Position: Certified Nursing Assistant II
Department: Emergency Department
Schedule: 24 Hours, Day / Evening / Night
Under the direction and supervision of the registered nurse and following hospital policies, procedures, protocols, and standards of practice, the Certified Nursing Assistant (CNA) participates in the delivery of patient care. The role encompasses the provision of direct clinical and supports services to patients and families across the healthcare continuum, functioning as an effective member of the health care team by contributing to the efficient operation of the patient care unit, and accountability for fiscally sound, quality patient/family clinical outcomes.
ESSENTIAL RESPONSIBILITIES / DUTIES:
Clinical Practice : Under the direction of the registered nurse (RN), performs a variety of appropriately delegated patient care interventions for patients and their families within the scope of their role .
- Collaborates with the RN throughout the shift to determine the appropriate work assignment and priorities as well as communicates the status of delegated task completion and outcomes of patient data findings to the RN throughout the shift.
- Maintains timely ongoing verbal communication with RN throughout the shift regarding patient condition. Notifies RN immediately of any significant change in a patient's condition and/or monitoring alarms (for example: change in vital signs, change in patient's mental status, abnormal blood sugar, patient fall, patient concerns with care).
- Upon initial contact with patients, visitors, and staff, identifies self as a CNA and introduces self to the patient by name. Wears appropriate name badge which identifies self as a CNA.
- Accurately collects and records patient data (vital signs, intake, and output, blood sugar, weights, restraint care/monitoring, other) and complies with hospital documentation standards to ensure a complete and accurate patient record.
- Accurately interprets & utilizes medical abbreviations and terminology following hospital policy.
- Initiates a prompt response to all patient call lights and seeks assistance from co-workers as appropriate.
- Assists with admission, discharge, and transfer of patients as appropriate for the inpatient or ambulatory area patients. Completes section of the Functional Health Assessment upon admission. Prepares room for admission and ensures patients have appropriate identification bands upon admission and throughout their hospitalization. Transport patients and their belongings, equipment, and supplies, as needed and as part of the transfer/discharge process.
- Makes routine patient room rounds to address patient needs.
- Provides and/or assists with basic hygiene including but not limited to bathing, dressing, mouth care, shaving, whirlpool baths, perineal and bowel care, foley care, application of condom catheters, emptying urinals and ostomy bags, and other associated hygiene tasks.
- Provides basic skincare including but not limited to back rubs, routine diabetic foot care, application of non-medicated ointments, application of elastic stockings, ace wraps, and venodynes, turning and repositioning patients every two hours, and other associated tasks.
- Sets up patients for meals and assists them with feeding and opening food containers; maintaining calorie counts and recording intake/output measures (I and Os).
- Performs basic oral suctioning.
- Performs postmortem care.
- Assists nurse/health team members during simple and complex treatments or procedures.
- Provides basic preoperative care and readies the patient for the OR in conjunction with the RN.
- Collects, labels, and sends/transports specimens with the appropriate lab slips/requisitions.
- When ambulating patients use safe and proper techniques, apply safety devices using hydraulic lifts or bed scales as needed.
- When providing one-on-one (1:1) or one-on-two (1:2) patient care, performs the duties of the certified nursing assistant for the patient assigned.
- Identifies emergency/crises and initiates appropriate response actions within the scope of her/his role, including immediate communication of such events to the registered nurse.
- Performs EKGs and phlebotomy services as directed.
- Performs basic patient testing, including but not limited to tests for guaiac, sugar and acetone, urine pH, glucose finger stick, O2 saturation, leg/girth measurements, visual acuity tests, peak flow tests, etc.
Maintains competence concerning a variety of other technical skills which may include, (depending on unit assigned) but are not limited to:
- PD cycler set up
- Cast / splint care
- Application of external monitors
- GU irrigation set up
- Chest tube set up
- Arterial line set up
- Basic ostomy care.
- Quad coughing
Support Services: Under the direction of the RN, works cooperatively with all health care team members to provide a variety of support services to meet patient, family, and staff needs within the scope of his/her role.
Addresses patient comfort and information needs by providing informative, non-clinical information to patients and families, orienting patients/visitors to the hospital, unit, patient room services, distributing patient mail/flowers, arranging the room to ensure necessary personal care items are available & accessible (includes call lights), distributes nourishments, changes linens & clothing, refill ice packs, run patient errands or other duties as assigned by the RN. Answers the telephone identifying unit, self & role; responds to caller's need within the scope of the role or takes and delivers messages promptly. In conjunction with the RN, responsible for initiating patient belongings tracking form and for properly securing patient belongings following hospital policy. Consults with RN if the patient refuses to secure their belongings or has their belongings sent home with a family member or friend.
Work Rules, Standards, & Competency Compliance :
- Acts in a manner that supports a positive and collaborative work environment and that are congruent with established standards, policies, procedures, and regulations within the scope of their role .
- Works cooperatively with all staff members and takes appropriate steps to resolve interpersonal conflicts. Seeks assistance from RN or off-Shift Nurse Manager as needed.
- Participates in staff meetings and appropriate in-services. Responsible for reading and reviewing minutes and clinical updates on the unit. Maintains accurate education records in HealthStream. Maintains competencies required to perform the role.
- Complies with established practice standards, policies, procedures, protocols, guidelines, and regulations, (for example DPH, JCAHO, Boston fire codes, OSHA).
- Reviews and is knowledgeable of appropriate policies, procedures, and work rules.
- Dresses appropriately according to dress code requirements, including wearing uniform and visible hospital I.D. badge while on duty.
- Assists in the orientation of new staff; serves as a resource to float staff.
- Adapts to changing patient and unit needs including but not limited to offers assistance to other team members, floating, adjusting assignments, etc.
- Communicates with the charge nurse/supervisor to coordinate break periods with unit activities. Maintains visibility on the unit and does not leave the work area without appropriate notification to the RN.
- Delivers care in a non-judgmental, non-discriminatory manner that is sensitive to and demonstrates respect for patient diversity.
- Acts in a manner that protects the confidentiality of patient, employee, and hospital information at all times.
Care of Unit Environment, Equipment, Materials, and Supplies :
- Performs a variety of environmental and inventory activities to ensure a safe, clean, and appropriately equipped environment for patients, visitors, and staff within the scope of their role .
- Initiates and performs spot and spill cleaning as needed, including biological spills. Assists with locating and transporting equipment for periodic sonic cleaning.
- Makes routine room rounds to unclutter, clean, and organize patient rooms/areas when needed.
- Checks inventories and restocks/replaces/assembles patient equipment and supplies.
- Appropriately disposes of trash, soiled linens, and medical waste & disposable items.
- Performs regular checks per policies to ensure that equipment is operating properly and has current safety inspections/expiration dates before patient use. Identifies broken/expired equipment/supplies; removes from service and notifies RN. Provides equipment delivery to appropriate repair sites as requested.
- Maintains appropriate equipment logs and records.
- Performs initial cleaning/decontamination of equipment/materials, e.g., removing reusable equipment from isolation rooms, and arranges for terminal cleaning as appropriate.
- Provides basic patient equipment care including but not limited to changing hearing aid batteries, cleaning/preparing breast pumps, etc.
- Interprets/translates for patients/family/visitors when conversant in her/his native language.
- Utilizes the hospital's values as the basis for decision making and facilitates the division's hospital mission.
- Follows established hospital infection control and safety procedures.
- Performs all other duties as assigned.
A high school diploma or GED certificate is required.
Requires a minimum of one of the following:
- One year of previous experience as a nursing assistant in an acute hospital setting, or
- Current enrollment in a nursing program and has completed two cycles of clinical rotation or
- Successful completion of an approved certified nursing assistant training or
- Successful completion of an approved certified Medical Assistant Training program.
KNOWLEDGE AND SKILLS:
- Ability to effectively speak, read, and write using the English language. Multilingual skills (beyond that of English) in languages appropriate to the patient populations served by the Medical Center is a plus.
- Ability to perform basic math and quantitative measurements, e.g., obtain height and weight, abdominal girths, measure urine output, calorie counts, etc.
- Ability to accurately interpret and utilize basic medical terminology and abbreviations.
- Ability to enter and retrieve computerized information/data. Ability to use Microsoft Outlook.
- Ability to pass clinical competency testing and basic math and abbreviation test.
- Physical ability to push, transfer and pull heavy loads (e.g., independently transport average-sized patients via wheelchair and stretcher, etc.) throughout the assigned shift.
- Physical ability to meet core job requirements following practice setting demands for the patient populations regularly served.
- Effective interpersonal skills to interact appropriately with nursing staff, patients, families/visitors, physicians, and other hospital staff.
- Organizational skills to set priorities and efficiently complete assigned work.
- Ability to manage stress related to patient care issues and changing organizational climate and personnel issues.
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