GENERAL DESCRIPTION OF CLASS
The CHARGE NURSE functions as a permanent shift charge nurse for a unit or ward and provides direct patient care to patients having physical and/or mental disorders.
This is the second level of a two-level series and is distinguished from the lower level by the permanent shift charge responsibilities.
DUTIES AND RESPONSIBILITIES
1. Charge Responsibilities. Typical tasks: makes patient assignments to nurses and other health care staff matching the level of skill with the illness of the patient and distributing the patient caseloads as evenly as possible; observes staff performance; resolves interpersonal problems among staff; assigns new patients to rooms; adjusts staff according to changing workloads; protects staffing needs for oncoming shift; verifies hours for payroll; transcribes and verifies physicians' orders.
2. Preparation of Nursing Care Plans. Typical tasks: examines patient's psychological, emotional, and physical condition, together with other health care professionals; assesses treatment needs and develops nursing care plan including such things as patient comfort, coping ability, daily living requirements; developing measurable goals, discharge planning (needs for wheelchair, portable toilet, community health follow-up such as Visiting Nurses Association or Meals on Nheels); makes suggestions or requests to primary physician for prescription items such as heating pad, egg crate mattress, physical therapy; carries out therapeutic treatment prescribed by the nursing care plan and evaluates response to treatment.
3. Direct Patient Care. Typical tasks: prepares for patient arrival by setting up bed with specific patient requirements such as ventilators, IVs, monitors, alarms, pumps, oxygen, mist tent; assesses patient's physical and emotional condition by such things as looking at pupils, coloring, alertness; watching for hemorrhaging, reactions; observing willingness to communicate, cooperativeness, combativeness, confusion; taking vital signs, conducting assessments of memory, asking about allergies, medication, drinking habits; checks tolerance to medications or treatment; administers medical and nursing regimens including medications and treatments; irrigates and cleans wounds, changes dressings, inserts and monitors IV's, draws blood, sets up traction, monitors vital signs, suctions and maintains tracheotomies, inserts or changes catheters, monitors fluid input and output; assists with surgery; operates and monitors sophisticated medical equipment which keeps track of major bodily functions; assists the patient in activities of daily living such as bathing, oral care, and feedings; evaluates effectiveness of care and adjusts accordingly; takes specimens and samples for testing; initiates cardiopulmonary resuscitation or other emergency response activities and codes when breathing or heart stops or seizures occur; evaluates and carries out physician's orders ensuring that they are appropriate such as not causing allergic reactions and given in proper dosages; coordinates all patient health services by communicating with nurses, doctors, pharmacy, laboratories, physical therapy, occupational therapy, respiratory therapy, dietary and social services; may have some security responsibility over medically ill/disabled patients.
4. Documentation. Typical tasks: keeps accurate legal written records through charting, nursing care plans, and case records of such things as: patient's health status and any changes; treatments; medications administered; unusual incidents involving patients and patient education; all data pertaining to surgery such as time patient entered operating room, time operation began, position of patient during surgery, diagnosis, supply counts for billing purposes; objective data such as patient requests or instructions to nursing staff on following shift; laboratory data; known allergies; height; weight; vital signs; documentation of preoperative care and procedures and postoperative care; may participate in collecting data for research purposes.
5. Typical tasks. educates patients and their families about the illness or disease process, pre- and postoperation processes and orientation to the hospital ward, operating room, birthing room, to provide relief from fear, anger, confusion, grief, or anxiety; trains patients or their families in post-hospital care such as how to bathe, clean wounds, and change dressings, feedings, suction and care for tracheotomies, care for sutures and catheters, taking vital signs and glucose levels, mobility such as how to get from bed to toilet, skin care, pain control, how to take medications such as insulin or antibiotics, operation of home monitors, CPR for parents of premature babies, parenting skills, breastfeeding, contraception, nutrition, and diet; trains residents, student nurses, and new employees in health care procedures; may give presentations in staff meetings or in-service training sessions on new or specialized procedures or health care techniques.
RELATIONSHIPS WITH OTHERS
Employees in this class are in regular contact in person with patients to provide care and education and with patients' families to provide support and answer questions regarding patient's condition and medical procedures. Employees are in regular contact in person with physicians to clarify chart orders, report changes in patient's condition and to collaborate on patient care. Employees are in regular contact in person with residents and student nurses to provide training and share information about patients and health care procedures. Employees are in regular telephone and in-person contact with support services such as pharmacy, dietitians, x-ray, patient transportation, respiratory therapy, occupational therapy, physical therapy, IV therapy, laboratories and outpatient social services to provide ancillary services to patients.
Employees in this class receive general supervision from a nursing supervisor or nursing manager who reviews work through nursing care plans, direct observation, and feedback from patients, patients' families, and physicians. Work performed by employees in this class is governed by Federal and State laws, hospital accrediting bodies, policies and procedures of the agency, and practices of the nursing profession.
Positions in this class are primarily found in hospitals, clinics, or other health care facilities in central and remote locations throughout State government (e.g., general government agencies, human or natural resource agencies, correctional, mental health, or higher education institutions, hospitals, etc.). They require the willingness to work within the environment associated with the position's location and purpose. This includes the willingness to maintain a sympathetic and understanding attitude toward physically ill, mentally ill, and/or developmentally disabled patients. Some positions require the willingness to work overtime, on-call and/or rotating schedules.
Possession of a valid Oregon registered professional nurse license at the time of appointment.