LICENSE PRACTICAL NURSE – Dermatology & Medical Oncology

DEFINITION:
The LPN is accountable for delivery of patient care in the clinic during office hours. The LPN is responsible for: practicing within the LPN scope of practice managing any assigned personnel and promoting collaboration among the disciplines. The LPN is accountable to the Physician Supervisor, Department Director, patient and family for all nursing behavior. Patient population includes: all age groups to include children, adolescents, adults and geriatrics.

EDUCATION:

REGULATORY REQUIREMENTS (IF APPLICABLE):
Currently authorized to practice as a Licensed Practical Nurse in the state of Oklahoma.

MINIMUM QUALIFICATIONS:

PREFERRED QUALIFICATIONS:
One to two years physicians office nursing experience, preferably primary care.

PRINCIPLE RESPONSIBILITIES:

1. Participates and implements age specific care and interaction.
1.1. Employee has attended departmental orientation (training) and annual inservice education for age specific training and implements in work area what was learned in age specific training.

2. Places patients in exam room for scheduled appointments.
2.1. Weight, blood pressure, pulse, temperature, as well as pain screening (noting scale) taken on all patients seen.
2.2. Review patients medications (add any new meds or delete any D/C meds) to medication sheet without error.
2.3. Note any complaints patient may verbalize.
2.4. Additional information documented per policy and procedure manual as appropriate for age of patient.

3. Actively assists in direct delivery of safe patient care and maintains a safe, comfortable environment for patients.
3.1. All necessary consents for treatment are properly executed.
3.2. Physician/ provider orders are implemented without error.
3.3. Evidence of required charting is in accordance with legal standards.
3.4. Inspections reflect a safe environment (sharp containers maintained per policy, medications secured, etc.).
3.5. Performs skills using proper techniques and procedures.

4. Assists with patient care.
4.1. As instructed by provider, may include suture removals, dressing changes, administration of P.O. or I.M. medications.
4.2. Appropriately charts treatment and how patient tolerated procedure to include pain scale, if applicable.
4.3. Explains procedure to patient and why indicated.
4.4. Informs provider of changes in patient status and/or condition.

5. Assists physician/provider with specialized procedures and set up for test.
5.1. Set up required supplies for test, obtain consent form when indicated.
5.2. Clean up after test, (Example procedure and instructions to patient, position patient for test (I.e. PAP smear, scopes, 24 holter monitor, EKG’s).
5.3. Assist physician/provider with procedure.

6. Ensures accurate documentation.
6.1. Chart patient contact.
6.2. Checks to make sure physician/provider has seen test results, read EKG’s answered patient calls, charted medication changes and instruction, made progress notes.

7. Contacts patients, nursing homes, and home health nurse with test results as directed by physician/provider.
7.1. Call with physicians/provider orders, explain results noted by physician/provider, educated patient in meaning of specialized test ordered or special diet ordered, and explain disease process as instructed by physician/provider, make copies of test if patient is referred to another physician/provider for further testing and treatment.

8. Prepares charts for scheduled appointments.
8.1. Makes sure new progress note slip is in chart, check medication sheet to make sure space available to review medicine or make new sheet if indicated, check chart for new medication ordered at last appointment, and list on medication sheet, put patient encounter on front of chart, at end of days appointments, put charts where instructed.

9. Orders supplies.
9.1. Check stock supplies.
9.2. Keep rooms well supplied (capes, drapes, gauze, gloves, etc.)
9.3. Set up system to know when to reorder so supplies are always on hand.

10. As ordered by physician/provider, prepare prescriptions (RX’s) for physician/provider signatures and chart RX’s to pharmacies.
10.1. Check med sheet to make sure physician/provider has ordered medication.
10.2. Make sure to note any RX’s written are noted in chart.
10.3. Place chart on physician/provider desk for signature.
10.4. Insures safety checks for RX accuracy are carried out.

11. Serves as patient advocate.
11.1. Maintains patient confidentiality.
11.2 Maintains patient dignity by providing privacy when discussing medically related topics.
11.2. Shows good judgment in seeking assistance when needed.
11.3. Provides patient safety, proper knowledge of drugs and emergency procedures.
11.4. Serves as a part of the medical team.

12. Assist with specialized test as ordered by physician/provider.
12.1. 24 Hour Holter Monitor.
12.2. Pulmonary Function Test
12.3. Be able to run EKG and/or Rhythm strip.
12.4. In some settings, may perform breathing treatments, drug screens, and breath alcohol testing.
12.5. Other tests as ordered by physician/provider.

13. In most practice settings: 1. Makes all referrals. 2. Manages vaccines for Children’s Program.
13.1. Schedules all outpatient referrals and testing appointments.
13.2. Coordinates with other offices for patient appointment and completes all paperwork.
13.3. Orders vaccines used for clinic needs.
13.4. Keeps accurate records of vaccines given and sends monthly reports to OK St. Department of Health Immunization Division.
13.5. Follows recommendations of written guidelines at each visit to determine appropriate immunization, counsels’ patient regarding risk and benefits and administers immunizations with accuracy as determined by the guidelines.

14. Demonstrates knowledge and skill in waived lab procedures.
14.1. Attends lab orientation and training.
14.2. Proficiency in lab testing procedures is demonstrated in phlebotomy skills and annual review.
14.3. All laboratory paperwork is filled out properly as per policy and procedure.
14.4. Lab test results are reported in a timely and organized manner
14.5. Ensures sample drug log is completed when samples are dispensed.

15. Maintains a clean and orderly work area.
15.1. Ensures out of date items are disposed of properly.
15.2. Logs are maintained and neatly legibly recorded in a timely manner
15.3. Lab area and patient room are kept orderly and clean.

16. Observes and enforces hospital policy
16.1. Observes and enforces hospital policy concerning telephone usage, work hours, dress code, and other related rules governing conduct while at work.

17. Handles frustrations appropriately.
17.1. Attempt to recognize and evaluate personal strengths and weaknesses, handles personal and professional frustrations appropriately.
17.2. Demonstrates maturity for accountability of job performance.

18. Demonstrates understanding of emergency procedure.
18.1. Fire drills, evacuation procedures and internal/external disaster plans are known and performed appropriately in a drill or crisis situation.

19. Keeps self informed.
19.1. Assesses personal learning and development needs, makes plans to meet identified needs with assistance of resource persons.
19.2. Seeks and attends training for procedures and equipment use.

20. Participates in mandatory annual services.
20.1. Keeps current attendance dates for all mandatory annual in-services in Staff Development Record Log.

21. Shows good judgment and decision making.
21.1. Strives for excellence in patient care, demonstrates responsibility and accountability for personal conduct while on duty.
21.2. Accountable for all actions taken and decisions made during scheduled shift.
21.3. Seeks assistance as necessary in solving clinical and management problems by following appropriate lines of communications.
21.4. Recognizes and responds to the fact that ethical dilemmas exist and confers with appropriate resource, confers with appropriate resource personnel when making ethical decisions.

22. Demonstrates good relationships with others.
22.1. Supports and encourages a harmonious working relationship within the department; uses verbal, nonverbal, and written communications skills, communicates effectively with co-workers, medical staff, and ancillary departments.

23. Planning and time utilization
23.1. Demonstrates a consistently well organized approach to all activities and other duties, as assigned.

24. Uses initiative.
24.1. Performs all duties in an independent manner with little or no need for direct supervision.

25. Participates in Hospital Guest Relations/Marketing Program.
25.1. There is evidence of increased Public Relations with all consumers of service at CCMH.
25.2. Projects a positive “can do” attitude.
25.3. Participates in hospital activities.

26. Demonstrates self-directed behavior.
26.1. Handles change appropriately. Offers possible solutions and/or constructive suggestions.
26.2. Functions effectively while maintaining a calm appearance and communicating in a calm consistent manner.
26.3. If problems arise between self and peers, they are handled in a professional manner.
26.4. Accepts responsibility and accountability for own actions

27. Observes courtesy standards through use of verbal amenities, pleasant facial and body expressions and pleasant voice tone when in contact with co-workers, physicians, consumers, patients, and visitors. Treats every guest and fellow employee with courtesy, concern, respect, and sensitivity.
27.1. Greets every guest in a manner which makes the guest feel welcome.
27.2. Consistently uses words that express respect and understanding in interpersonal contacts with guests, physicians, and fellow employees.
27.3. Allows guests to express themselves fully without interrupting; asks questions to encourage two-way communications, and ensures that guest or employee understands information given.
27.4. When interacting with the hostile guest, remains calm and avoids retaliating with anger.
27.5. Identifies and initiates appropriate interaction with depressed or withdrawn persons. Encourages communication of problems or feelings.

28. Demonstrates customer satisfaction directed behavior.
28.1. Offers assistance to any guest who appears lost or in need of assistance.
28.2. Utilizes proper telephone etiquette, giving name, title, and department. Is pleasant and attentive, takes accurate notes and facilitates clarification of key information.
28.3. Makes an effort to be helpful by being informed and prepared to answer commonly asked questions.

PHYSICAL REQUIREMENTS:

HAND AND ARM USE:
1. Must possess sufficient dexterity to prepare medications and to give injections on a daily basis. Must be able to operate and handle medical equipment and technologically complex devices including but not limited to keyboards, monitors and IVAC’s on daily basis. Must be able to write neatly and legibly on a daily basis.

LIFTING AND CARRYING:
1. Requires occasional lifting of adult and pediatric patients. Requires lifting of monitors, oxygen tanks, backboards, boxes of supplies and other equipment on daily basis. Must obtain assistance when weight exceeds individual ability.

PUSHING AND PULLING:
1. Requires transfer and transport of patients and/or various equipment including but not limited to: beds, wheelchairs, patients, audio/visual equipment, carriers carts and monitoring equipment.

STANDING/WALKING/SITTING/CLIMBING:
1. Requires to stand, walk, reach or stoop more than 75% of the working day. Requires to work in a cramped position while assisting with medical procedures. May be required to run or climb during emergency situations.

SENSE OF TOUCH:
1. Must possess sense to touch in order to palpate pulses, veins body temperature and for assessment of possible physical abnormalities. Ability to determine different degrees of temperature and textures.

HEARING:
1. Must be able to hear patients speak to obtain history and to assist with the physical assessment including but not limited to auscultation with a stethoscope. Must be able to hear to obtain physical orders verbally and per telephone, and to hear various ringing alarms while performing other job duties.

VISION:
1. Must be able to see and assist with assessment of the patient condition, and to perform various procedures including but not limited to preparing and giving medications, evaluating cardiac, blood pressure and pulse oximetry readings. Must have accurate color perception to evaluate skin color, circulation, abrasions, and oximetry readings. Must have accurate color perception to evaluate skin color, circulation, abrasions, and

MENTAL REQUIREMENTS:

MATHEMATICS:
1. Must be able to successful pass a medication administration test. Must be able to count, add, subtract, multiply and divide.

MEMORY:
1. Must be able to remember all activities related to the care of the patient.

LANGUAGE ABILITY:

READING:
1. Must have skills in the English language to comprehend all materials regarding all aspects of patient care within the limits of the essential performance standards identified in the appropriate job description.

WRITING:
1. Must be able to write in English neatly and legibly on a daily basis with a high degree of accuracy.

SPEAKING:
1. Must be able to speak clearly to verbally communicate in English all aspects of patient care which includes but is not limited to physicians, patients, family and other health care workers.

REASONING:
1. Must be able to assimilate complex data concerning patient diagnosis and in all unit procedures.