Senior Staff Nurse - Emergency Department

POSITION TITLE                :  Senior Staff Nurse

REPORTS TO                     :  Director of Emergency Room

Assumes responsibility for the daily clinical operation of the clinical area. Functions as a primary source for assistance and guidance on clinical issues to Nursing Staff. Coordinates the day-to- day running of the Emergency Room, ensuring that patients are discharged on time and coordinating patient admissions from other departments under the guidance of the line manager.

General:

• Provides age-specific patient-centered care utilizing the nursing process:
  • Performs patient assessment using appropriate, problem-focused, and age- specific assessment techniques.
  • Performs continual critical care assessment of patient and family's physical and psychological needs.
  • Involves the patient, significant others, and health care providers in the plan of care when appropriate.
  • Collaborates with a multi-disciplinary team to provide patient care.
  • Coordinates and plans critical care/clinical pathway, and prioritizes care,based on individual needs.
• Revises the care plan as necessary.
• Initiates appropriate transfer plan.
• Recognizes subtle cues to anticipate potential problems.
• Documents all relevant data in the medical record according to hospital/departmental standards.
• Ensures availability and maintenance of supplies and equipment needed for the unit and patient care.
• Performs clerical duties when needed.
• Assumes responsibility for meeting Joint Commission International Accreditation (JCIA) required mandatory education (e.g. fire, safety, infection control and others).
• Participates in staff meetings and unit committees/projects.
• Participates in developing and achieving unit goals.
• Maintains a safe environment for patients and staff.
• Performs safe handling and administrating of Narcotic/Controlled and Semi- Controlled Drugs and documentation as directed by policies and procedures.
• Ensures completion of unit competencies i.e. pain management, and utilization of Emergency department devices.
• Maintains clinical and professional competency based on the latest research and established standards of practice.
• Completes yearly, the critical care nursing competencies (basic).
• Participates in unit-based Continuous Quality Improvement (CQI) activities (data collection, CQI teams, incident reporting, customer complaint reporting, medication error reporting etc.).
• Participates in ongoing educational activities.
• Maintains mandatory educational requirements.
• Performs additional duties when required.

Operational Management:

• Coordinates the provision of safe, efficient, and economical 24-hour nursing care in line with established standards of care.
• Supervises, demonstrates, assists and teaches staff in improving, maintaining and obtaining new clinical skills.
• Renders and supervises care services based on age appropriateness and developmental needs of patients.
• Assists and develops the formation of measurable goals for the unit.
• Creates and supports an environment which fosters teamwork, cooperation, and respect for cultural diversity.
• Assists the Manager in all scheduling, policy writing and other projects as defined.

• Monitors attendance of staff to annual mandatory in-services.
• Assists manager with completion of departmental and unit-specific competencies.
• Assures 100% of new staff completes a planned departmental orientation within 120 days.
• Promotes development and use of care planning and/or other means of planning care.
• Maintains accountability for budgeting/financial management and optimal use of resources in the unit.
• Supports, enforces, and interprets institutional and departmental policies and procedures to staff.
• Promotes professional and clinical growth of self and staff.
• Participates in hospital-wide and nursing committees.
• Integrates evidence-based research/practice into clinical and management processes in the unit, as indicated.
• Promotes physician satisfaction with nursing services provided.
• Assists and promotes budgetary management.
• Monitor unit stock, inventory and lost charges count as well as store organization.
• Ensures daily unit responsibilities (checking crash cart, refrigeration temperature checklist, etc) are assigned.
• Oversees the orientation of new staff members.
• Ensures supplies from the Central Sterile Supply Department (CSSD) and Pharmacy are ordered to keep the unit stocked at prescribed levels and ensure that there are no expiry date items available in the unit.
• Oversees that staff members (Staff Nurses, Healthcare Assistants, Unit Clerk Interpreters) are working within their specific roles and job descriptions.
• Performs nursing interventions/procedures per established standards of care and policy and procedures.
• Assists medical colleagues with diagnostic therapeutic interventions.
• Maintains accurate and thorough documentation following established Joint Commission International Accreditation (JCIA) standards.
• Follows up clinical and PI indicators and reports to the Head Nurse.
• Communicates with the narcotic supervisor pharmacist, reporting any incident or loss to the manager.
• Maintains the Dubai Health Authority's narcotic, controlled and semi-controlled drug books.
• Maintains patient medications and refunds to the pharmacy any discontinued medications.
• Oversees floor stock medications.
• Conduts the narcotic handover to the next shift and replaces the needed items.
• Ensures a complete and accurate handover has been given to the next shift.
• Monitors link nurses' performance (infection control, pain management and clinical education).
• Participates in the unit auditing as per Manager instructions.

• Takes active lead in creating and working on unit-based PI activities (data collection, PI teams, etc.).
• Assesses education needs and provides effective and age-appropriate education to patients/families.
• Advocates the Patient's Bill of Rights.
• Demonstrates an awareness of professional standards - keeps up to date with professional literature and changes in standards.
• Maintains patient, doctor and staff confidentiality in all areas of the hospital.
• Develops personal goals and objectives.
• Attends at least eight (8) of the twelve (12) monthly unit meetings and reads and signs for the other four (4) meetings missed on time.
• Ensures the delivery of high-quality care to assigned patients in an efficient manner.
• Assists other staff members in improving their assessment skills, giving input when need is identified.

Unit Specific:

• Interprets arterial blood gas.
• Interprets basic Electrocardiogram (ECG).
• Monitors arterial pressure.
• Monitors central venous pressure.
• Performs chest, abdomen, and back burn care.
• Prepares Central Venous Access Devices (CVAD) for adults and pediatrics:
  • Sampling blood from central venous access catheter.
  • Flushing and locking the central venous access catheter.
  • Changing central venous catheter dressing.
  • Changing central venous catheter needless connector and line tubing.
• Prepares Implanted Venous Access Devices (IVAD) for adults and pediatrics:
  • Accessing implanted port.
  • Accessing implanted port (top entry).
  • Sampling blood from the implanted port.
  • Removing the non-coring needle from the implanted port.
• Prepares chest tubes:
  • Monitoring and caring for the chest tube drainage system.
  • Setting up chest tube drainage system.
• Conducts COVID-19 Polymerase Chain Reaction (PCR) testing.
• Measures creatinine levels.
• Administers emergency medications to paediatrics.
• Performs intubation with direct visualization.
• Inserts and assists with intraosseous infusion device.
• Removes the intraosseous infusion device.
• Administers Intravenous (IV) alteplase for acute ischemic stroke.
• Measures ketone levels.
• Administers moderate sedation.
• Performs rapid strep test using point-of-care testing (POCT).
• Applies splints and casts.
• Cares for tracheotomy tubes:
  • Suctioning tracheostomy.
  • Managing tracheostomy tube cannula and stoma.
• Prepares mechanical ventilation during patient transport.
• Conducts triage using the Emergency Severity Index (ESI).
• Operates urine analysis machine.
• Uses defibrillator for pediatric patients:
  • Performing cardioversion.
  • Performing defibrillation.
  • Performing transcutaneous pacing.

For Pediatrics:

• Conducts aspiration precautions:
  • For child or adolescent
  • For children receiving enteral tube feedings
  • For infant
• Calculates pediatric fluid requirements.
• Conducts Implantable Venous Access Device (IVAD) for pediatrics:
  • Accessing implanted port.
  • Sampling blood from the implanted port.
  • Removing the non-coring needle from the implanted port.
• Monitors cardiopulmonary status in paediatrics.
• Prepares chest tubes in paediatrics:
  • Monitoring and caring for the chest tube drainage system.
  • Setting up chest tube drainage system.
  • Assisting with chest tube removal.
• Utilizes handheld resuscitation bags and masks in paediatrics.
• Conducts health history interviews and physical assessments in paediatrics.
• Manages infiltration and extravasation in paediatrics.
• Administers oxygen via nasal prongs to neonates.
• Administers nebulized drugs to paediatrics.
• Manages obstructed airways in children and infants.
• Samples blood from a peripherally inserted central catheter in paediatrics.
• Changes in dressing on the peripherally inserted central catheter in paediatrics.
• Manages seizures in paediatrics.
• Cares for pediatric tracheostomies:
  • Suctioning tracheostomy.
  • Changing tracheostomy ties.
  • Changing tracheostomy tube.

Preceptor's Responsibilities (when applicable):

• Completes the Preceptor workshop and meets the criteria indicators for the preceptor role on the unit.
• Plans, implements and evaluates the individualized competency-based orientation in collaboration with the orientee, nurse manager, and clinical resource nurse.
• Provides appropriate feedback on time to orientee and Nurse Manager.
• Provides objective documentation to the nurse manager utilizing the American Hospital Dubai's established standards of care (Competency List "Green Book and Blue Book").

• Bachelor's degree in nursing (minimum of three (3) years full-time course duration) or
• Degree in Nursing (minimum two (2) years course duration) and Registration as a Registered Nurse from Canada, USA, UK, Ireland, South Africa, New Zealand, and Australia.
• For UAE nationals graduates of UAE or non-UAE universities are exempted from the experience and clinical training requirements for the applied title. (UAE nationals must submit a copy of their birth certificate and the mother's family book).
• Non-UAE national graduates from UAE universities are required to successfully complete six (6) months of clinical training post-graduation in an APS health facility (except for Registered and assistant Nurse titles).
• Must hold a valid License/Registration to practice in their home country and/or country of last employment (where applicable).
• Must hold a minimum of a valid Basic Life Support (BLS) Certification or others according to the scope of practice.

• Minimum of three (3) to five (5) years of recent post-graduate experience in the Emergency Room.
• Previous Team Leader or Senior Staff Nurse experience is an advantage.
• Knowledge of and ability to render care and services based on age, appropriateness, and developmental needs of patients.
• Skills in assessment of patient and family's physical and psychological needs.
• Skills in coordination and planning of care and prioritising care based on individual needs.