DeBakey VA Medical Center – Houston, TX

ICU RNs:

• 12-hour nights
• ICU nurses are required to float as needed to other departments, including MedSurg, Stepdown (SDU), Spinal Cord unit and Community Living Center (CLC).  Most of the time, the floating is to MedSurg and SDU.
• All candidates must agree to an in-person Meet & Greet, held on Tuesdays, Wednesdays, and Thursdays.
• The estimated time for onboarding (credentialing and security clearance) is 45-60 days from when all paperwork is submitted.
• Must not have artificial nails or visual tattoos. 

Orientation:

• Orientation is held every other Wednesday and Friday, then a week of shadowing.  The 3rd week will be on your own. 

Scheduling: 

• On the 2nd Monday of each month, the VA will open the next month's schedule.  Nurses will have 10 days to fill in their availability.  Once closed, the VA will fill in gaps based on need, provider hours, etc. 
• Nurses must work a minimum of 3 to 12-hour shifts per week.  There may be an opportunity to work a 4th, but no guarantee.
• Nurses must work four total weekend shifts per month.  Per the VA, that can be every Saturday or two full weekends; however, that works out to 4 shifts per month.
• If a Nurse calls out on a weekend shift, they will automatically be assigned to the following weekend.
• VA will not sign off on more than 2 weeks of vacation.
• If a Nurse is requesting leave, they will need to complete the PFS Leave Request Form and place it in the drop box in the resource center.  The VA will work with PFS to review and approve/deny, depending on length, hours missed and facility need.

POSITION DUTIES AND RESPONSIBILITIES:

• 2.1. RN: The RN will utilize their broad-based clinical knowledge to effectively assess, implement health promotion and prevention interventions, manage acute and chronic illness states, assist patient/residents in the attainment of optimal levels of functioning rehabilitation, evaluate patient/resident response to actual or potential health problems, and provide supportive measures for the dying patient/resident and their significant others. Nursing care is performed in accordance with the Texas Registered Nurses Practice Act. The VA Nurse Manager(s), or appropriate nursing leadership delegate (i.e., Assistant Nurse Manager), will provide the RN with clinical oversight during their tour of duty. The more specific duties and responsibilities of the Registered Nurse are described below and will be assessed by MEDVAMC before provider acceptance.

• 2.1.1. Maintain patient/resident confidentiality and a safe patient/resident care environment, including familiarity with requirements such as medication administration, patient/resident/family education, discharge process, restraint usage, hazardous waste disposal, etc., as defined by The Joint Commission and all other VA regulatory bodies (i.e., Long Term Care Institute and Office of Inspector General).

• 2.1.2. Provide patient/resident-centered care by performing the following tasks:

• 2.1.2.1. Assess the health care needs of the patient/resident and maintain or develop a plan of care to meet interdisciplinary goals,

• 2.1.2.2. Assess and act on significant changes in the patient’s/resident’s health condition,

• 2.1.2.3. Carry out the plan of care by performing/assigning delegated tasks,

• 2.1.2.4. Collect and document pertinent data into the electronic patient/resident medical record using designated temp plates with no personalized or customized documentation,

• 2.1.2.5. Complete nursing assessments within required time frames, and in accordance with policy and procedure,

• 2.1.2.6. Identify and act on predictable needs of the patient/resident,

• 2.1.2.7. Meet the health care needs of patient/resident by assessing and assisting the patient/resident to meet expressed needs,

• 2.1.2.8. Meet the emotional and spiritual needs of patients/residents and/or families,

• 2.1.2.9. Prioritize and complete tasks within the RN’s assigned shift.

• 2.1.2.10. Update patient/resident care plans,

• 2.1.2.11. Notify the assigned physician of any changes in condition,

• 2.1.2.12. Practice the VA core values Integrity, Commitment, Advocacy, Respect, and Excellence (ICARE),

• 2.1.2.13. Report incidents of verbal or physical abuse immediately to the Nurse Manager of the unit to which they are assigned or to designated off-shift nursing leadership.

• 2.1.3. Perform the following tasks:

• 2.1.3.1. Head-to-toe assessment,

• 2.1.3.2. Insert IV lines,

• 2.1.3.3. Care and management of peripheral and central lines, including PICC lines,

• 2.1.3.4. Administer medication, including IV,

• 2.1.3.5. Coordinate and participate in the admission and discharge of patients,

• 2.1.3.6. measure vital signs/hemodynamic monitoring, including Pain (the 5th Vital Sign), pulse oximetry, etc.

• 2.1.3.7. Perform wound care, including dressing changes (sterile and non-sterile) and obtaining wound cultures as necessary,

• 2.1.3.8. Obtain and deliver specimens to the lab,

• 2.1.3.9. Perform tracheostomy care,

• 2.1.3.10. Perform non-acute and/or acute ventilator care, if needed,

• 2.1.3.11. Perform suctioning, including oral, nasogastric, and tracheostomy,

• 2.1.3.12. Perform deep suctioning, which may include obtaining specimens,

• 2.1.3.13. Assess for and administer tube feedings,

• 2.1.3.14. Assist with routine urinary and bowel elimination, including catheters, colostomies, and digital stimulation. Educate patients/residents and their families regarding health and diagnoses, as well as medication administration, including indications for each medication.

• 2.1.3.15. Respond and assist in an emergency,

• 2.1.3.16. provide clinical oversight to Licensed Practical Nurses, Nursing Assistants, Health Technicians, and Intermediate Care Technicians,

• 2.1.3.17. Bar Code Medication Administration (BCMA) with a 100% accuracy rate shall be used in the applicable areas for medication administration. BCMA is designed to provide electronic validation and documentation of medication administration, reduce medication misadventures, provide an online patient/resident medication record, and promote a safer inpatient/resident care environment. A spot check (random review) of patient/resident charts or incident reports will be conducted. If issues are found, remedial training will be provided to the contractor employee. If remedial training is unsuccessful, the contractor employee may be removed from providing services under the Contract.

• 2.1.3.18. PRN medication effectiveness,

• 2.1.3.19. PPE and Hand Hygiene Compliance,

• 2.1.3.20. Administration of Blood Products,

• 2.1.3.21. Administer the Braden Scale to assess the risk of skin injuries and provide recommendations and interventions to prevent them.

• 2.1.3.22. Perform Fall Risk Assessment to decrease the risk of falls and falls with injuries and provide recommendations and interventions to decrease the risk of falls and falls with injuries.

• 2.1.3.23. Provide Joint Patient Reporting System (JPRS) for patient incidents,

• 2.1.3.24. Clear all CPRS clinical alerts daily,

• 2.1.3.25. Perform skin assessment to identify potential skin injuries and provide recommendations and interventions,

Overview

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Disclosures