The Registered Nurse Exchange Tier 1 is able to provided nursing care relief across the ARH system in either of the following:  CVICU or CVOR. The Registered Nurse Exchange Tier 1 is able to provided advance nursing care in critical care areas requiring substantial specialized knowledge, judgement and nursing skill based upon the principles of psychological, biological, physical, and social sciences in the application of the nursing process.  The RN Exchange Tier 1 must collaborate with physicians and multidisciplinary team members; provide physical and psychological support to patients, friends, and families; supervising assigned team members and students. In addition to the above the RN Exchange Tier 1 can also perform the duties outlined for RN Exchange Tier 2 and RN Exchange Tier 3.

Application of the nursing process in the following:

1. Completes patient assessments, formulates plan of care, oversees implementation of plan of care, evaluate and adjust plan of care utilizing critical thinking skills
2. The performance of other nursing acts which are authorized or limited by the board, and which are consistent either with American Nursing’s Association Standards of Practice or with Standards of Practice established by nationally accepted organizations of registered nurses.
3. Care, counsel health teaching and promotion, utilizes Teach Back methodology as affirmation of comprehension
4. The administration of medication, intravenous therapy and treatment as prescribed by a LIP
5. Supervision, delegation and follow-through to other personnel in the performance of activities relating to nursing care.
6. Mentors and precepts students and orients new staff as assigned
7. Reports up chain of command Clinical Nurse Manager/Nurse Manager/House Nurse Coordinator pertinent information
8. Participates on various teams, committees or performance improvement initiatives
9. Ensures a safe and secure environment for patients, coworkers and self
10. Participates in Discharge Planning and Transition of Care (able to define pt needs)
11. Serves as a patient advocate and escalates patient related concerns timely
12. Timely documents pertinent findings in medical record
13. Assist patients in performing activities of daily living and functions as an active team member
14. Assumes responsibility for personnel professional development
15. Utilizes effective communication skills and active listening, exhibits compassionate and empathetic attitude
16. Practices Hands Off communication utilizing SBAR; Performs Bedside Shift reporting utilizing SBAR (unless contradicted)
17. Functions as a positive influence, role model and adheres to professional code of conduct
18. Respects dignity and confidentiality of all matters relating to patients
19. Refer to Special Addendum and Staff Nurse Position Description
20. Performs other job duties as assigned.

Definition: Supervision                                          

The provision of guidance by a qualified nurse for the accomplishment of a nursing task with periodic observation and evaluation of the performance of the task including validation that the nursing task has been performed according to established standards of practice [201 KAR 20:400 Section 1 (7)].

Minimum Education: 

High School Diploma or GED; Lic. Registered Nurse in State; Graduation from an accredited school of nursing.

Minimum Work Experience: Minimum of two (2) years acute care nursing experience one (1) of which CVICU and/or CVOR. Evidence of clinical expertise in the practice of critical care. Experience with Electronic Health Record Preferred.

Required Licenses/Certifications: Registered Nurse License;  ACLS, EKG interpretation Competencies.

Required Skills, Knowledge, and Abilities:  

Evidence of clinical expertise in the practice of critical care or open heart surgery.

Able to operate without assistance Critical Care equipment such as hemodynamic monitoring, ventilators, temporary pacemakers, defibrillators, balloon pumps or function independently in open heart cases. 

Excellent interpersonal skills and ability to work with providers at all levels essential.

Must be self-directed, able to communicate clearly in writing and verbally and effectively influence others to achieve necessary outcomes.

Demonstrated ability to facilitate a working environment conducive to change, enabling positive outcomes in a highly complex system.

Must possess basic computer skills.