The Emergency Department RN is responsible and accountable to a
group of patients for a designated time frame and provides care to
the patients via therapeutic use of the nursing process, in
collaboration and integration with other health care team members.
S/he demonstrates the knowledge and skills necessary to provide
care relevant to the patient(s) under his/her care, applying
principles of growth and development over the life span. S/he
assesses and interprets patient data needed to identify each
patient's requirements relative to his/her age-specific needs. S/he
functions in the role of a primary RN in Triage, Main ED, & Fast
Standard I. Assessment: The Registered Nurse Collects Health
Rationale: GRMC nursing practice is characterized by a high
degree of autonomy and requires a broad-base of subjective and
The priority of data collection is determined by the patient's
immediate condition or needs.
Pertinent data is collected by using appropriate assessment
Data collection involves the patient, significant others, health
care providers, and other GRMC personnel, when appropriate.
The data collection process is systematic and ongoing.
- Relevant data is documented in a retrievable form.
Standard II. Diagnosis: The Registered Nurse analyzes the
assessment data in determining diagnoses.
Rationale: The Registered Nurse at GRMC uses independent
judgment and available data to formulate a nursing plan of
Plans of care are derived from assessment data.
Plans of care are validated with the patient, significant
others, health care providers, and records maintained by other
departments, when needed.
- Plans of care are documented in a manner that facilitates the
determination of expected outcomes and care plan.
Standard III. Outcome Identification: The Registered Nurse
identifies expected outcomes individualized to the patient.
Rationale: The Registered Nurse at GRMC identifies outcomes
based on unique factors that affect the Registered Nurses ability
to provide services.
- Measurement Criteria
- Outcomes are derived from the diagnoses.
- Outcomes are documented as measurable goals.
- Outcomes are mutually formulated with the patient and health
care providers, when possible.
- Outcomes are realistic in relation to the patient's present ant
- Outcomes are attainable in relation to resources available to
- Outcomes include a time estimate for attainment.
- Outcomes provide direction for continuity of care.
Standard IV. Planning: The Registered Nurse develops a care plan
that prescribes interventions to attain expected outcomes.
Rationale: Effective planning is essential for appropriate
The plan is individualized to the patient's condition or
The plan is developed with the patient, significant others,
health care providers, and other GRMC personnel, when
The plan reflects current nursing practice.
The plan is documented.
The plan provides for continuity of care from the time of entry
into the healthcare system, through transfers to other departments,
to final discharge from GRMC, when appropriate.
- The plan provides for discharge follow-up based on the
patient's need for health care, when appropriate.
Standard V. Implementation: The Registered Nurse implements the
interventions identified in the care plan.
Rationale: The Registered Nurse is the most appropriate health
care provider at GRMC for ensuring that actions are taken to meet
the physical, mental, and health education needs of the
Interventions are consistent with the established care plan.
Interventions are implemented in a safe, appropriate, and timely
- Interventions are documented.
Standard VI. Evaluation: The Registered Nurse evaluates the
patient's progress toward attainment of outcomes.
Rationale: The Registered Nurse at GRMC uses the nursing process
to evaluate the outcome of nursing actions, interventions, and
patient education. The Registered Nurse may alter the care plan,
expand the database, introduce new interventions, and develop
patient education activities.
Evaluation is systematic and ongoing.
The patient's responses to interventions are documented.
The effectiveness of interventions is evaluated in relation to
Ongoing assessment data are used to revise diagnoses, outcomes,
and the care plan, as needed.
Revisions in diagnoses, outcomes, and the care plan are
- The patient, significant others, health care providers, and
other GRMC personnel are involved in the evaluation process, when
Standard VII. Quality of Care: The Registered Nurse
systematically evaluates the quality and effectiveness of nursing
Rationale: The Registered Nurse at GRMC ensures that quality
nursing care meets measurable community standards.
- The Registered Nurse participates in quality-of-care activities
as appropriate to the individual's position, education, and
practice environment. Such activities may include the
a. Identifying aspects of care important for quality
b. Identifying indicators used to monitor the quality and
effectiveness of nursing care.
c. Collecting data to monitor the quality and effectiveness of
nursing care, as appropriate.
d. Analyzing quality data to identify opportunities for
improving care, as appropriate.
e. Formulating recommendations to improve nursing practice or
f. Implementing activities to enhance the quality of nursing
g. Participating in the work of interdisciplinary teams that
evaluate clinical practice or health services.
h. Developing policies and procedures to improve the quality of
The Registered Nurse uses the results of quality-of-care
activities to initiate changes in practice, as appropriate.
- The Registered Nurse uses the results of quality-of-care
activities to initiate changes throughout the health care delivery
system, as appropriate.
Standard VIII. Performance Appraisal: The Registered Nurse
evaluates his/her own nursing practice in relation to professional
practice standards and relevant statutes and regulations.
Rationale: The Registered Nurse at GRMC balances professional
performance with the maintenance of safety and quality patient
The Registered Nurse regularly engages in performance appraisal,
identifying areas of strength as well as areas for professional and
The Registered Nurse seeks constructive feedback regarding
his/her own practice.
The Registered Nurse takes action to achieve goals identified
during performance appraisal.
- The Registered Nurse participates in peer review as
Standard IX. Education: The Registered Nurse acquires and
maintains current knowledge in nursing practice.
Rationale: The diverse health care needs at GRMC and the need
for nursing autonomy require the Registered Nurse to engage in
- Measurement Criteria
- The Registered Nurse participates in ongoing educational
activities related to clinical knowledge and professional
The Registered Nurse seeks experiences to maintain clinical
- The Registered Nurse seeks knowledge and skills appropriate to
the practice setting.
Standard X. Collegiality: The Registered Nurse contributes to
the professional development of peers, colleagues, and others.
Rationale: The Registered Nurse at GRMC has the responsibility
and opportunity to positively influence peers, colleagues, and
others regarding health care issues, education, and practice.
The Registered Nurse shares knowledge, skills, and information
with peers, colleagues (including other GRMC personnel), and
The Registered Nurse provides peers with constructive feedback
regarding their practice.
- The Registered Nurse contributes to an environment that is
conducive to the clinical education of nursing students, as
Standard XI. Ethics: The Registered Nurses decisions and actions
on behalf of patients are determined in an ethical manner.
Rationale: The Registered Nurse at GRMC has an ethical
commitment to the patient and the nursing profession that must not
The Registered Nurse practice is guided by The Code for Licensed
Practical Nurses and related ANA position statements, such as the
Patient Bill of Rights and JCAHO standards, Standards for nursing
care for the patient care unit and Nurse Practice Act.
The Registered Nurse maintains patient confidentiality.
The Registered Nurse acts as a patient advocate.
The Registered Nurse delivers care in a non judgmental and
nondiscriminatory manner that is sensitive to patient
The Registered Nurse delivers care in a manner that preserves
and protects patient autonomy, dignity, and rights.
- The Registered Nurse seeks available resources to help
formulate ethical decisions.
Standard XII. Collaboration: The Registered Nurse collaborates
with the patient, significant others, criminal justice system
personnel, and health care providers in providing patient care.
Rationale: The Registered Nurse at GRMC collaborates with public
and private health care providers to ensure comprehensive
continuity of services.
- The Registered Nurse communicates with the patient, significant
others, GRMC personnel, and health care providers regarding patient
care and nursing's role in the provision of such care.
- The Registered Nurse consults with health care providers for
patient care, as needed.
- The Registered Nurse makes referrals, including provisions for
continuity of care, as needed.
Standard XIII. Resource Utilization: The Registered Nurse
considers factors related to safety, effectiveness, and cost in
planning and delivering patient care.
Rationale: The Registered Nurse at GRMC is uniquely positioned
to determine the priority, availability, and appropriateness of
resources required to meet the patient's health care needs.
The Registered Nurse evaluates factors related to safety,
effectiveness, efficiency, and cost when two or more practice
options would result in the same expected patient outcome.
The Registered Nurse assigns tasks or delegates care based on
the needs of the patient and on the knowledge and skill of the
- The Registered Nurse assists the patient and significant others
in identifying and securing appropriate, available services to
Standard XIV. Training: The Registered Nurse will be required to
train, educate, supervise and evaluate students from outside
entities or organizations with whom GRMC has an established
- Current New Mexico or multi-state Registered Nurse license
- BLS (AHA)
- ACLS (AHA) within 3 months from hire
- PALS (AHA) within 3 months from hire
- Basic ECG Course recognition within 3 month from hire date
- Moderate Sedation Certification within 3 months from hire
- CEN preferred
- ENPC preferred
- NRP preferred
- TNCC preferred
- Emergency and/or critical care experience preferred
- One year of Medical Surgical experience preferred
Note: Job description available upon request.
All required documents must be presented at time of hire.
EXTERNAL APPLICANT: Employment is contingent upon successful
completion of pre-employment drug and alcohol testing.
GRMC is an Equal Opportunity Employer