Kristine Jade Bulanadi

• Supervise the day-to-day nursing activities of the facility and will ensure that the highest degree of quality care is maintained.
• Monitored patient reactions to drugs and carefully documented findings.
• Managed care from admission to discharge.
• Provided direct patient care, stabilized patients, and determined next course of action.
• Trained new nurses in proper techniques, care standards, operational procedures, and safety protocols.

· Perform and accurately document physical, psychosocial, and emotional assessments. All assessments take into consideration age specific criteria (children, adolescents, adults and older adults)

· Actively anticipate patient's and/or patient's family needs and expectations and utilize these in conjunction with their assessment to develop an appropriate plan of care. Maintain and utilize competencies per unit expectation.

· Identify and implement appropriate nursing interventions based on the completed assessment. Confer with all members of the health care team in a collaborative fashion. Share information and observations of patient and/or patient's family.

· Appropriately prioritize nursing interventions based upon completed assessment. Promptly identify changes in condition as evidenced by nursing assessment, labs, x-rays, etc. Report changes and take follow-up action as appropriate. Actively involve patient and family/care-giver in plan of care.

· Evaluate implemented interventions and modify care according to the evaluation. Document interventions and modifications to the plan of care.

· Adhere to appropriate hospital and/or Department of Nursing policies, procedures, clinical pathways and nationally accepted standards of nursing practice. Incorporate ANA standards, into the provision of safe, quality patient care, utilizing current literature, and research. Practices in accordance with our Professional Practice Model "Relationship Based Care" and delivers care using our Care Delivery System " PACE" – Patient Focused, Accountable, Coordinated and Continuous and Evidence Based.

· Provide appropriate and timely answers and/or education to patients, patient’s families, significant others and/or caregivers. Assess competence, obtain feedback/evaluation of understanding from patient, family, significant other and/or /caregivers.

· Welcome and orient patient, family, significant other and/or caregiver to the unit. Encourage patient/family participation in care. Review personalized patient plan of care with patient/family every shift. Update white boards accordingly and set daily goals with patient input. Explain special diets, tests, procedures and medications in easily understood and appropriate language. Make hourly rounds on patients.

· Duties performed may include one or more of the following core functions: a) Directly interacting with or caring for patients; b) Directly interacting with or caring for human-subjects research participants; c) Regularly maintaining, modifying, releasing or similarly affecting patient records (including patient financial records); or d) Regularly maintaining, modifying, releasing or similarly affecting human-subjects research records.

1. Serves as a patient advocate, by focusing on patient needs, patient rights, confidentiality, and religious and cultural preferences. Maintains positive working relationships with all Parkland internal and external customers, employees, etc. Serves as a resource for patients and other healthcare team members. Serves as a resource for specific clinical patient care issues. Provides patient care educational information and training to patient and family members.

2. Performs appropriate patient assessments including continuous surveillance. Recognizes changes in a patient's condition and provides appropriate interventions as necessary. Consults with other team members as required, notifies providers to report changes in patient condition and implements orders in a timely manner. Exercises independent judgment in providing safe nursing care to the critically ill/stable patient.

3. Must be able to manage an adult ICU patient with neurological, pulmonary, cardiovascular, gastrointestinal, genitourinary disorders/conditions. Must provide safe medical administration using the patient's six (6) rights, provide maintenance and management of IV access, must be able to perform POC monitoring, demonstrate safe infection control practices and CRRT for the adult ICU patient. Supports pain management as appropriate for each individual patient, provides emergency resuscitation care of an adult and provides an individualized plan of care.

4. Maintains and implements knowledge of applicable rules, regulations, policies, laws and guidelines that impact or govern nursing practice, and ensures the hospital and Parkland are in compliance. Develops effective internal controls that promote adherence to applicable state/federal laws and the program requirements of accreditation agencies and federal, state, and private health plans. Maintains and updates knowledge of sanitation, infection control, safety, supplies, equipment, appropriate utilization of supplies and materials.

5. Completes appropriate documentation. Maintains accurate and timely entries and notations in patient care records and hospital documents. Ensures that all records and documents meet the standards, goals, and objectives of the Adult ICU/Critical Care department and Parkland.

6. Works with other staff in providing direction to non-nursing staff. Participates in information exchanges with nursing and other Parkland staff that support the standards, missions, goals and objectives of the Adult ICU/Critical Care department and Parkland. Seeks and utilizes direction from more experience staff and team members as needed. Provides appropriate hand off any time care is relinquished. Serves as a preceptor or trainer to newer nursing staff members, as needed.

7. Identifies ways to improve work process and improve patient and customer satisfaction. Makes recommendations to supervisor, implements and monitors results as appropriate in support of the overall goals of the Adult ICU/Critical Care department and Parkland.

8. Stays abreast of the latest developments, advancements and trends in nursing practice by attending seminars/workshops, reading professional journals and actively participating in professional organizations. Maintains State of Texas Licensure as a Registered Nurse, plus any additional required licensures/certifications. Integrates knowledge gained into current work practices.

9. May also be required to perform duties on inpatient units (with a modified patient assignment) as directed by the Centralized Staffing Office.

10. Employee commits to working a minimum of two shifts per pay period when the Hospital has the need. These shifts may include weekends, and one major and minor holidays. Employee will be required to float to areas within skillset. . (Major Holidays: Christmas Eve, Christmas Day, New Year's Eve and New Year's Day //Minor Holidays: Labor Day, Thanksgiving, Easter, Memorial Day, Fourth of July//Weekends are defined as 3:00PM Friday to 7:00AM Monday)

11. The employee will not be eligible for pay increases with evaluations.

12. The employee will be required to float to areas within skillset as needed and must maintain competency.

13. Employees in the RN PRN program will be classified in a regular relief status with no benefit eligibility.

14. Employees in this program will accept the assignments given by the Hospital, to include accepting on-call assignments. Employees will be expected to float as needed to clinical departments for which the Hospital has deemed them qualified and competent.

15. The Hospital does not guarantee any work or minimum number of hours per week.

16. Employees must have two years of prior work experience in their specialty area to be eligible to participate in the RN PRN program but also must have two years overall nursing experience.

17. Employees identified as not meeting the scheduling requirements set forth in the job description. Should they not meet the scheduling requirements, staff will be performance managed and encouraged to seek roles for which they can meet the scheduling requirements.

• Clinical Judgment: Using clinical reasoning, conducts accurate clinical assessments according to practice standards
• Identifies and prioritizes patient and family needs
• Develops, implements and evaluates the nursing plan of care
• Modifies plan to meet clinical outcomes
• Clinical Inquiry: Systematically evaluates the quality and effectiveness of nursing practice, including, but not limited to, nursing sensitive indicators
• Supports evidence-based practice changes through research utilization and experiential learning
• Participates in quality/performance improvement initiatives
• Caring Practices: Creates a compassionate, supportive, safe and therapeutic environment for patients, families and staff
• Develops therapeutic relationships with patient and family and maintains appropriate boundaries
• Manages both emotional and physical pain with the aim of promoting comfort and healing and preventing unnecessary suffering
• Response to Diversity: Recognizes, appreciates and incorporates a patient's and family's unique differences, such as culture, spiritual beliefs, gender, race, ethnicity, lifestyle, socioeconomic status, age, and values, into an individualized plan of care
• Advocacy and Moral Agency: Preserves and protects the confidentiality, autonomy, dignity and rights of patient and family and represents their concerns
• Creates an individualized plan that accurately reflects patient and family values and goals
• Identifies and helps resolve ethical and clinical concerns
• Facilitation of Learning: Facilitates learning for patients and families, nursing staff, other members of the health care team and community; integrating appropriate education throughout the continuum of care to help them participate and/or make informed decisions about their health care and treatments, including health promotion and disease prevention
• Assesses and documents learning needs and outcomes
• Collaboration: Works collaboratively and interdependently with colleagues and community to develop and implement an integrated plan of care
• Open and sensitive to all team members' unique contributions
• Delegates tasks and care to appropriate staff and ensures timely follow-up
• Systems Thinking: Uses strategies and available resources for problem-solving for patients, family and staff
• Recognizes that resources are limited and considers factors related to safety, effectiveness and efficiency in planning and delivering patient care
• Professionalism: Improves nursing practice and the work environment through participating in shared governance and decision-making processes and meaningfully recognizing the contributions of others
• Participates in the staffing process from education and planning to evaluation
• Identifies personal goals and commits to ongoing professional growth through continuing education, networking with professional colleagues, membership and involvement in professional nursing organizations, self-study, professional reading, certification and seeking advanced degrees
• Contributes to the professional development of peers, colleagues and others
• Demonstrates commitment to community service.

• Acts as clinical resource for the staff
• Assess the health care needs of the patient and maintain or develop a plan of care
• Assess and act on significant changes in the patient’s health condition
• Carry out or assign Unit RN the plan of care by performing delegated tasks
• Collect and document pertinent data into the electronic patient/ medical record
• Complete nursing assessments within required time frames, and in accordance with policy and procedure
• Identify and act on predictable needs of the patient
• Follows up in a timely manner in response to all patient’s/ family concerns including communication with administrator on site
• Assists with admission and discharge processes to ensure efficient throughput and high quality, patient-centered care
• Participate in the ongoing assessment of the quality of patient care services provided in the unit, in collaboration with other members of the management team
• Notify assigned physician of any changes in condition
• Supports the mission, goals, and objectives of the hospital.

• Provides total patient care as assigned according to the core standards of patient care and established policies and evidence based practices
• Assumes accountability for assessing, planning, implementing and evaluating care as well as discharge planning for each patient
• Contributes to decreasing the length of stay/waiting time as per unit specific goal
• Works in collaboration with Case Management to achieve goals
• Documents all relevant information correctly, appropriately and in a timely manner
• Reports equipment failures, safety and security issues, and/or reduction of supply inventory to Head Nurse or designee
• Demonstrates collaborative multi-disciplinary partnerships working towards the achievements of constant improvement in quality patient care
• Acts as an advocate for patients and families
• Identifies ideas that will improve the quality of patient care and issues that will negatively impact on patient care outcomes, using the professional practice framework
• Participates through team working and collaborative partnerships in identifying and implementing solutions through evidence based practice or research to demonstrate improvements reflected at unit level
• Promotes a safe environment and safe patient care by embracing a safety culture and identifying areas of risk to Head Nurse or designee
• Complies with policies for personal and patient safety and for the prevention of healthcare associated infections
• Contributes to the achievement of cost efficiency savings on unit
• Maintains an awareness of resource utilization, exercising care in the ordering and use of staff, equipment and materials
• Contributes to the achievement of clinical quality outcome indicators and patient satisfaction
• Leads unit based Performance Improvement activities as assigned
• Contributes to special Projects / assignments linked to nursing strategic priorities and professional practice model
• Serves on unit based and divisional councils as assigned/elected
• Contributes to the development, implementation and evaluation of unit activities
• Participates in the development and evaluation of IPPs
• Assists in promoting and sharing knowledge via mentorship in line with relevant research and evidence based practice
• Participates in patient education programs
• Develops and sustains own knowledge, clinical skills and professional awareness and maintains a professional profile
• Provides documented evidence of performance and maintenance of skills consistent with position
• Participates in new staff/nursing student orientation aimed at developing competence and performance
• Assists in maintaining a suitable learning environment and acts as a preceptor/mentor in the supervision and teaching of nursing students and new staff to develop their competence
• Demonstrates transcultural principles in nursing practice
• Participates in the promotion and maintenance of effective communication and teamwork
• Treats colleagues, patients, and visitors with dignity and respect at all times
• Actively welcomes and provides support for new staff/students to the unit
• Contributes to the retention of all staff to meet the unit specific turnover rate goal
• Participates in retention activities
• Upholds the organizational values at all times.

• Placing orders for equipment and supplies
• Creating reports for facility management
• Resolving patient issues
• Resolving employee conflicts
• Creating schedules for nursing staff
• Participating in the hiring of new nursing staff and training new hires
• Coordinating patient payments with payments department or process payments on their own
• Providing patient paperwork to doctors
• Organizing nurses' notes regarding patients
• Allocating nursing and healthcare resources where needed
• Assisting with and coordinating patient care.

• Follow open and closing procedures according to office policies and procedures
• Greets and checks in patients in a polite, prompt and helpful manner
• Has patients complete and sign any appropriate forms
• Reviews all completed forms for accuracy and updates, including insurance information
• Collects all copayments, deductibles and outstanding balances according to Policies and Procedures
• Answer phones, transfers call and communicates messages from patients to physicians, medical assistants and office staff when appropriate
• Works collaboratively with Centralized Services to support patient needs
• Check Out patients, schedule follow up appointment’s and provide patient with appointment related documents
• Maintain effective and organized system to ensure timely patient flow
• Maintain all logs and required checks
• Respond appropriately and timely to patient concerns and/or needs or escalates patient concerns to manager as needed
• Ensures their work is being performed according to company policies, procedures, and standards
• Provides high quality care and service excellence to our patients
• Performs other administrative and clerical duties as assigned
• Participates in a variety of department initiatives
• Ensures all OSHA, HIPAA, and other regulations are followed
• Follows proper reporting protocols for any compliance or incident reporting as needed
• Maintains strict patient and employee confidentiality.

• Assesses individual patient for care prioritization and other care strategies especially in taking care of vulnerable patients in considerations of their comfort, hygiene, diagnosis and others
• Transcribes and implements doctor’s orders and performs advance technical procedures especially in the high alert areas within the level of known competency and seeks assistance from the Nurse Unit Manager (NUM)/ Assistant Nurse Manager (ANUM) when needed
• Performs independent nursing interventions, utilizing the nursing process framework
• Makes a timely escalation of required medical interventions for an emergent situation
• Administers medication, blood and blood components with knowledge of the cause and effects thereof
• Ensures that all supplies and medical devices are adequate and are encoded in the computer for proper charging and replacement
• Maintains the principles of environment of care
• Assesses patient and signi?cant others learning needs and educate on patients health needs as deemed necessary
• Ensures that informed consent is obtained whenever indicated
• Performs a timely and accurate documentation of all pertinent observations and patient care interventions rendered
• Reports immediately for timely interventions, safety related incidents such as adverse drug events, patient’s falls and others
• Observes patients and family rights and confidentiality at all times
• Acts and performs within the professions ethico-moral standards
• Attends to personal and professional improvements thru attendance to training and others
• Participates in quality improvement projects initiated by the unit, group and hospital wide
• Escalates panic values of laboratory tests, patients concerns to doctors and appropriate authorities
• Ensures that all doctors are noti?ed of their admissions, referrals and discharges promptly
• Collaborates with Doctors, ancillary services, pharmacy, dietary, laboratory, billing office and other patients requirements that they need to provide
• Prepares equipment and instruments and ensures its safety, functionality and sterility
• Anticipates and attends to patient and his/her significant others need to fulfil the goal of costumer delight
• Actively participates in the nursing care plan to ensure continuity of care and documents nursing interventions and outcomes
• Directs and supervises nursing aides and ward clerks
• Operates, facilitates and troubleshoots use of various medical equipment and machines
• Performs other duties that may be assigned to or required of the job.

• Gathers the patient’s History of Present Illness from the patient and/or the patient’s companion
• Checks, measures, records and reports vital signs of patient accurately
• Assists physicians in examining patients, performing diagnostic and therapeutic procedures and bedside procedures
• Administers medications as prescribed by the doctors
• Prepares patients for diagnostic and therapeutic procedures
• Identifies, plans, evaluates, and performs prescribed nursing care needed by the patient
• Performs shift to shift endorsement.