to deliver care to patients undergoing operative procedures.

Adheres to the Association of Operating Room Nurses (AORN) Standards of Care to develop, implement, evaluate, and revise an appropriate problem-oriented care plan, problem solving nursing plan for the care of patients in the perioperative setting.

The Preadmission phase, focus is on preparation of the patient, family, or significant other physically, sociocultural, and spiritually for the experience. Interviewing and assessment techniques are used for identification of potential or actual problems that may result. Education and interventions are initiated for optimization of positive outcomes.

Functions independently as the primary circulating nurse for the assigned OR room with full competency and understanding of the declared surgical procedures.

Collaborates with members of the surgical team and other multi-disciplinary team in assessing, planning, implementing and evaluating patient care for the scheduled, unscheduled or emergency surgical procedure.

Initiates resuscitative and life-saving measures: diagnostic, treatment bases on approved Unit Standing Orders, Unit Standard of Care from the American Association of Critical Care Nurses (AACN) and any other professional organizations, American Heart Association (AHA). These may be in addition to Hospital Standards and AHA, Advanced Cardiac Life Support (ACLS) guidelines.

In the absence of a physician, the nurse independently determines and implements proper emergency measures after identifying and interpreting life-threatening condition and initiating life-saving measures in accordance with practice under the AHA guideline for the provision of Basic Life Support (BLS), ACLS and Pediatric Advanced Life Support (PALS).

Administers therapeutic interventions, such as medication, treatments, intravenous fluids, blood product transfusions, oral/nasogastric tubes, oxygen therapy and other diagnostic interventions, etc.

Using independent judgment, critical thinking and decision-making skill as appropriate based on physician orders.

Compiles and interprets data from various sources: assessment, history and physical, laboratory findings, ba5eline vital signs. Competent with the hemodynamic devices and independently managing the surgical patient requiring local anesthesia or Moderate Sedation/Analgesia of the assessment of cardiopulmonary status, respiratory status, hemodynamic status and pain level status throughout the procedure.

Provides comprehensive, holistic patient care to meet the physical, emotional and spiritual and cultural needs of patients undergoing scheduled surgery and for the critically ill patients and families undergoing emergency surgical procedures.

Operates monitors and analyzes data from the specialized equipment, such as: cardiac monitors, defibrillators, arterial lines, central venous pressure lines, thoracic suctioning and drainage devices, surgical instrumentation, Electrocautery units (ESU), Sequential Compression devices, Irrigation and suction systems, chest tube insertions, Vascular access, Pneumatic Tourniquet, and Autoclaves, etc.

Monitors the level of supply and assures sterility of materials used in furthering Quality Assurance of patient care to prevent injury.

Documents and charts in the patient’s health record observations, assessments, nursing interventions, therapeutic measures administered, and referrals to ancillary staff for follow-up care. Consults other ancillary departments for patient advocacy purposes as appropriate.

Monitors health records for Government Performance and Results Act (GRPA) standards (Immunizations, tobacco, alcohol, depression, domestic violence screening, etc.).

Provides education of health promoting and disease prevention concepts to patients, and their families;

thus, indirectly to the community.

Participates in Evidence-Based Practices through maintaining own knowledge of current trends and interventions of all aspects of perioperative nursing care and surgery.

Upon the assignment of the Stand-By Call for emergency surgery for after hours, weekends or holidays, the nurse functions as a team leader and supervises the movement and action of other team members.

Demonstrates total independence which is exercised and the accountability are at its maximum.

B. Administrative Duties (15%):

Serves as Unit Charge Nurse attending to daily operations and communicates concerns to the Supervisory Nurse (SN) as appropriate. Responsibilities involve daily unscheduled surgery scheduling, staff assignments, proper levels of supplies, maintaining equipment’s and assure patient safety and care.

Orients new staff to the department and the routine functions of the department. Provides in-services to other nursing staff as appropriate.

Collaborates in developing and evaluating standards of care for the perioperative patient. Participates in planning and conducting continuing education in the department. Identifies specific surgery care problems that affect patient care outcomes and seeks resolution to avoid re-occurrence.

Participates as a member on a hospital committee relative to the specific patient care issues, or the hospital performance improvement program.

Performs quality improvement/performance improvement audits, surveys, peer chart reviews thereby developing or revision of the nursing care standards, policies or procedures based on these findings.

Attends and completes all mandatory competencies and training for the facility and OR. Completes nursing orientation program according to unit policy and maintains proficiency on the provision of BLS, ACLS and PALS certifications. If failure to obtain the certification then he/she will be reassigned to another unit.

Ill. FACTORS:

Factor 1- Knowledge Required by the PositIon:

Knowledge of and ability to apply a full systems range of physical and psychological skills (cardiopulmonary, neurological, musculoskeletal, gastrointestinal, genitourinary, renal, endocrine, and integumentary systems) in order to determine the patient’s current health status and to plan for improvement.

Knowledge of professional nursing principles, practices, concepts and procedures as applied to critical care patient, i.e., nursing diagnosis, problem-oriented care plan development, use of emergency drugs, resuscitative methods, Interpretation of EKG rhythm strip, ABG’s and other laboratory data.

Clinically capable in nursing management to assist the surgeon performing the surgical procedures of patients experiencing problems with cholecystitis, cholelithiasis, diabetes, renal failure, alcoholism, pa ncreatic, acute trauma, orthopedics, urologica I, gynecological, oral maxilla-facia I, podiatry, pediatric dental, Ear, Nose, Throat (ENT).

Ability to use specialized equipment with the knowledge, skills and dexterity in maintaining, caring and troubleshooting the function of the equipment. Maintenance of a sterile field and adherence to aseptic practices for individuals in the OR in fulfilling the professional responsibility to protect patients from injury and reduce patient risk for surgical site infection.

Ability to educate and counsel patients and healthy individuals in order to encourage patients to assume partial or total responsibility for their own health care and to help patients understand disease and injury prevention and health maintenance.

Ability to work with the Native Culture, taking into consideration existing beliefs, communication patterns, and cultural practices regarding health and life styles.

Awareness of and demonstrates the ability to apply The Joint Commission accreditation standards to acute care setting.

Knowledge of critical care diagnostic and treatment such as central line and swan-ganz placement, endotracheal intubation, arterial line placement, general, epidural and spinal anesthesia. Provides skillful assistance to the Anesthesiology and APN (Nurse Anesthetist).

Specific knowledge of nursing management of patients with cardiac dysrhythmias, adult respiratory distress or failure, hypertensive or hypotensive crisis, sepsis, cardiopulmonary arrest, diabetes, and malignant hyperthermia.

In compliance with The Joint Commission standards: ability to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served in the area of nurse care support for all age groups. Knowledge of principles of growth and development over the life span, possess the ability to assess data reflective of the patient’s status, and interpret the appropriate information needed to identify each patient’s requirements relative to his or her age specific needs for the following developmental groups: from eighteen months to pediatrics, adolescent, adults, and geriatrics.

Factor 2- Supervisory Control:

The incumbent works under the general supervision of the Supervisory Nurse or his/her designee;

consults with the physician on medical and surgical problems not covered by protocol or care within the scope of practice or capability; resolves most conflicts and uses individual judgment to coordinate activities with other health care professional. Review of work is conducted by the supervisor for overall effectiveness in meeting the objectives of the unit and those set by community served.

Factor 3- Guidelines:

Guidelines include doctor’s orders, standing orders, nursing policy and procedure manuals, and Perioperative Standard and Recommended Practices, hospital and agency policies. These guidelines are not intended to provide specific instruction and sound clinical judgment is required to Interpret guidelines and determine the appropriate actions from the assessment of the patient and laboratory data.

Factor 4- Complexity:

Provides comprehensive nursing care with a full range of professional nursing proficiency and skill. This includes assessing the needs of patients with a variety of critical conditions, administering medications, operating specialized equipment and responding appropriately in emergency situations. Perioperative nursing is a highly specialized area and independently determines the need for consultation with the physician for unusual problems. Analysis of each patient’s condition involves area of uncertainty and instability. Incumbent teaches and counsels patients and families on the management of medications, nutrition and treatment at home.

Factor 5- Scope and Effect:

The purpose of the work is to plan and provide nursing care for surgical patients providing for a full range of assessment of needs, planning of care, and performing specialized and emergency surgical intervention. The nurse takes the opportunity to consult with other professionals and disciplines to facilitate the improvement of health care. The work affects the physical and psychological well-being of the patient and family.

Factor 6- Person Contacts:

Contacts are with patients, their families, other healthcare professionals, and ancillary hospital staff, and community healthcare providers.

Factor 7- Purpose of Contacts:

Contacts with patients and their families are to exchange and obtain information required to provide care, to counsel, teach, encourage and persuade; for example, to motivate the patients for their self-care, improve their health habits and follow medical orders, specifically post-operative care and follow-

up. These contacted may have fears of the planned or unplanned surgical intervention and require great tact and sensitivity due to the seriousness of the patient’s health, condition, and status. With hospital and community healthcare providers, contact are essentially to exchange, obtain, and provide information required to provide care.

Factor 8- Physical Demands:

The work requires considerable walking, standing, pushing, bending, and lifting in helping patients to and from beds, wheelchairs, stretchers, etc. And in moving equipment, medical supplies and the ability to function in a highly stressful situation for prolonged period of time.

Factor 9- Work Environment:

In the hospital environment there is common exposure to contagious disease, some exposure to flammable and toxic gas exposure and to x-ray radiation. Some degree of risk in working with emotionally disturbed patients or mentally challenged patients and families. Employee is expected to adhere to the surgical attire and appropriate personal protective equipment (PPE) is worn to promote worker safety and a high level of cleanliness and hygiene within the perioperative environment.

IV. OTHER SIGNIFICANT FACTORS:

This position is subject to rotating Stand-by Call assignment for the evening, night, weekend, and/or holidays to provide emergency surgery procedure of patient care.

Routine duties shall include providing nursing care services to individuals eligible for services provided by the IHS in homes, schools, clinics, job sites, and other community locations within the assigned service unit.

This position has been designated as essentialand as such, the incumbent of the position is required to occupy government quarters on an availability basis for providing protection of life and/or property.

This position is covered under the Indian Child Protection Act and is hereby designated an authorized child care position subject to P.L. 101-630 and P.L. 101-647.