The Critical Response Nurse (CRN) is an advanced clinical expert who can deliver composed guidance and care under emergent circumstances. The CRN assesses, analyzes, plans, implements, and evaluates patients in crisis following established patient care standards for Legacy Health System throughout the hospital. The CRN acts as a physician liaison by relaying expert physical assessments and provides delegated treatments as needed within both the inpatient and emergency department arenas including emergent transfer to a higher level of care. The CRN is a primary emergency responder and secondary responder to critical situations deemed by the hospital need, this may include but is not limited to Code Blue, Code Green, ED Code 3, pediatric code blue, pediatric emergencies, Family Birth Center (FBC) STAT events, Neonatal Intensive Care Unit (NICU) resuscitations, and NICU code blue events, The CRN may support additional areas such as Endoscopy, Interventional Radiology (IR), Cath Lab, and the perioperative suites.

Legacy Meridian Park Medical Center has a 16-bed Medical Surgical Intensive Care Unit located 12 miles SW of Portland. Our ICU provides care to patients who are seriously ill or at high risk of developing life-threatening problems as a result of complex medical processes, renal or respiratory failure or patients who have suffered strokes, heart attacks or undergone invasive surgery.

NURSING PROCESS: Application of the Nursing Process.

• Conducts and documents health status assessments of individuals or groups.
• Demonstrates expert critical care nursing process assessment skills to include cardiac, respiratory, neurological, and metabolic.
• Collecting objective and subjective data from observations, examinations, interviews, and written records in an accurate and timely manner as appropriate to the client’s health care needs in accordance with LHS documentation standards using LHS communication tools. The date includes, but is not limited to:

1. 1. Physical and emotional status
   2. Growth and development
   3. Cultural, religious, and socio-economic background
   4. Client and family health history
   5. Information gathered from family or significant others
   6. Information gathered from other health care team members
   7. Client knowledge and perception about health status and potential for maintenance of health status and health care goals
   8. Ability to perform activities of daily living
   9. Patterns of coping and interacting
   10. Environmental factors (e.g. physical, social, emotional, and ecological)
   11. Available and accessible human and material resources 

• Develops and modifies the plan of care based on assessment and coordination with other health care team members. This includes:
•  Identifying priorities in the plan of care

1. 1. Setting realistic and measurable goals to implement the plan of care
   2. Identifying nursing intervention(s) based on the nursing assessment
   3. Prescribing nursing orders
   4. Identifying measures to maintain comfort, support human functions and responses, maintain an environment conducive to wellbeing and to provide health teaching and health counseling. 

• Initiating nursing interventions through:

1. 1. Providing direct care
   2. Assisting with care
   3. Following nursing orders
   4. Assigning, delegating, and supervising care
   5. Teaching clients, their family members, or significant others
   6. Referring to appropriate resources
   7. Providing an environment conducive to safety and health.
   8. Communicating and documenting nursing interventions and responses to care, to other members of the health care team in accordance with LHS standards and tools for documentation.
   9. Promoting continuity of care across the health care settings.
   10. Providing client advocacy by defending the client’s right to receive care based on the plan of care, which includes receiving complete and accurate information and ensuring that patients’ rights are protected.

• Evaluates the responses of individuals or groups to nursing interventions, (evaluations should involve the client, their family or significant others, and health team members). This includes: 

1. 1. Documentation and communication of evaluation data to the appropriate members of the health care team.
   2. Evaluation data as a basis for reassessing the client’s status, revising the plan of care, prescribing changes in nursing interventions and issuing nursing orders.

Education:

Academic degree in nursing (BSN or MSN/MN) required. Internal candidates promoting may meet the degree requirement with verification of bachelor’s or master’s degree in progress with an expected completion date within 2-years of the promotion date; progress will be reported periodically to the site Chief Nursing Officer (CNO).

Experience:

Experience in hemodynamic monitoring application of clinical physiology required.

Three years of critical care clinical experience within the last five years strongly preferred. Emergency Department and IV infusion experience strongly preferred..

Current applicable state RN license required.

Basic Life Support (BLS), Advanced Cardiovascular Life Support (ACLS),  National Institutes of Health Stroke Scale (NIHSS) are required within six months of hire.

CCRN certification is preferred at time of hire/promotion, or required within 1 year of hire/promotion. Pediatric Advanced Life Support (PALS) and Trauma Nursing Core Course (TNCC)/Advanced Trauma Care for Nurses (ATCN) or equivalent Trauma certification are required based on site specific criteria.