AGENCY RN ORIENTATION

BASIC INFORMATION

Greater Baltimore Medical Center

Center for Nursing Excellence

Updated 2007

Dear Colleagues:

I would like to take this opportunity to extend a warm welcome to you on behalf of the Nursing Department of the Greater Baltimore Medical Center (GBMC). I am delighted that you have “chosen” to practice at our hospital. You will discover that GBMC offers a caring and friendly environment. As a 292 bed community hospital, we are small enough to know each other, but large enough to offer a variety of nursing specialties and opportunities for professional development.

As the Vice-President for Nursing, I want to share my goal for the Nursing Department. The goal is simple – provide quality nursing care to our patients. We are often challenged in the provision of quality nursing care, but I believe that we can accomplish this through a spirit of collaboration and teamwork. This requires us to focus on the needs of our patients and work as a team, not only with other nurses, but also with other hospital departments and physicians. The priorities are: patient satisfaction and safety, staff satisfaction, performance improvement, and appropriate use of resources. Open, honest, and respectful communication is promoted in the nursing department. I often make informal rounds on the patient care units and encourage you to say “hello” and share your experiences. Work is an important part of life and I want you to have an enjoyable and satisfying experience at GBMC.

Thank you for joining GBMC. Please know that I appreciate and am aware of the key role you play in the success of the nursing department and the hospital. Remember, every day, with every patient and family contact, you truly have the ability to make a positive difference.

Sincerely,

Jody Porter, RN, BSN, MBA, CNOR

Senior Vice-President Care Services &

Chief Nursing Officer

GBMC’s MISSION STATEMENT

The Mission of GBMC Healthcare is to provide medical care and service of the highest quality to each patient with a…

Vision to be the leading community medical center in Maryland, committed to medical, professional and community education, and dedicated to the GREATER…

Values of Respect, Excellence, Accountability, Teamwork, Ethical Behavior, and Results.

GBMC Campus Map

GBMC Parking Fees

  • First 30 minutes: FREE
  • 31 to 60 minutes: $2
  • 61 minutes to 180 minutes (1-3 hours):$3
  • 181 minutes to 360 miutes (3-6 hours): $4
  • Over 6 hours:$5
  • Maximum daily rate is $5

Driving Directions
The Medical Center is located on North Charles Street in Towson, just north of the Baltimore city line, between Bellona Ave. and Towsontown Blvd. GBMC is also an easy drive South from the Baltimore Beltway (I-695), Charles Street Exit 25. GBMC is only 15 minutes from Baltimore's Inner Harbor.

From Downtown Baltimore:
Take I-83 North (Jones Falls Expressway) to Northern Parkway exit.
Turn right onto Northern Pkway.
Follow to North Charles St., turn left and follow Charles for 2.2 miles.
Turn right into GBMC.

From I-695 (Baltimore Beltway):
Turn right onto Exit 25, Charles Street.
Go South for 1.5 miles past Towsontown Blvd.
GBMC is the next light;
turn left into the Medical Center.

From West:
Take I-70East to I-695 West (Towson).
Follow 695 to Exit 25, Charles Street.
Follow I-695 directions above.

From Pennsylvania:
GBMC is approximately 25 minutes from the Pennsylvania border.
Take I-83 South until it splits left to I-695 East (Towson).
Take I-695 and immediately turn right onto Exit 25, Charles Street.
Follow I-695 directions above.

From Eastern Shore:
Take the Bay Bridge to 97 North (Baltimore).
Follow to I-695 (Baltimore Beltway).
Take I-695 North (Towson) to Exit 25, Charles St.
Follow I-695 directions above.

From Delaware:
Take I-95 South to I-695 West (Towson). Follow 695 to Exit 25, Charles Street.
Turn left from the exit ramp,
and left again onto Charles St.
Go South for 1.5 miles past Towsontown Blvd.
GBMC is the next light;
turn left into the Medical Center.

From Washington, D.C., BWI Airport:
Take I-295 North (BW Parkway) to I-695 West (Towson).
Follow I-695 to Exit 25, Charles St.
Follow I-695 directions above.

PHILOSOPHY OF NURSING

It is the belief of nursing that every individual has the right to quality healthcare regardless of economic or social status. Such delivery of care will be consistent with the Mission Statement of the Hospital and the mandates of the Board of Directors.

It is the belief of nursing that the nurse will utilize his/her skills, knowledge, and judgment to identify and meet the client’s needs in collaboration with the client, his/her support system and other health professionals. It is essential that the nurse deliver care in an efficient and effective manner, producing desirable, high quality patient outcomes.

It is the belief of nursing that quality-nursing practice has its origins in Orem’s Theory of Self Directed Care. This theory has been validated through ongoing nursing research, which requires nursing to continue the effort to further define and improve the standards of nursing care for clients. Nursing strives to work collaboratively with the client, support system and all other clinicians to establish a plan of care that maximizes the client’s participation and responsibility for healthcare decisions and ongoing health. Nurses are encouraged to use autonomous critical decision making in exercising nursing judgment. Collaboration with the client is necessary to deliver effective nursing care. The nurse will act as a coordinator to achieve an outcome of optimal self-care along the health continuum of the client. Such a dynamic process will ensure the commitment of nursing in making a contribution to the overall state of wellness for its clients.

It is the belief of nursing that new knowledge is constantly emerging within the health and social sciences. Since nursing is committed to excellence in practice, it is paramount the new knowledge be made available through a process of continuing education.

It is the belief that nursing research is the basis for professional nursing practice and thereby is an integral part of our daily practice.

It is the belief of nursing that quality nursing care is facilitated in an environment of professionalism and collaboration. Therefore, emphasis is based on professional and collaborative relationships between the nurse, his/her client, and their support system(s) and the interdisciplinary healthcare team in order to provide a quality continuum of care. The patient care is directed by the Registered Nurse, and supported buy the Licensed Practical Nurse, Nursing Student I and II, Nursing Support Technician, Nursing Assistant, and other interdisciplinary health team members.

COMMITMENT TO NURSING EXCELLENCE

The commitment of nursing is:

  1. To provide the client with high quality nursing care that can be measured and evaluated, through the Performance Improvement Initiative and Clinical Research.
  1. To provide the client with cost effective nursing care that is consistent with the mission, goals, and objectives of the institution.
  1. To provide and environment that supports nursing research and education, and their application to client-centered nursing practice.
  1. To create a working environment that encourages professional growth and personal satisfaction through a continuous process that supports change and addresses the learning needs of the organization.

HELPFUL ORIENTATION INFORMATION

Emergency Phone Numbers

Cardiac Arrest – x2300

Security – x2222

Fire - x3473 or “FIRE”

Bomb Threat – x2222

Utility Outage – x2171

Adverse Drug Reaction – x2377

Safety Officer – x2105

Administrative Coordinator – x3135 – pager 406

Rapid Response Team – x2777

Emergency Codes

Code Yellow = Disaster

Code Pink = Infant/Child Abduction

Code Red = Fire

Code Blue (adult/child/infant) = Cardiac Respiratory Arrest

Code Green = Combative Person(s)

Code Purple = Security Response Only

Code Gray = Elopement

Dress Code and Uniforms:

All licensed staff is required to look professional when interfacing with the public. A well-groomed personal appearance, which includes cleanliness, proper hygiene, and appropriate attire is essential in the hospital. Hair should be cleaned, neatly combed, and worn at a length and style that is appropriate to the job. Hair should not fall in the face or obstruct eye contact. Extremes in dyeing, bleaching, or coloring of hair is not permitted. Unnatural colors such as blues, greens, oranges, purples, or bright reds/yellows are not permitted. Jewelry should be worn in moderation as appropriate for the job. Employees should not use excessive amounts of cosmetics, cologne, perfume, etc. Beards and mustaches should be clean and neatly trimmed. Fingernails are to be clean and neatly manicured. Natural nail tips / artificial nails shall be no longer than ¼ inch from the tip of the finger. Polish and designs may be used to compliment your skin tone, however, extreme colors or surface decorations are not permitted.

Tattoos must be covered (and not visible) at all times.

Visible body piercings (tongue, eyebrow, nose, or lip rings, etc.) must be removed while in the work environment.

Clothing and uniforms must be of professional appearance, clean, pressed, and in good repair. Undergarments may not be visible through clothing. Hosiery and undergarments are required at all times. Evening hosiery (e.g. sparkles, fishnets) is not permitted. Hosiery and/or socks must be worn at al times while on duty.

Footwear is required. Non-skid shoes are recommended. Footwear must be appropriate for the type and location of work being performed as determined by the department director. Open toe shoes are not permitted in patient care departments.

Shoes must be polished and kept in good repair. Athletic type shoes, below the ankle, which are predominantly solid in color, coordinating with uniforms or standard color combinations, may be worn.

For women: Dresses, skirts, or culottes may not be shorter than 3” above the knee. Dress shirts and polo shirts are acceptable. Colored sweaters and smocks are permitted, but t-shirts with logos or advertisements are not allowed.

For men: A white or colored dress shirt, polo shirt, or colored scrub top is required. White or colored uniform pants are acceptable with uniform shirt.

Staff in the following areas must wear scrub suits provided by GBMC: General OR, Sherwood Surgical Center, Labor and Delivery, Special Procedures, Women’s Surgical Center, Autopsy Room, and Central Supply.

Infection Control: yellow isolation gowns should be NOT be worn outside of patient care areas.

Shift Times:

You will be prepared to begin work at the designated start times. Please arrive to the staffing office (3rd floor, outside unit 38) 10-15 minutes before the start of your shift to sign in and arrive on your assigned unit on time.

Shift times are usually 7am-3:30pm, 3pm-11:30pm, 11pm-7:30am, or 7am/pm-7:30am/pm. PACU, PCU, Endoscopy, or the Emergency Department may use different time sequences (i.e. 11am-11:30pm).

Sick Call Out:

Call your agency per the policy of the agency. The agency will then notify the hospital of your absence.

Access to Equipment & Medications:

Access codes for the medication cabinets, medication room, Accudose Medication system, and Omnicell will be given to you by the Charge Nurse on orientation to the assigned unit. You will also have to complete an access sheet for the Accudose system and fax it to pharmacy.

Paging via Beeper:

Many staff members are reached via pager or beeper. To beep someone on an in-house pager, dial 3135 and after the instructions, enter the three digit beeper number and your telephone extension, as instructed. Press the pound sign (#) after you enter your extension. After the tones, hang up.

Staff on in-house pagers include Clinical Specialists, Clinical Educators, Respiratory Therapists, Social Workers, Case Managers, Enteral Stomal Therapist/Wound Care Specialists, Physicians Assistants, Nurse Practitioners, Hospitalists, Physician House Staff, Contract Surgeons, Anesthesia, Pain Service, Clinical Managers, and Administrative coordinators.

Chain of Command:

Who do you call with a concern or conflict?

  • Charge Nurse
  • Most senior medical provider
  • Attending Physician
  • Chairman
  • Chief of Staff / Chief Medical Officer

Shift Report:

Report may be either taped or verbal depending upon the specific nursing unit.

Competence Assessment:

You must complete all required computer training, skills training, hospital required competencies, and nursing competencies before you may begin working at GBMC. Initial verification of you competency, inclusive of age-specific competence, will be provided by your agency and through completion of a skills checklist during your orientation to GBMC. You will demonstrate ongoing competence by practice observation and self-learning activities.

Capillary Blood Glucose Monitoring:

Capillary Blood Glucose Monitoring requires initial and annual competence testing. To complete the initial competence on the Sure Step Flex Glucose Meter, you will need to:

  1. Watch the videotape “Sure Step Flex Glucose Meter Training Program” (16 minutes).
  2. Complete the self learning packet and post test for Sure Step Flex Glucose Meter.
  3. Complete a quality control for the Sure Step Flex Glucose Meter.

Once you have completed the competency, you will be assigned an identification number to be used when performing glucose monitoring on patients.

Advanced Directives:

It is required that all patients be approached about advanced directives upon admission to the hospital or outpatient procedure areas. The admitting officer is responsible for asking for a copy of the advance directives and placing this copy with the admitting information. If the patient forgot to bring the advance directives to the hospital, a copy should be requested form the family or significant other.

On admission of the patient to the nursing unit, the nurse caring for the patient is responsible for checking to see that the advance directive is placed in the front of the medical record. If no advance directive is present, the nurse caring for the patient is responsible for follow-up communication with the family or significant other to obtain the advance directive. Such communication should be noted in the nursing progress notes and in the Admission Database.

Café Hours:

Full Breakfast: 6:30am-10:00am

Continental Breakfast: 6:30am-11:00am

Lunch (including sushi/sauté/deli sandwich stations): 11:00am-2:00pm

Dinner: 4:30pm-8:00pm

Soups/Pizza/Grill/Salad Stations: 11:00am-9:00pm

Closed: 10:30am-11:00am and 9:00pm-6:30am

Weekly Menu options can be found on the GBMC Infoweb. To access menus, double click on the Internet Explorer icon from any computer in the hospital. Under the “Checklist” column in the middle of the screen, click on “Daily Menu.” This will open the Food and Nutrition Services page. Click on “Weekly Café Menu” to open the menu on the screen.

WORKPLACE ISSUES

Cultural Sensitivity and Diversity

Key Points to Remember:

  • We are all the same, but we are all different. Even though heritage and family customs may be different, every individual still deserves respect and dignity
  • Apply the Platinum rule: “Do unto others as they would like to have done unto them.”
  • Apply the Golden rule: “Do unto others as I would have done to me.”
Reach out to those who are different from yourself.

Enrich yourself by learning the culture of others.

Share cultural aspects of yourself with others.

Pay attention to how you treat those who are different from yourself.

Enjoy the uniqueness that diversity creates.

Connect with others to create a harmonious working environment.

Treat others with dignity.

Health Insurance Portability and Accountability Act (HIPAA)

  • Applies to all healthcare providers, health plans, and healthcare clearinghouses
  • Privacy Rule protects all individually identifiable health information regardless of format or medium (i.e. name, birthdate, medical record number, telephone number, address, admission date, insurance information, etc.)
  • Disclosure limited to the individual or for treatment, payment, healthcare operations, hospital directory (room number, phone number, general condition), clergy, and with authorization.
  • Requires healthcare providers to use only the minimum amount of information required to get the job done
  • Patient Rights
  • Right to request restrictions on the use and disclosure of protected health information
  • Right to receive confidential communications of protected health information
  • Right to access protected health information
  • Right to amend protected health information
  • Right to an accounting of disclosures
  • Logging Disclosures
  • Required by law after April 14, 2003
  • At GBMC, disclosures can be logged on the Infoweb (accessed by double clicking on the Internet Explorer icon on any computer desktop). If you have questions regarding a disclosure, you can check the Compliance home page on the Infoweb, contact Tara Miller (privacy officer for GBMC) at 410-308-8177, or call Medical Records at x2274.
  • What do you need to know?
  • Keep all protected health information confidential and secured
  • Sign off computers when finished
  • Never share your password
  • Avoid hallway conversations and elevator chats
  • Do not leave protected information on fax machines
  • When sending a fax, always use a universal cover sheet and ensure accuracy when dialing numbers

Number 713

GBMC

MANAGEMENT POLICY AND PROCEDURE MANUAL

VOLUME II- HUMAN RESOURCES

HARASSMENT

REVIEWS/APPROVALS:EFFECTIVE DATE: 02/21/03

______

President

I.PURPOSE

To establish the policy and procedures concerning protection of GBMC employees against harassment or a hostile and intimidating work environment. To define prohibited actions and establish procedures for reporting, investigating, and resolving violations of this policy.

II.POLICY

The Medical Center strives to protect employees (and applicants for employment) against sexual harassment or against a hostile and intimidating environment.

GBMC is committed to providing a work environment for its employees which fosters mutual respect among coworkers and is free of harassment. Improper activity will not be tolerated. All incidents of workplace hostility or harassment must be reported and will be promptly investigated by the Medical Center.