Clinical Nurse I - Med Surg-PCU 360 (0.9 FTE, Nights)
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0.9 FTE, 12 hour Night Shift
At Stanford Children’s Health, we know world-renowned care begins with world-class caring. That's why we combine advanced technologies and breakthrough discoveries with family-centered care. It's why we provide our caregivers with continuing education and state-of-the-art facilities, like the newly remodeled Lucile Packard Children's Hospital Stanford. And it's why we need caring, committed people on our team - like you. Join us on our mission to heal humanity, one child and family at a time.
This paragraph summarizes the general nature, level and purpose of the job.
The Clinical Nurse I is a newly licensed new-to-practice RN or RN with less than 12 months as a Registered Nurse that demonstrates basic safe practice within the organizational professional practice model. The Clinical Nurse I seeks guidance to integrate concepts, knowledge, skills and attitudes to meet standards for competent professional nursing practice as specified in the Clinical Nurse I job description addendum and exhibits core values which reflect its mission.
The Clinical Nurse I is accountable for the provision of direct care to patients who may range in age from infancy to adult and demonstrates within the competency domains of Evidence Based Practice and Research, Safety, Professionalism, Person and Family Centered Care, Leadership, Technology/ Informatics, Teamwork and Continuous Quality Improvement.
The Clinical Nurse I works closely with the inter-professional health care team to facilitate the coordination of care across the continuum. The nurse focuses on developing the knowledge and skills necessary to provide individualized care based on physical, psychosocial, cultural, educational, safety, and age appropriate considerations of assigned patients.
The Clinical Nurse I requires consultation with more experienced clinicians and benefits from feedback while demonstrating growth in the ability to care for increasingly complex patients. The nurse demonstrates how nursing practice impacts the organizational vision, mission, and goals and the care delivery system. The nurse complies with all regulations and standards of regulatory and accrediting bodies.
The essential functions listed are typical examples of work performed by positions in this job classification. They are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks, and responsibilities. Employees may also perform other duties as assigned.
Employees must abide by all Joint Commission Requirements including but not limited to sensitivity to cultural diversity, patient care, patient rights and ethical treatment, safety and security of physical environments, emergency management, teamwork, respect for others, participation in ongoing education and training, communication and adherence to safety and quality programs, sustaining compliance with National Patient Safety Goals, and licensure and health screenings.
Must perform all duties and responsibilities in accordance with the hospital’s policies and procedures, including its Service Standards and its Code of Conduct.
• PATIENT AND FAMILY CENTERED CARE - Recognizes the patient (or the patient's designee) as the source of control and full partner in providing compassionate and coordinated care based on respect for the patient's preferences, values, and needs.
- Seeks to develop and understand effective communication with patients and families regarding the clinical plan of care and care development process
- Engages patients and families in active partnerships to plan and deliver care
- Is aware of and is able to locate all advance care planning documentation, and knows the decision maker for their patients in the event that patients cannot speak for themselves
- Fosters a healing environment for patients and families
- Keeps the patient and family at the center of all decisions
- Assesses patient's and family's ability and readiness to learn, and adapts the teaching plan considering patient level of comprehension, style of learning from the point of entry through discharge
- Completes comprehensive systematic assessment relevant to practice setting
- Integrates clinical reasoning and knowledge as the foundation for decision-making
- Manages patient care assignments appropriate to skill level
- Identifies cultural needs and perspectives in the relief of pain, discomfort, and suffering
- Incorporates cultural competence, diversity, and inclusion into practice
- Views each patient as a unique person
- Balances patient's rights and organization's responsibilities in providing professional and ethical care
- Utilizes ethical, legal, and regulatory principles in the provision of care
- Assumes responsibility and authority for establishing a therapeutic relationship with the patient/ family and creating an individualized plan of care, and evaluates patient's response and intervenes to ensure optimal patient outcomes.
- Promotes family presence and participation with care in accordance with patient preferences
• EVIDENCE BASED PRACTICE AND RESEARCH - Evaluates and integrates best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care and system effectiveness.
- Elicits and respects patient and family values when considering EBP decisions
- Participates in data collection, research or both
- Consults with experts when the basis for practice is questioned
• SAFETY - Minimizes risk of harm to patients, families, providers and self through system effectiveness and individual performance.
- Recognizes and responds appropriately to unsafe situation, and to patient and family safety concerns
- Is able to articulate the appropriate documentation of unsafe events and propose solutions to correct future occurrences
- Communicates concerns related to safety risks to patients, families and the health care team
- Integrates safety principles and National Patient Safety Goals into own practice
- Uses available resources to prevent injury
- Recognizes own limitations and seeks assistance when indicated
- Utilizes and discusses policy, procedures, and guidelines to support practice.
- Uses organizational error reporting systems for near miss and error reporting
- Administers medications and executes regimens as authorized by the state licensure to ensure the best possible outcomes for patients
- Applies use of technology and standardized practices that support safety and quality
- Practices autonomously within their scope as defined by the CA State Board of Nursing and the American Nurses Association Scope and Standards of Practice, including standards for safe medication administration
- Delegates work appropriately and provides direction and guidance to clinical support personnel
- Acknowledges and discusses risks associated with transitions
- Promotes active patient and family partnership and engagement in care to promote safety
- Integrates appropriate training and processes for related point of care laboratory testing
• CONTINUOUS QUALITY IMPROVEMENT - Utilizes data and QI methods to identify potential and actual problems and opportunities to provide care that is safe, timely, efficient, effective, and equitable.
- Recognizes how data is used in QI efforts
- Describes the use of PQMS/QI processes
- Understands how unit quality affects system effectiveness
- Participate as a team member on a performance improvement project
- Describes and uses outcome data at the patient level to make care decisions.
• TEAMWORK - Effectively engages in the process of cooperation, coordination, and collaboration in their efforts to provide for safe, quality outcomes for patients within an inter and intra-professional teams, including virtual teams.
- Interacts effectively with patients, families, nursing and inter-professional teams, fostering open communication, mutual respects, and shared decision- making to achieve quality patient care.
- Initiates referrals
- Functions as the coordinator of the patient’s plan of care and applies communication practices that minimize risks across transitions of care.
- Recognizes the impact of his or her behavior on others
- Embraces the cultural diversity and individuality of health care team members
- Acknowledges own contributions to effective and ineffective team functioning
- Uses respectful language appropriate for a given difficult situation, crucial conversation, or inter-professional conflict
- Demonstrates active engagement in enhancing patient care and promoting a positive workplace environment
- Solicits input from other team members to improve individual and team performance
• TECHNOLOGY/INFORMATICS - Utilizes appropriate information and technology to communicate, manage knowledge, mitigate error, and support decision making across the continuum.
- Demonstrates the ability to use clinical systems and technology to accomplish a specific task
- Protects patient confidentiality
- Documents and plans patient care in an EMR
- Consistently provides accurate, timely and complete documentation in the EMR
- Consistently utilizes the EMR to communicate with the care team and evaluate patient needs
- Identifies and responds appropriately to clinical decision support notifications and alerts
- Takes part in risk evaluation and understands the legal implications of late and inaccurate EMR documentation
• PROFESSIONALISM - Demonstrates a commitment to the nursing profession through life-long learning, adherence to the ANA Code of Ethics for Nurses, participation in a professional organization, and advancing community outreach.
- Seeks to develop effective communication skills and actively contributes to a healthy work environment
- Values recommendations of professional nursing organizations
- Actively contributes to a healthy work environment (refer to AACN Standards for Establishing and Sustaining Healthy Work Environments)
- Participates in shared decision-making and shared governance activities
- Participates in activities that promote the development and practice of nursing
- Uses appropriate channels of communication to voice concerns and identify solutions (such as shared governance) to maintain safety, quality and patient satisfaction
- Adheres to the ANA's Code of Ethics for Nurses and professional nursing/ organizational standards
- Articulates the application of and integrates high ethical standards and core values into everyday work activities
- Displays sound moral and ethical character and judgment, and promotes accountability
- Demonstrates willingness to learn and actively engage in personal, professional growth
- Establishes and follows through with personal goals that support unit, organizational, and Lucile Packard/ Stanford Children's Health goals and imperatives
- Participates in formal and informal peer review
- Actively seeks and accepts constructive feedback through supervisor and peer review
- Demonstrates responsibility for continued competency in nursing practice and develops insight through reflection, self-analysis, self-care, and life- long learning
- Participates in community outreach
- Uses appropriate channels of communication to voice concerns and identify solutions (such as shared governance)
- Displays sound moral and ethical character and judgment, and promotes accountability
- Supports decisions once they have been made and agreed upon, and adjusts practice accordingly
- Understands and maintains a current working knowledge of scope of practice as outlined by state Board of Nursing.
• LEADERSHIP - Effectively collaborates and applies innovative, systems thinking to engage in systematic, evidence-based problem-solving and decision making to promote effective changes within a complex care delivery system supporting the vision of Lucile Packard Children's Hospital/Stanford Children's Health.
- Supervises nursing care that is provided by others and for which the nurse is responsible, by using best practices of management, leadership, and evaluation
- Delegates and collaborates effectively to meet patient care needs
- Listens objectively to all sides of an issue before making a judgment
- Demonstrates engagement in unit and system initiatives
- Communicates thoughts, feelings, and ideas to justify a position
- Employs appropriate social skills
- Demonstrates ability to learn on the fly
- Develops conflict resolution skills for self and team members
- Initiates actions to resolve conflict
Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.
Education: Graduate from a accredited nursing program.
Experience: None required.
License/Certifications: Required: Current California RN license.
Current BLS as a health care provider issued by the American Heart Association (department requirement).
Knowledge, Skills, & Abilities
These are the observable and measurable attributes and skills required to perform successfully the essential functions of the job and are generally demonstrated through qualifying experience, education, or licensure/certification.
• SKILL REQUIREMENTS-Ability to perform functions as described in the position description addendum according to the clinical level.
• MACHINE, TOOLS, AND EQUIPMENT OPERATED: Must be proficient in the operation of clinical equipment/machines, computers and technology within the nurse’s practice setting.
• FISCAL ACCOUNTABILITY AND RESOURCE STEWARDSHIP: Judicious use of materials and supplies in the provision of direct and indirect patient care. Prevention of damage, misuse or loss of equipment in the provision of direct patient care.
• SUPERVISION: The Clinical Nurse may be responsible for guiding, assisting and directing unlicensed assistive personnel as defined by the California Nurse Practice Act and/or the organization’s policies and procedures.
The Physical Requirements and Working Conditions in which the job is typically performed are available from the Occupational Health Department. Reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions of the job
• PERSON AND FAMILY CENTERED CARE: The nurse places the patient and the family at the heart of every decision and empowers them to be partners in their care. The nurse delivers compassionate and coordinated care based on the patient/family perspective incorporating preferences, values and needs in the plan of care.
• EVIDENCE BASED PRACTICE AND RESEARCH: The nurse evaluates and integrates best current evidence with clinical expertise and patient and family preferences and values for the delivery of optimal health care and system effectiveness.
• SAFETY: The nurse minimizes risk of harm to patients, families, providers and self through system effectiveness and individual performance.
• CONTINUOUS QUALITY IMPROVEMENT (CQI): The nurse utilizes data and QI methods to identify potential and actual problems and opportunities to provide care that is safe, timely, efficient, effective, and equitable.
• TEAMWORK: The effectively engages in the process of cooperation, coordination, and collaboration in an effort to provide for safe, quality outcomes for patients within inter and intra-professional teams, including virtual teams.
• TECHNOLOGY/ INFORMATICS: The nurse utilizes appropriate information and technology to communicate, manage knowledge, mitigate error, and support decision making across the continuum.
• PROFESSIONALISM: The nurse demonstrates a commitment to the nursing profession through lifelong learning, adherence to ANA's Code of Ethics for Nurses, participation in a professional organization and advancing community outreach.
• LEADERSHIP: The nurse effectively collaborates and applies innovative, systems thinking to engage in systematic, evidence-based problem solving and decision making to promote effective changes within a complex care delivery system supporting the vision of Lucile Packard Children's Hospital, Stanford Children's Health.
• REFERENCES: The following Competencies and subsequent Knowledge, Skills and Attitudes are based on the latest evidence and recommendations in nursing. Identification of key competencies originated from the Institute of Medicine and expanded to formal use through the Quality Safety Education for Nurses (QSEN) Institute.
- Benner PE. From novice to expert: excellence and power in clinical nursing practice. Commemorative ed. Upper Saddle River, NJ: Prentice-Hall; 2001.
- Board of Registered Nursing. Standards of competent performance. State of California, Department of Consumer affairs Retrieved from http://www.rn.ca.gov/regulations/title16.shtml#1443.5
- Burke K. Johnson T, Site C, Barnsteiner J. Creating an Evidence-Based Progression for Clinical Advancement Programs. American Journal of Nursing (2017) 117(5): 22-35.
- Committee on Quality Health Care in America, Institute of Medicine, editor. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academy Press; 2001. Quality chasm series. https://www. nap.edu/catalog/10027/crossing-the-quality-chasm-a-new-health-system-for-the.
- Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine, editor. The future of nursing: leading change, advancing health. Washington, DC: National Academies Press; 2011. https:// www.nap.edu/catalog/12956/the-future-of-nursing-leading-change-advancing-health.
- Greiner AC, et al., editors. Health professions education: a bridge to quality. Washington, DC: National Academies Press; 2003. Quality chasm series. https://www.nap.edu/catalog/ 10681/health-professions-education-a-bridge-to-quality.
- Cronenwett L, et al. Quality and safety education for nurses. Nurs Outlook 2007;55(3):122-31.
- Cronenwett L, et al. Quality and safety education for advanced nursing practice. Nurs Outlook 2009;57(6):338-48.
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