Registered Nurse Medical Step Down Experienced

Our hardworking, tight-knit community of more than 4,000 dedicated employees fosters an environment of care and compassion. Each member plays a vital role in our collective mission to deliver excellent healthcare through innovation, education, and research. At Mount Sinai, we take pride in our achievements, aiming to be a beacon of quality healthcare in South Florida. We welcome all healthcare professionals to join our thriving community and contribute to our pursuit for clinical excellence.

Department

Job Description

Summary

Experienced RN Medical Step Down

Days/Nights

Position Responsibilities

Medical Step Down Responsibilities

• Maintains annual clinical competence in care of surgical patients, administration of vasoactive medications, and telemetry monitored patients.

• Assesses clinical and diagnostic data of the surgical population served.

• Troubleshoots unit specific equipment.

• Monitors patient hemodynamic response to interdisciplinary plan of care and intervenes appropriately.

• Performs tracheostomy care according to hospital policy and procedure.

• Provides individualized teaching to patients/family requiring surgical procedures, telemetry monitoring, and vasoactive medication administration.

• Interprets ABG results and intervenes appropriately.

• Administers medications via PCA or Epidural pumps competently.

• Assess, monitor, and document patient response to chest tube management.

• Assesses clinical, diagnostic, and laboratory data of the population served.

• Prepares surgical patient and demonstrates care post operatively

Assessment

• Performs initial vital signs and admission history to include introduction to patient and family. Assessment of chief complaint and notification of physician within 15 minutes of arrival to unit.

• Obtains and documents a complete nursing admission assessment, including physiological and psychological factors to develop an interdisciplinary plan of care within eight hours of admission.

• Performs and documents an accurate systems assessment at the beginning of each shift.

• Responds to diagnostic data and initiates appropriate action or intervention.

• Assesses patient education needs on admission and daily.

• Assesses psychosocial needs specific to patient's age, growth, and development.

Planning

• Initiates an interdisciplinary plan of care within eight hours of admission.

• Establishes priorities for patient care based on patient needs as evidenced by completion of assigned duties within shift.

Implementation

• Verbalizes understanding of patient diagnosis and interdisciplinary plan of care.

• Safely and correctly initiates and documents nursing interventions in emergency situations.

• Performs 24-hour chart check at the beginning of each shift.

• Prepares intravenous solutions using aseptic technique.

• Administers, observes, and documents intravenous therapy according to hospital policy.

• Administers medications within 30 minutes of scheduled time. Observes and documents effectiveness. Recognizes and reports adverse reactions immediately.

• Provides individualized instructions each shift to patient/significant other regarding the plan of care.

• Demonstrates safe and correct use of unit specific equipment.

• Ensures that each patient's general hygiene needs are met daily.

• Performs pre-operative and post operative care and instruction for each assigned surgical patient during shift.

• Adheres to standard precautions including hand hygiene guidelines at all times.

• Documents specific patient valuables on designated form when received and immediately arranges for appropriate storage.

• Performs dressing changes using aseptic technique.

• Collects and labels specimens per policy when ordered by physician.

• Performs bedside glucose monitoring according to policy.

• Administers internal feedings via ng tube, g tube, and/or j tube.

• Reports all abnormal findings immediately to physician.

• Initiates wound and skin protocol upon identification of actual or potential skin breakdown.

• Performs ostomy care to include irrigation, appliance usage, and reinforcement of teaching.

• Inserts intermittent or indwelling urinary catheter using aseptic technique.

• Administers oxygen therapy according to physician order.

• Transfers patients in/out of the unit in an efficient manner, by obtaining a complete and correct set of physician's orders. Completes documentation of transfer summary. Ensures appropriate completed referral forms accompany intra-facility transfers, including giving/receiving of report.

• Demonstrates safe and correct use of restraints as per policy.

Evaluation

• Documents/reports patient responses or outcomes resulting from: nursing interventions, treatments/procedures, interpersonal interactions, and patient/family education.

• Evaluates and documents patient's progress towards established goals/objectives every shift.

• Updates/revises patient care problem list and individualized patient care standards based on patient/family responses, progress towards goals, and/or change in medical status every shift.

• Evaluates patient length of stay and related transfer/discharge planning needs based on anticipated problems/needs, internal or community resources, and support systems.

Professional and Staff Development

• Obtains 100% mandatory hospital and unit specific inservices annually, prior to evaluation date.

• Plans, presents, and documents unit inservice as required by level.

• Documents competency in clinical skills annually.

• Attends staff meetings as required.

• Uses established lines of communication for resolution of problems and interpersonal conflict.

• Ensures productivity daily by delegating assignments to immediate subordinates at the beginning of the shift and evaluates completion of duties assigned.

Leadership

• Participates in PI program by identifying PI indicators of major aspects of care at the unit level.

• Collects PI data as assigned.

• Documents and charges supplies used daily.

Qualifications

License/Registration/Certification

• Current FL Nursing License, Current Basic Life Support, and Current Advanced Cardiac Life Support required.

Education

• None

Experience

• Level III: Min 2 year RN

Benefits

We believe in the physical and mental well-being of our employees and are committed to offering comprehensive benefits that fit their personal needs:

• Health benefits

• Life insurance

• Long-term disability coverage

• Healthcare spending accounts

• Retirement plan

• Paid time off

• Pet Insurance

• Tuition reimbursement

• Employee assistance program

• Wellness program

• On-site housing for select positions and more!

Degree

Requirements

Certification