The purpose and overall goal of Pre-Anesthesia Screening (PAS) is to gather the clinical information necessary for the safe and effective administration of anesthesia through a process that is convenient for patients and physicians and results in efficient surgical throughput. The Nurse Practitioner of the Pre-Op clinic has overall supervision of the pre-operative clinic provided in the Surgery area, in addition to the flow of the pre-surgical testing and pre anesthesia clearance for patients to gain admittance to the operating room. The Nurse practitioner of the Pre-op clinic will provide input and assist with major decision making processes in regards to cardiac, pulmonary, and overall general health clearance for optimizing the health of patients who will undergo future surgery. They will play a major role in collaboration with the CRNA team and Internal Medicine department to decide if a patient is physically fit to undergo surgery and to decide if the patient’s laboratory markers deem them to be safe candidates for the administration of general anesthesia. Through the development of algorithms and checklists by the CRNA and surgical/Internal medicine team the NP of the Pre-OP clinic will follow these flowsheets to ensure safety of the surgical patient. This pre-op clearance process will allow EKG’s, labs, concerning physical disabilities, medication issues, and allergies to be pre-assessed prior to the day of surgery optimizing patient outcomes and preventing medical errors. The NP of Pre-op clinic will work along with the Chief CRNA to improve overall flow, function, safety and efficiency of the pre-operative and pre-anesthesia processes.
- Serves as Nurse practitioner of the pre-op clinic, incumbent assigns, directs all nurses and staff in the pre-op clinic.
- Serves under the Chief of CRNA and is directed by the Chief CRNA and all responsibilities.
- Oversees the day-to-day tasks and activities of pre-op clinic. This includes evaluating ALL patients sent from surgical clinics in a timely fashion to be evaluated and cleared for surgery. This will include a medical history to include allergies and medications, family history of anesthesia complications, physical exam and assessment through algorithms for readiness for surgery. When health or medical concerns arise, the NP will have a dual collaboration with the CRNA present a plan for surgical clearance. Consults to CRNA and IM should be made for all high risk patients. Cardiac clearance and pulmonary clearance may be needed and future testing will ultimately be determined by the CRNA or IM physician. The NP will be responsible for collecting labs and performing the EKG in the pre- op clinic.
- Supervises the activities of the staff in the pre-op clinic. Ensuring the patients are receiving the appropriate educational information from the pre-op nurse as well as appropriate pre-operative preps to include but not limited to bowel preps, antibiotics, and pre-op at home surgical preps.
- Provides input and attends meetings for all departments directly affected by pre-operative services.
- Plans, organizes, coordinates, and directs the operational services of pre-op clinic along with the Chief CRNA, both advise the Chief of Surgical Services, Medical Officer and the Chief Executive Officer of TCRHCC on perioperative matters concerning the pre-anesthesia testing clinic.
- Participates with members of other departments, in planning joint administrative and technical programs; and making recommendations for maximum coordination of pre-operative services with other patient services.
- Along with the Chief of Anesthesia, incumbent is also responsible for assuring that TCRHCC meets the requirements of the Joint Commission on Accreditation of Hospitals (JCAHO) with regard to quality of care within the pre-operative anesthesia clinic and assures that hospital policies and procedures are followed.
- Committee responsibilities include OR committee attendance.
- Incorporates cultural and developmental needs into plan of care.
- Provides documentation of patient care in the patient record according to established standards of care.
- Participates in performance improvement activities which include collecting, analyzing data to identify quantifiable measures to maintain quality and the promotion of desired outcomes.
- Perform preoperative diagnostic procedures accurately and according to standards, policies, and procedures. Demonstrates competency in performing phlebotomy, obtaining various types of laboratory specimens, electrocardiograms, or other diagnostic tests.
- Effectively explains perioperative instructions, perioperative treatments, patient care principles, and nursing goals to patient and family/significant others.
- Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield.
- Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates)
- Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee, and external customer satisfaction.
- Completes all patient care documentation in the electronic health record entries accurately and in real-time.
- Participates in departmental workflow and or testing teams as related to electronic health record or other project initiatives
- Perform other duties as assigned or directed.
MENTAL AND PHYSICAL EFFORT
The physical and mental demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
The Incumbent must be able to frequently sit, stand, walk, bend, kneel, crouch, twist, maintain balance, and reach. Must be ability to lift, push, pull up to 10 pounds frequently and occasionally help with lifting, pushing, pulling greater than 10 pounds. Must have the ability to frequently utilize sensory requirements of far vision, near vision, depth perception, seeing fine details, and hearing normal speech frequently. Incumbent must also be able to hear overhead pages over a loudspeaker at times. The Incumbent must have the hand manipulation ability to do simple grasping and use of keyboards. The position will require the Incumbent to be exposed frequently to infectious disease, chemical agents, dust, fumes, gases, and hazardous or moving equipment frequently. Occasionally may be exposed to extremes in temperatures or humidity, unprotected heights, and loud noises.
The Incumbent must be autonomous with working alone for prolonged periods of time. Must be able to frequently cope with high level of stress; cope with anger/fear/hostility of others in a calm way; concentrate; handle a high degree of flexibility; handle multiple priorities in stressful situation; demonstrate a high degree of patience; and work in areas that are close and crowded. The Incumbent may frequently need the ability to make decisions under high pressure; manage altercations; and, adapt to shift work.
- Master of Science in Nursing (MSN) – Family Nurse Practitioner (FNP)
- Must have completed a nurse practitioner degree
- Experience in a pre-op clinic setting preferred
- Must have active CPR/BLS certification
- 1-3 years of experience as an RN
- Must possess a valid, current, full and unrestricted license to practice as a Nurse Practitioner in any state within the United States, District of Columbia, or the Commonwealth of Puerto Rico
- Must be credentialed to serve on the Medical Staff (provide all related information as requested and needed for credentialing process)
Other Skills and Abilities:
A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers. All employment references must address and indicate success in each one of the following areas:
- Positive working relationships with others
- Possession of high ethical standards and no history of complaints
- Reliable and dependable; reports to work as scheduled without excessive absences
- Successful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of TCRHCC a record of satisfactory performance and that the applicant can perform the essential functions of the job
- Successful completion of fingerprint clearance requirements, physical examinations, and other screenings indicating that the applicant is qualified to be employed by TCRHCC and demonstrating to the satisfaction of TCRHCC that the applicant can perform the essential functions of the job
- Submission of all required employment-related documents, applications, resumes, references, and other required information free of false, misleading, or incomplete information, as determined by TCRHCC.