Registered Nurse, Podiatry Wound Care, 40 hrs (Days)

Boston Medical Center (BMC) is more than a hospital. It's a network of support and care that touches the lives of hundreds of thousands of people in need each year. It is the largest and busiest provider of trauma and emergency services in New England. Emphasizing community-based care, BMC is committed to providing consistently excellent and accessible health services to all-and is the largest safety-net hospital in New England. The hospital is also the primary teaching affiliate of the nationally ranked Boston University School of Medicine (BUSM) and a founding partner of Boston HealthNet - an integrated health care delivery systems that includes many community health centers. Join BMC today and help us achieve our Vision 2030 which is a long-term goal to make Boston the healthiest urban population in the world.

Position: Registered Nurse
Department: Podiatry Wound Care
Schedule: Full Time, 40 hour, Days

POSITION SUMMARY:

The registered nurse, adheres to the rules and regulations of the Massachusetts Board of Registration in Nursing. is primarily responsible for professional performance and direct patient care. The role encompasses nursing assessment, diagnosis, planning, intervention, evaluation, and coordination of care for patients and their families across the health care continuum. The registered nurse is accountable for clinical, educational, quality and fiscal patient care outcomes using the model of care designed by the nursing department and in accordance with established agency policies, procedures, protocols, guidelines and standards of practice.

ESSENTIAL RESPONSIBILITIES / DUTIES:

STANDARDS OF CARE

• Consistently and effectively utilizes all steps of the nursing process in the provision of timely, safe, efficient and appropriate patient/centered care.
• Assesses the patient and family in a systematic and ongoing manner for both overt and covert signs and symptoms in accordance with the standards of clinical nursing practice.
• Collects pertinent data using appropriate assessment techniques.
• Prioritizes data according to the patient's immediate condition or needs.
• Involves the patient, family/significant others and appropriate health care providers in the collection of data when appropriate.
• Consistently uses clear, concise and effective written/oral communication and complies with departmental policies when sharing/documenting relevant patient care data.
• Identifies emergency/crisis situations, communicates such in a timely manner to appropriate health care team members, and responds appropriately when needed.
• Analyzes the assessment data to determine appropriate nursing diagnoses.
• Demonstrates use of critical thinking skills, derives and documents appropriate diagnoses from patient and family assessment data.
• Identifies expected outcomes individualized to the patient.
• Derives and documents realistic, appropriate clinical and educational patient-centered outcomes consistent with patient's diagnoses, capabilities and expectations in accordance to the standards of clinical nursing practice.
• Develops outcomes as measurable goals which include a time estimate for attainment and provides direction for continuity of care.
• Mutually formulates outcomes with the patient, significant others and health care team when appropriate.
• Develops a plan of care that prescribes interventions to attain expected outcomes.
• Develops and documents an individualized plan of care that reflects the patient's condition, prioritizes his/her needs, and provides for continuity of care.
• Develops the plan with the client, significant others and appropriate health care providers.
• Develops a plan reflective of current nursing practice standards, policies, procedures, protocols and guidelines.
• Implements interventions identified in the nursing and medical plan of care.
• Prioritizes patient care interventions based on fluctuating patient and unit needs.
• Demonstrates the knowledge and skills necessary to provide care appropriate to the age groups of patients regularly served. Consults appropriate resources when patients outside regularly served age populations are present.
• Effectively delegates appropriate patient care activities to co-workers with appropriate knowledge and skill level and ensures that co-workers have completed the delegated tasks in a timely manner.
• Provides for a safe, clean unit environment through use of appropriate risk management practices, e.g. labeling and removing broken/expired equipment/materials from service.
• Demonstrates safe technical competence based on patient needs, including but not limited to direct Implements patient care interventions/treatments and administers medications in accordance with established practice standards, policies, and protocols.
• Educates patient and family regarding current illness, procedures, treatments, plan of care as well as health maintenance, promotion, and illness/injury prevention.
• In emergency/crisis situations, demonstrates effective decision making in accordance with standards of clinical nursing practice, re-prioritizes patient care needs, initiates appropriate response actions, and directs other team members to ensure a complete and coordinated response.
• Documents interventions according to departmental policy.
• Evaluates the patient's progress toward the attainment of clinical and educational outcomes.
• Conducts systematic and ongoing patient reassessments and evaluations.
• Evaluates the effectiveness of interventions in relation to desired outcomes and includes the patient, significant others and appropriate health care providers in the evaluation process as needed.
• Demonstrates use of critical thinking skills through the incorporation of ongoing assessment data in the revision of diagnoses, outcomes and the plan of care.
• Provides follow-up care in person via home visits and via telephone when needed and when appropriate.
• Documents patient's response to interventions as well as revisions in diagnoses, outcomes and plan of care according to departmental policy.

STANDARDS OF PROFESSIONAL PERFORMANCE

• Systematically evaluates the quality, cost, and effectiveness of nursing practice.
• Participates/leads quality improvement and/or research activities as appropriate to the individual's position, education, skills, and practice environment.
• Uses the results of patient satisfaction, quality improvement and/or research data to initiate changes in practice.
• Accounts for completing daily patient classification data and incident reports in a timely manner.
• Participates in cost containment initiatives and practices.
• When two or more practice options exist that achieve the same quality of expected patient outcome, evaluates factors related to safety, effectiveness and cost when selecting the appropriate option.
• Acts in a professional manner relative to practice standards, statutes, and regulations.
• Practices in compliance with established practice standards, policies, procedures, protocols, guidelines, statutes and regulations (example: DPH, JCAHO, Fire Code, OSHA, and DEA).
• Functions without supervision in a manner appropriate for level of experience and education.
• Responsible for seeing things through to completion and for informing appropriate staff of outcomes.
• Offers, seeks out and acts upon constructive feedback regarding professional practice to improve daily practice and to achieve goals identified during performance appraisal.
• Takes appropriate steps to effectively resolve peer conflicts or investigate questionable activities. Discusses such with individuals involved and seeks assistance from nurse manager when appropriate.
• Maintains accurate annual professional development record.
• Demonstrates flexibility and ability to positively adapt to changing staffing/clinical/patient census needs including but not limited to offering assistance to others, adjusting patient assignments, floating to other areas/units, etc.
• Demonstrates reliability in regard to attendance and punctuality standards.
• Maintains a presentable appearance in accordance with dress code requirements including wearing a visible identification badge that identifies one's self as a registered nurse.
• The nurse acquires and maintains current knowledge in nursing practice.
• To maintain clinical competence in appropriate practice area, participates in ongoing educational activities to enhance clinical knowledge and update requisite skills.
• Independently identifies need for in-service/educational sessions and seeks experience to meet such needs and to maintain clinical skills.
• Completes the following mandatory requirements: annual BLS certification, institutional mandatory education, e.g., safety regulations, infection control standards, etc., and departmental/unit specific competencies.
• Actively participates on unit or departmental based task forces, councils, or committees.
• The nurse contributes to the professional development of peers, colleagues, and others.
• Takes initiative to share knowledge and skills willingly with colleagues, students, and novice practitioners in a collegial manner.
• Provides peers with constructive feedback regarding their practice and professional skills.
• Acts as a resource for new employees, float staff, and other unit team members.
• Assists in the orientation and/or acts as preceptor for new employees and/or nursing students.
• The nurse's decisions and actions on behalf of patients are determined in an ethical manner.
• Delivers care in a manner that preserves/protects client autonomy, dignity, confidentiality, and rights.
• Acts as a patient advocate in order to facilitate meeting identified patient needs.
• Delivers care in a non-judgmental and nondiscriminatory manner that is sensitive to and demonstrates respect for patient diversity.
• Seeks available resources to help formulate ethical decisions.
• The nurse collaborates with client, significant others and health care providers in delivering client care.
• Communicates and consults with client, significant others and members of the health care team regarding required patient care.
• Works cooperatively and constructively with all departments and health care team members to establish an environment that supports the process of collaboration.
• Participates as an integral member of the health team during family/staff meetings, formal/informal shift rounds/reports, and medical/grand rounds.
• Coordinates appropriate internal and external referrals to assist patients to gain access to services, pre-approvals, etc.
• Coordinates discharge activities including arranging for home/agency referrals when necessary.
• Other duties
• Interprets/translates for patient/family/visitors when conversant in their native language as needed.
• Acts as a shift charge nurse when requested/needed and oriented to charge.
• Performs all other related duties as assigned.

JOB REQUIREMENTS

EDUCATION:

• Graduate of an accredited school of nursing with an Associate ' s degree or Bachelor's degree in nursing (BSN). BSN preferred. Candidates who do not have a BSN must enroll in a Bachelor program one year from date of hire and must complete their BSN by the end of the semester in which the four year anniversary of employment at BMC occurs.

EXPERIENCE:

• 2-4 years of nursing experience with wound based knowledge required
• Ambulatory nursing experience preferred

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:

• Registration and current RN licensure in the state of MA in good standing required.
• Requires current basic life support (BLS) certification. Some units may require Advanced Cardiac Life support(ACLS) certification.
• Additional certifications may be required for certain practice areas

Additional Requirements

Current WOCN Certification preferred or required within 1 year of hire

Additional Details

• Assist providers during wound clinic
• Assist with procedures including, debridement of toenails, debridement of calluses, debridement of warts, injection of joints, injection of heel, injection of nerves, diagnostic injections, aspiration of cyst or similar, debridement of ulcers, perform slant back of nails, perform partial/total nail avulsions, drain blisters, treat cuts/wounds, lacerations.
• Apply dressings to wounds/ulcers and outer dressings (profore, UNNA boot, jones compression, felted foam)
• Prepare/place/arrange for wound vac
• Route, assist, and follow-up on medication, orthotics, diabetic shoe orders, physical therapy, referrals/, home supplies, VNA
• Write letters for school/work and read/answer faxes related to clinical care
• Coordinate and prepare disability/FMLA paperwork
• Check podiatry medications supplied for expiration dates
• Triage symptom based patient calls
• Assist in arrangement of urgent vascular consult for ABI/DVT
• Call/Document ED (emergency department) expects
• Obtain prior authorization for biologics (Apligraf, Grafix)
• Perform/assist with research projects in podiatry

KNOWLEDGE AND SKILLS:

• Basic computer proficiency inclusive of ability to access, enters, and interpret computerized data/information.
• Effective interpersonal skills to facilitate communication with various members of the health care team, patients, and families.
• Organizational skills to set priorities and efficiently complete assigned work.
  Multilingual skills (beyond that of English) in languages appropriate to the patient populations served by the medical center preferred.
• Relevant clinical experience and/or specialty, certification required for certain practice areas, e.g., enterstomal therapy, epidemiology, peri-operative areas.
• Analytical ability to solve clinical nursing issues and conduct quality improvement research utilization projects.
• Ability to effectively delegate appropriate patient care activities.
• Effective verbal and written communication skills appropriate to the patient populations served.
  Physical ability to meet the core job responsibilities in accordance with practice setting demands for the patient populations regularly served.
• Ability to effectively manage stress due to critical issues related to patient care, changing organizational climate and personnel issues.

Equal Opportunity Employer/Disabled/Veterans