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Nursing Process
• Assessment:
1. Performs routine aspects of patient treatment, care and progress (i.e. basic data collection,
physical assessment, vital signs, weights, intake & outputs, blood glucose monitoring).
2. Collects body fluids for specimens.
• Diagnosis/Care Needs:
- Analyzes assessment data with preceptor and/or supervising RN to identify care needs and verbalizes needed care to the preceptor and/or supervising RN.
• Implementation:
1. Nursing care is based on identified nursing diagnoses/care needs and standards of patient care.
2. Implements patient education and involves the patient and family and/or
significant other as appropriate.
• Evaluation:
1. Recognizes and reports to the RN any alterations in the patient’s health status and
responses to treatment.
• Documentation: Documents patient care in a clear concise manner.
In collaboration with RN:
1. Completes nursing admission and assessment form.
2. Initiates the Nursing Care Plan with identified patient problems (utilizing nursing diagnosis),
expected outcomes and nursing intervention.
3. Documents treatments and nursing intervention on appropriate chart forms.
4. Completes discharge instruction sheet as appropriate.
Quality of Care
- Regularly performs appropriate utilization of equipment, tubes and drains as designated in department specific orientation.
- Promotes restorative and/or therapeutic care by assisting with activities of daily living (i.e. hygiene, feeding, mobility, elimination, and simple physical/respiratory/occupational/speech therapy).
- Maintains clean and safe work environment.
- Applies standard precautions during patient contact and when handling contaminated materials.
- Follows established organizational clinical policies for position and clinical area.
- Adheres to Arizona State Board of Nursing and KRMC guidelines as per nursing school level, status, and or nurse licensure.
Level I: First Semester Nursing (RN) students
- Enrolled and in good standing in the 1st semester of RN school.
- Vital sign monitoring.
- POC testing.
- Hourly rounding.
- Patient ADLS (activities of daily living), mobility assistance.
- Documenting care in EHR and reporting findings to RN.
- Performs specific nursing skills under RN supervision and as validated by the hospital.
- Active participation in professional development workshops as provided by program.
- Employee duties as assigned and per training in ancillary support areas and nursing units.
Level II: Second Semester Nursing (RN) Students
- Completed 1st semester in RN school.
- Maintain active enrollment and good standing in 2nd semester of RN school.
- Continued active participation in professional development workshops as provided by program.
- All duties of Level I and other duties as assigned by nursing/clinical area.
Level III: Third Semester Nursing (RN) students
- Performs all duties of a Level II but may be paired with a registered nurse to provide full patient care and assessment under the direction and supervision of a registered nurse.
- With assigned RN, manage a full patient load and assist with RN-specific tasks.
- Active participation in professional development workshops and career planning activities as directed by program.
- Maintain active enrollment and good standing in 3rd semester of RN school.
Level IV: Fourth Semester Nursing (RN) Students/LPN
- With assigned RN, manage a full patient load and assist with RN-specific tasks.
- Perform RN-level tasks under supervision of RN and as validated through school and hospital.
- Direct clinical care provided based on level in school or licensure (NT IV or LPN).
- Active participation in professional development workshops and career planning activities as directed by program.
- Maintain active enrollment and good standing in 4th semester of RN school.
- Active participation in transition to practice activities to prepare for transition to RN position.
Grad Nurse and RN Resident
- With assigned RN, manage a full patient load and assist with RN specific tasks.
- Perform RN level tasks under supervision of RN and as validated through school and hospital.
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