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Registered Nurse Critical Care

Location: Nashua, NHDepartment: EMERGENCY DEPARTMENTFacility: St. Joseph HospitalJob ID: JR956

Job Summary:

Essential Duties and Responsibilities

  • Supports and promotes the mission and values of Covenant Health Ministry.
  • Renders professional nursing care to patients within an assigned unit of the hospital, in support of medical care as directed by medical staff and pursuant to objectives and policies of the hospital
  • Compliant in completion of all unit specific competencies and requirements required to care for critically ill patients within the department during orientation period onboarding and annually as assigned.
  • Involved in quality improvement planning and processes for the area of practice 
  • Clinical documentation and care plans completed comprehensively for all patients assigned in a timely manner within the electronic health record (EHR), including Vital Signs, assessments, care plans, and information related to any change in condition.
  • Knowledge and understanding of responsibilities during down-time
  • Responds quickly to all patient monitoring alarms
  • Provides emotional support for patients and families during difficult situations
  • Collect specimens as ordered and in the order required per policy, labeling and sending to the lab in a timely manner
  • Engages and participates in unit or organizational committees and councils.
  • Ability to analyze patient assessments and data, communicate findings, document and implement actions timely and accurately
  • Pursues personal growth and development through continuous learning opportunities within and outside of the organization.
  • Seeks feedback and accepts constructive criticism regarding practice and takes actions as appropriate.
  • Practice reflects knowledge of current practice standards (ANA, NH Nurse Practice Act, Specialty standards).
  • Communicates patient information appropriate for continuity and safe care through hand offs, walking rounds, and physician/provider interaction.
  • Provides a safe and secure environment for patients, visitors, and staff by following established procedures and protocols
  • Implements resources and initiatives that are in place or in process to improve patient safety.
  • Works within guidelines of Just Culture Environment to promote error reporting and adoption of safe practices.
  • Assures issues are addressed through appropriate use of the chain of command
  • Completes hourly rounding in collaboration with LNAs (Licensed Nursing Assistant) on all assigned patients
  • Identifies and assists in correction of patient care safety issues.
  • Builds respectful relationships through early and pro-active identification of concerns, compliments, or suggestions
  • Collaborates unit to unit and shift to shift for resolution of conflicts and issues in a timely manner
  • Consults with nurses in other department/units to draw upon expertise in other clinical areas/specialties.
  • Works collaboratively with Providers to complete assessments and perform bedside procedures.
  • Displays professional, positive perspective, including when faced with difficult circumstances
  • Seeks opportunities to assist all team members
  • Actively participates in unit-based shared governance and with the philosophy of the unit and the organization.
  • Appropriately delegates aspects of care and unit activities to other nursing personnel
  • Provides support and mentors new nurses and other disciplines withing the department through preceptorship and other methods as requested by the department leadership.
  • Participates in Peer Review maintaining confidentiality.
  • Participates in DNV survey readiness. 
  • Demonstrates characteristics of the SPIRIT of St. Joseph Hospital with a commitment to my co-workers and holds peers accountable for the same.
  • Follows organizational HIPAA compliance policy.
  • Demonstrates fiscal responsibility through complete and accurate timekeeping, as well as patient supply utilization.
  • Avoiding unauthorized use of overtime and managing ETO per policy.
  • Participates in annual evaluation 360 process as requested.
  • Provides quality care by remaining up-to-date on Nurse Sensitive Indicators.
  • Responds to emergency situations per department/role requirements such as Code Blue and rapid response team.
  • Other duties as consistent with this role.

Emergency Department, additional responsibilities include:

  • Triages patients and determines priority of care (ESI level) based on physical, psychological, and social needs including factors influencing patient flow through the system.
  • Implement protocol orders associated with approved chief complaints.
  • Performs focused assessment related to chief complaints in a timely manner according to established triage guidelines
  • Reassess arrived patients after initial triage to ensure no change in condition.
  • Provides quality care for patients presenting with acute illness and/or trauma requiring emergent/urgent attention and able to recognize potential life-threatening conditions for early intervention
  • Initiates corrective action as appropriate when information from monitoring equipment shows adverse symptomology or patients demonstrate adverse clinical symptoms
  • For admitted/boarding patients, complete required documentation per policy
  • Engages in initiatives aimed at improving patient throughput

Cardiac Cath and Angiography Lab additional responsibilities include:

  • Ability to learn complex technologies effectively
  • Experience with complex/critical care medication infusions, including titration management
  • Enhanced knowledge of anatomy and physiology, especially cardiac
  • Experience with emergency cardiac interventions
  • Provide in-depth history and medication review (pre-admission testing) of all patients scheduled for procedures to ensure patient safety peri-procedure.  Demonstrates the ability to correctly identify periprocedural safety issues, and report to physician accordingly.
  • Demonstrates clinical expertise in creating and maintaining a sterile field.
  • Plans and provides equipment and supplies based on procedure and physician needs.
  • Participates in on-call assignments and demonstrates flexibility to cover staffing as needed. 
  • Ability to be within 30-minute radius when on call.
  • Ability to safely administer procedural sedation.  Pass annual sedation examination. Documents sedation according to policies and procedures.
  • Maintains safe working environment to include radiation safety/appropriate personal protection attire.
  • Demonstrates criteria for arterial and venous sheath removal. RN has working understanding of guidelines provided in physician orders for safe sheath removal when patient has been given blood thinners prior to sheath removal.
  • Demonstrates the ability to identify criteria for equipment including Intra-Aortic Balloon Pump (IABP), IMPELLA etc.  Assist MD with set up, insertion and maintenance of equipment as needed.
  • Assist with insertion of Flow wire, Opsens and IVUS.  RN must demonstrate contraindications and reversal for IV adenosine infusion.
  • Demonstrates a working knowledge of hemodynamic waveforms.  Obtains the ability to monitor arterial waveform during left heart catheterization. Able to identify damping and ventriculization of arterial waveforms.  Able to correctly identify different hemodynamic waveforms during right heart catheterizations. 

Job Requirements

Job Knowledge and Skills

  • Basic Dysrhythmia preferred or obtained prior to completion of orientation.
  • NIHSS certification preferred or obtained prior to completion of orientation
  • Certification in Specialty preferred
  • Call shifts required for Cath Lab and Stress Lab.
  • CPI training preferred or obtained within 6 months of hire.
  • CPI advanced training for the ED and ICU within 6 months of hire.

Education and Experience

  • Current New Hampshire RN license required
  • Graduate of an approved Nursing program strongly preferred
  • 3-5 Years Critical Care Experience preferred for the Cardiac Cath/Angiography Lab
  • ASN required, BSN preferred
  • BLS required
  • ACLS Preferred for all critical care RN roles (excluding the Operating Room and Pre-Admission testing and is required prior to completion of orientation)
  • PALS Preferred –
    • Required prior to completion of orientation for Urgent Care, and PACU
    • Required prior to assuming care for critically ill pediatric patient for Emergency Department (may have ENPC in place of PALs)
  • TNCC – Preferred – required within 18 months of hire for the Emergency Department
  • TCAR – Preferred – required within 1 year of hire for the ICU and PACU.
  • Crisis Prevention Institute (CPI) training preferred or obtained prior to completion of orientation
  • Membership in a professional organization preferred.

Covenant Health Mission Statement

We are a Catholic health ministry, providing healing and care for the whole person, in service to all in our communities.

Our Core Values:

•Compassion

We show respect, caring and sensitivity towards all, honoring the dignity of each person, especially the poor, vulnerable and suffering.

•Integrity

We promote justice and ethical behavior, and responsibly steward our human, financial and environmental resources.

•Collaboration

We work in partnership, dialogue and shared purpose to create healthy communities.

•Excellence

We deliver all services with the highest level of quality, while seeking creative innovation.

Applicants, employees and former employees are protected from employment discrimination based on race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age (40 or older), disability, and genetic information (including family medical history).

Comp Range:

$33.43 – $46.04

Rate of pay displayed reflects the beginning of the pay scale.  At the time of an offer, determination of your offer will reflect your skills and experience as it relates to the position.

Our people make the difference. See firsthand what makes our employees and culture shine!

St. Joseph Hospital, Nashua, N.H.

We have been serving the local community since 1908. Our main campus is in the heart of Nashua, N.H., and we have satellite campuses in Hudson, Merrimack and Milford. Our 208-bed hospital combines the latest technologies with personalized medicine. Living and working here, you’ll be part of our tight-knit community and experience a quality of life you can’t get elsewhere.

St. Joseph Hospital in Nashua, N.H.

Life in New England

Every season brings a new reason to love New England’s scenic and cultural treasures. Hikers, bikers and skiers find their bliss among the rolling hills and rocky peaks of some of the country’s prettiest landscapes, all within 50 miles of Boston. In fact, New Hampshire has consistently ranked one of the top states in the U.S. to raise a family.

Birds eye view of a church in New England

Competitive Benefits Package

We create an outstanding work environment for our physicians, nurses and employees. Health coverage, tuition reimbursement, an Employee Assistance Program and community volunteering activities are just some benefits for our team members. A competitive compensation and benefits package helps you and your loved ones stay healthy, meet your financial goals and thrive professionally and personally.

group of six employees wearing blue scrubs and white lab coats. They are standing with their arms folded and smiling.

St. Mary’s Health System, Lewiston, Maine

St. Mary’s Health System was founded in 1888 by the Sisters of Charity of Saint-Hyacinthe. Today, the integrated medical system includes an acute care community hospital, a group of primary care and specialty providers, urgent care and emergency department, plus an extensive complement of outpatient specialty, behavioral and mental health services. Living and working here, you’ll be part of our talented and compassionate caregivers serving Androscoggin County.

A photo of St. Mary's Health System Regional Medical Center building in Lewiston, Maine

Life in New England

Every season brings a new reason to love New England’s scenic and cultural treasures. Hikers, bikers and skiers find their bliss among the rolling hills and rocky peaks of the country’s prettiest landscapes in the Appalachian range. The twin cities of Lewiston-Auburn are the second-largest metro area in Maine and just 30 miles north of Portland. The region offers a reasonable cost of living and some of the safest neighborhoods in the country.

Scenic overlook of twin cities of Lewiston-Auburn

Competitive Benefits Package

We create an outstanding work environment for our physicians, nurses and employees. Health coverage, tuition reimbursement, an Employee Assistance Program and community volunteering activities are just some benefits for our team members. A competitive compensation and benefits package helps you and your loved ones stay healthy, meet your financial goals and thrive professionally and personally.

group of six employees wearing blue scrubs and white lab coats. They are standing with their arms folded and smiling.

St. Joseph Healthcare, Bangor, Maine

Founded in 1947 by the Felician Sisters, St. Joseph Healthcare comprises an acute care hospital and a range of inpatient and outpatient services meeting the community’s evolving needs. Our more than 800 dedicated employees encompass our Mission through compassion, supporting a patient’s mind, body and spirit. Living and working here, you’ll be part of our tight-knit community and experience a quality of life you can’t get elsewhere.

large brown brick hospital that has its name, “St. Joseph Hospital” written in green. There are red flowers in the front and a blue sky.

Life in New England

Rated the No. 1 small city in the U.S. in the millennium edition of Places Rated Almanac, Bangor is in the heart of Penobscot County. It allows excellent access to everything the state offers, including scenic coastlines and beaches, camping and hiking, and charming small towns. The state provides a reasonable cost of living and some of the safest neighborhoods in the country

group of small brick buildings with a water canal in the front. There are trees along the canal and lights reflecting off the water.

Competitive Benefits Package

We create an outstanding work environment for our physicians, nurses and employees. Health coverage, tuition reimbursement, an Employee Assistance Program and community volunteering activities are just some benefits for our team members. A competitive compensation and benefits package helps you and your loved ones stay healthy, meet your financial goals and thrive professionally and personally.

group of six employees wearing blue scrubs and white lab coats. They are standing with their arms folded and smiling.

Why Covenant Health?

Covenant Health and our family of organizations have been healing and transforming lives for more than a century, and we continue to be unwavering in our Mission. In addition to providing an environment that is both challenging and rewarding, we offer:

  • Mission driven organization and colleagues
  • Numerous locations across New England and part of Pennsylvania, including some remote and hybrid positions
  • Highly competitive salaries that are market-based and experience rated
  • A comprehensive and flexible benefits program designed to protect and enhance your health and financial security
  • Additional benefits like wellness programs, earned time off, extended sick leave, leaves of absence, family and medical leave
  • Professional development and education opportunities
  • A healthy and effective balance between your work and life responsibilities

St. Joseph Healthcare – Bangor, ME

Pillar: A heartfelt purpose

Since 1947, St. Joseph Healthcare has been a comforting and reassuring presence for our friends and neighbors in Maine. Providing patient-focused care is a genuine calling and a sacred trust for us. If you have a heart for bringing your best to each individual interaction you have, we invite you to join us.

Pillar: A guiding mission

For more than 75 years, the people of St. Joseph Healthcare, have delivered the highest quality care, treating everyone with respect and dignity. We’re passionate about improving healthcare access and elevating quality of care for everyone we serve. Join us, and you too will find an open door and welcoming environment where you will be valued for your abilities and the unique qualities that make you… you. It’s a career you can believe in.

Pillar: An ideal combination

Looking for the best of both worlds? Do you want to provide individualized care with a genuine human touch, while also enjoying the support and resources of a strong regional health system? You’ll find it at St. Joseph Healthcare. Here, you’ll deliver compassionate, community-focused care that is elevated through state-of-the-art technology. Join us and discover how combining the personal and the progressive brings out the best in our care – and each other.

Pillar: A bright future

St. Joseph Healthcare has a rich heritage of caring for our Bangor, Maine community. And the best is yet to come. To make it happen, we’re investing in our future, putting our employees front and center, supporting their growth and development, and opening an exciting career paths for them to explore. Join us and help us move boldly forward while extending our more than 75 year legacy of compassion

St. Joseph Hospital – Nashua, NH

Pillar: A heartfelt purpose

At St. Joseph Hospital in Nashua, NH, we’re committed to being a skilled, knowledgeable, and reassuring presence for every person who comes to us for care. Providing patient-focused care is a genuine calling and a sacred trust for us. If you have a heart for brining your best to each individual interaction you have, we invite you to help us deliver our covenant of compassion.

Pillar: A guiding mission

At St. Joseph Hospital in Nashua, NH, everything we do flows from our dedication to treating everyone with respect and dignity. We’re passionate about improving healthcare access and elevating quality of care for everyone we serve. Our “A” Hospital Safety Grade from the Leapfrog Group, offers tangible proof of our commitment to the highest quality care. Join us, and you too will find an open door and welcoming environment where you will be valued for your abilities and the unique qualities that make you… you.

Pillar: An ideal combination

Looking for the best of both worlds? Do you want to provide individualized care with a genuine human touch, while also enjoying the support and resources of a strong regional healthcare system? You’ll find it at St. Joseph Hospital Nashua, NH. As a Level III trauma center and a certified Primary Stroke Center, we deliver compassionate, community-focused care that is elevated through state-of-the-art technology. Join us and discover how combining the personal and the progressive brings out the best in our care – and each other.

Pillar: A bright future

St Joseph Hospital, in Nashua, NGH, has a rich heritage of caring for our community. And the best is yet to come. To make it happen, we’re investing in our future, putting our employees front and center, supporting their growth and development , and opening up exciting career paths for them to explore. Join us and help us move boldly forward while enhancing our important legacy.

St. Mary’s Health System – Lewiston, ME

Pillar: A heartfelt purpose

From our very beginning in 1888, St. Mary’s Health System, has been a trusted member of the Lewiston community and a consistent source of skilled, compassionate caring for everyone who has ever walked through our doors. Providing hope and healing to our neighbors is a genuine calling and a sacred responsibility for us. If you have a heart for bringing your best to each individual interaction you have, we invite you to join us.

Pillar: A guiding mission

At St. Mary’s Health System, everything we do flows from our commitment to treating everyone with respect and dignity. From our 223-bed hospital, to our many outpatient locations and ancillary facilities, we’re passionate about improving healthcare access and elevating quality of care for everyone we serve. Join us, and you too will find an open door and welcoming environment where you will be valued for your abilities and the unique qualities that make you… you.

Pillar: An ideal combination

Looking for the best of both worlds? Do you want to provide individualized care with a genuine human touch, while also enjoying the support and resources of a strong regional health system? You’ll find it at St. Mary’s Health System in Lewiston, Maine. Here, you’ll deliver compassionate, community-focused care that is elevated through state-of-the-art technology. Join us and discover how combining the personal and the progressive brings out the best in our care – and each other.

Pillar: A bright future

St. Mary’s Health System has a rich heritage of community care that spans nearly a century and a half. Yet, we’re looking forward to even greater things ahead. We’re investing in our future, putting our employees front and center, supporting their growth and development, and opening up exciting career paths for them to explore. Join us and help us move boldly forward while enhancing our important legacy.

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