The Total Joint Unit provides care for patients undergoing elective hip and knee replacements and other orthopedic procedures such as shoulder and back surgeries. This unit works closely with the Navigator to teach classes that provide information to help patients be successful after joint replacement. Because of the collaboration between nursing and the Navigator, we have seen a reduction in post op complications. Patient experience scores consistently exceed system goals. The nurse /patient ratios varies from day to day depending on surgery schedule but does not exceed 1:6. This is a small 13 bed unit that works closely together to care for all its patients.

Plans, coordinates and directs quality, compassionate care by maintaining standards of professional nursing practice and creating positive therapeutic relationships with patients/families.  Supervises LPNs, PCAs, PCAs/US, US, Ortho Techs and other non-licensed staff.

1. Assesses condition on each assigned patient on admission and on an ongoing basis to include but not limited to the patient’s physical condition, psychological status, social status, spiritual and cultural needs, pain assessment/management, nutritional and functional status, developmental or age related factors, and discharge planning needs.
2. Plans, provides, and documents patient and/or significant other education based on physical, behavioral, psychological, developmental, and age-related factors, after identifying barriers to learning.
3. Evaluates and regularly reevaluates patient care; coordinates care planning with patient, family, providers and other disciplines to achieve patient-centered outcomes.
4. Assigns and delegates nursing care to team members in accordance with the patient’s needs and the capabilities of the team members.
5. Applies safety principles when performing care. 
6. Accurately documents observations, care provided and changes in care plan.
7. Provides accurate handoff reports and participates in unit based huddles
8. Assists in performance improvement (PI) activities by serving on PI teams as warranted, assisting with PI measures and supporting and implementing changes necessary for improvement.
9. Performs initial and annual competency per job class.

DCH Standards:

• Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation.
• Performs compliance requirements as outlined in the Employee Handbook
• Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self.
• Performs essential job functions in a manner that ensures the safety of patients, visitors and employees.
• Identifies and reduces unsafe practices that may result in harm to patients, visitors and employees
• Recognizes and takes appropriate action to reduce risks and hazards to promote safety for patients, visitors and employees.
• Requires use of electronic mail, time and attendance software, learning management software and intranet.
• Must adhere to all DCH Health System policies and procedures.
• All other duties as assigned.

Minimum Knowledge Skills and Experience Requirements:

Current Alabama RN license required.

Current American Heart Association (AHA) Basic Life Support (BLS) Provider training required.  

Must be able to read, write legibly, speak, and comprehend English.

Acute Care – Current American Heart Association (AHA) Basic Life Support (BLS) required. Cardiac/Critical Care – Current AHA BLS and AHA ACLS required.

Emergency Department – Current AHA BLS, AHA ACLS, Pediatric Advanced Life Support (PALS), and Trauma Nursing Core Course (TNCC).

Perioperative – Current AHA BLS and AHA ACLS required.

Additionally:

PACU – AHA PALS required

Prep & Discharge/Post-Surgical – Does not require ACLS. 

Rehab – Current AHA BLS required.

Women’s/Children – Current AHA BLS required.

Additionally:

NICU – Current AHA Neonatal Resuscitation (NRP) and STABLE Program required.

Labor & Delivery – Current AHA ACLS, AHA NRP, and Intermediate Fetal Monitoring required.

Mother Baby Unit – Current AHA NRP, and STABLE Program required.

Pediatrics – Current AHA PALS required.

Clinical Support –       

Current AHA BLS required.

Additionally:

Cardiac Monitoring Unit – Current AHA ACLS required.

North Harbor – Current AHA BLS required.

WORK CONTEXT

• Demonstrate leadership skills
• Requires decision making that will affect others
• Responsible to achieve outcomes
• Must be able to communicate clearly and accurately
• Ability to delegate to team members and students
• Must be able to receive delegation
• Address conflict and stressful situation
• Communicate with different personalities and engage in face to face discussion
• Dealing with unpleasant or verbally/physically aggressive personalities
• Must be able to use electronic mail, telephone and texting
• Must be able to work in groups
• Must be able to perform structured and unstructured work
• Must be meet time pressure and time lines
• Includes possible exposure to human body fluids, disease, infection, lab chemicals and hazardous materials and/or cleaning solutions
• Requires wearing of common protective and safety equipment such as gloves, safety glasses, mask, gowns, etc.

 PHYSICAL FACTORS

• Medium work. Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects.  Must be able to tolerate prolonged periods of standing and walking

• Must be able to reach reasonable distances in any direction
• Must be able to stand, walk, kneel, bend, sit and stoop
• Must be able to run in an emergency
• Must have the ability to exert maximum muscle force to lift, push, pull and carry objects
• Must be able to move fingers in a coordinated manner and must be able to feel and perceive temperature, texture, shape and size with fingertips
• Must be able to perform the duties with or without reasonable accommodation
• Must possess stamina to work prolonged shifts
• Hearing and vision must be normal or corrected to within normal range.
• Physical presence onsite is essential.