RECOVERY ROOM NURSE

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Definition and Purpose:  The Recovery Room nurse is the professional nurse responsible for providing quality post-procedure nursing care up to, and including, safe discharge from the facility.

Qualifications:

1. Must be a graduate of an accredited school of nursing.
2. Must have a current license to practice in Massachusetts.
3. Two years’ experience as a staff nurse
4. Be flexible with the hours:  Work to accommodate patient and physician’s needs (e.g., afternoon block time, rescheduling of patients due to surgery schedule, same-day add-ons).
5. Possess an exceptional capacity for compassion and patience in dealing with a very difficult, demanding patient population.
6. Skilled in Phlebotomy.
7. Current BLS certification
8. ACLS & PALS required

General Performance:  In addition to understanding and supporting the mission of the Same Day SurgiClinic, all profession RNs on staff shall:

1.         Recognize the psychological, physiological and surgical needs of each patient and respond with appropriate plan of nursing care

2.         Participate fully in patient/family teaching and respect patient’s rights

3.         Maintain a safe working environment

4.         Be flexible and adaptable to the demands of an ever-changing and sometimes unpredictable

            perioperative workplace

5.         Relate in a supportive and positive manner to other members of the staff nursing, and to the

            office and medical staff

6.         Use proper communication channels and refer problems to the Director of Nurses when

            appropriate

7.         Complete assignments accurately and adapt easily to changes in workload and schedule

8          Participate fully in the Quality Assurance Program and assist in the development and revision

            of policies and procedures to improve the delivery of care in the facility

9.         Be efficient and economical in the utilization of supplies and equipment;

10.       Dispense and manage medications accordance with facility policies;

11.       Assist in the orientation of new employees. 

 (A)  Initial assessment:  After receiving reports from the anesthesiologist and operating room nurse, the Recovery Room nurse will make an initial assessment of the patient’s condition with special attention to the following parameters:

                        – level of consciousness and patient’s responsiveness

                        – muscular tone and adequacy of respiration

                        – vital signs, circulation, skin color, and airway patency

                        – condition of dressing and suture line

                        – status of the intravenous

                        – level of comfort and evaluation of pain control

                        – presence of nausea or vomiting

(B)  Continuing assessment:  All patients receiving general anesthesia will have their heart rate and rhythm, pulse oximetry and blood pressure monitored at regular intervals until the patient is deemed stable by the Recovery Room RN.  Special skills required of the Recovery Room Nurse include the following:

            – Knowledge of cardiac monitoring and the ability to recognize dysrhythmia.

– Can interpret vital signs and seek consultation when there are significant changes;

            – Recognition of physical symptoms and signs and to react appropriately;

            – Ability to assess pain and use appropriate pain management techniques;

            – Strives to maintain patient privacy in difficult clinical surroundings;

            – Ability to be flexible, organized and function under stressful conditions.

            The Recovery Room nurse in this phase will be documented using the Aldrete Scoring System (activity, respiration, circulation, consciousness and color, each item being given a score of 0, 1, or 2).  A score of 9 out of 10 is required before a patient will be transferred to the stepdown recovery area for Phase II recovery. 

(C)  Discharge from the facility:  The Recovery Room nurse will assess the patient’s readiness for discharge using the following criteria:

                        – alert and oriented to time and place

                        – stable vital signs for at least one-half hour

                        – pain is controllable by oral analgesics

                        – emesis, nausea controlled

                        – minimal bleeding from operative site

                        – able to retain fluids and void (procedure specific)

                        – ambulatory as expected after procedure.

            Discharge instructions will be reviewed with the patient and the adult escort who will take the patient home.  Patients who have received general or MIVA anesthesia will be discharged by an anesthesiologist.  Patients who have received local anesthesia or conscious IV sedation will be discharged by the operating surgeon. 

(D)  Next Business Day after the procedure:  The Recovery Room nurse contacts each patient, makes an assessment of the post-op status, answers the patient’s questions and institutes a plan of correction if significant problems arise. 

Working Conditions/Physical Requirements of Job:

1.  May be required to manage the care of patients during altered states of consciousness.
2. Physically demanding job, requiring standing, and walking for extended periods of time.
3. Lifting and carrying items weighting up to 50lbs.
4. Exposure to blood, body fluids, communicable disease, chemicals and repetitive motion.
5. Full range of body motion including handling and lifting patients.
6. Working irregular hours.