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Graduate Nurses (T&RC) and Registered Nurses 1 (T&RC) perform similar nursing tasks and activities; coordinate and provide nursing care to individuals in State University of New York teaching and research center hospitals; administer treatments and nursing procedures within established guidelines and as prescribed by licensed health care providers; and consult on nursing matters with treatment teams and other disciplines.

Levels in the series are primarily distinguished by scope and independence of operation, which is based on incumbents' credentials (i.e., possession of a limited permit as a graduate nurse or eligible to enter examination for licensure as a registered professional nurse; or possession of a license and current registration as a registered professional nurse in New York State).

Graduate Nurse (T&RC): entry level; possesses a limited permit as a graduate nurse or is eligible to enter examination for licensure as a registered professional nurse in New York State; under the close supervision of a higher-level registered nurse, provides direct nursing care to individuals in accordance with Article 139 of the Education Law.

Registered Nurse 1 (T&RC): full performance level; possesses a license as a registered professional nurse in New York State; under the general direction of a higher-level registered nurse or licensed health care provider, independently provides direct nursing care to individuals in accordance with Article 139 of the Education Law; supervises nursing care activities; and provides clinical supervision and training to Graduate Nurses (T&RC), Teaching & Research Center Licensed Practical Nurses, and direct care staff.

Registered Nurse 2 (T&RC): advanced performance level; provides direct nursing care to individuals in an acute care environment requiring advanced clinical interventions; performs professional nursing functions in three areas: direct individual care, preceptor, and clinical management.

Registered Nurse Supervisor 1 (T&RC): supervisory level; provides administrative and clinical supervision to lower-level registered nurses and direct care staff; oversees and coordinates nursing services for an assigned unit; and may be involved in teaching and orientation functions.

Related Classes Teaching & Research Center Licensed Practical Nurses are licensed practical nurses that provide direct nursing care to individuals receiving treatment in State University of New York teaching and research center hospitals under the direction of a registered nurse, physician, or other licensed health care provider.

Graduate Nurse (T&RC):

• Prepares or assists with preparation of nursing care plans consistent with individuals' comprehensive treatment plans and medical needs.
• Carries out treatment procedures, administers medications, and monitors individuals' conditions.
• Records notes and maintains individuals' medical records and nursing care plans, including nursing care, medications, and treatments, reactions to care and treatment, intake and output of liquids and solids, and vital signs.
• Participates in the development, implementation, and revision of individual care plans as a member of a multidisciplinary treatment team.
• Modifies nursing care plans based on individual condition and responses to care and treatment.
• Triages individuals by inquiring about illnesses, injuries, and symptoms, and records findings and observations.
• Assesses findings, and either refers individuals directly to a physician in emergency cases or initiates appropriate remedial action; as directed, assists physicians with treatment functions.
• Provides education and counseling to individuals and families regarding health, medications, procedures, and treatment goals.
• Practices and ensures compliance with established infection control policies and procedures.
• May train paraprofessional staff by demonstrating nursing techniques and providing instructions on use of techniques and nursing equipment.

Registered Nurse 1 (T&RC):

• Independently performs the duties described above and provides clinical supervision and instruction to Graduate Nurses (T&RC), Teaching & Research Center Licensed Practical Nurses, and direct care staff in completing care tasks.
• Delegates responsibility for appropriate nursing activities, skills, and/or procedures to nursing and direct care staff; and makes clinical rounds to assess individuals' nursing care needs and observe and evaluate the provision of nursing services.
• May perform the full range of supervisory duties over Graduate Nurses (T&RC), Teaching & Research Center Licensed Practical Nurses, and direct care staff; provide information to Registered Nurse Supervisors 1 (T&RC); and prepare or contribute to the preparation of reports and performance evaluations for lower-level staff involved in nursing care activities.

Registered Nurse 2 (T&RC):

• Direct Individual Care: Provides nursing care to individuals in an acute care environment requiring complex nursing skills; uses advanced knowledge and skill in nursing assessment, planning, implementation, and evaluation activities.
• Observes and responds to individual emergency situations, and sets priorities for care based on individual acuity, preferences, and the possibility of effective intervention. Implements nursing interventions in response to changes in individual status and unusual circumstances.
• Interprets assessment data to determine if individuals are at physiological or psychosocial risk.
• Takes steps to decrease stress and increase the effectiveness of individual coping mechanisms; uses effective communication strategies with individuals, families, staff, and the general public.
• Assesses individual status upon entry to the hospital and throughout hospitalization.
• Identifies implications of individuals' statuses and prioritizes data collection based on individuals' immediate needs.
• Identifies safety and security risks to promote a culture of safety and to prevent injury and harm to individuals, visitors, and staff.

Preceptor:

• Guides lower-level, and new to specialty, registered nurses in choosing nursing interventions, developing skills, and applying knowledge.
• Serves as a resource nurse for staff members, orienting new staff and providing feedback on nursing skills for specialty care areas.
• Develops and maintains care standards knowledge bases for specialty care areas and develops care guidelines for unit-specific individual populations.
• Maintains a minimum standard of continuing education for specialty areas.
• Evaluates and assesses individual staff and nursing student development needs.
• Counsels and implements a variety of teaching strategies to meet those needs in consultation with nursing management staff.
• Participates in in-service and other educational programs related to clinical specialties.
• May identify, develop, and implement nursing research studies on clinical units, in consultation with medical staff consultants.

Clinical Management:

• Consults and coordinates with other health care team members to resolve complex clinical issues and develop short and long-term clinical goals for assigned units.
• Integrates and evaluates clinical care knowledge specific to the needs of unit individuals; develops unit-specific policies and procedures in consultation with nursing management staff.
• Identifies and implements corrective actions to improve the quality of individual care; may oversee equipment testing and supplies.
• Leads and attends various hospital committees.
• Assists Registered Nurse Supervisor 1 (T&RC) staff with implementing and achieving unit operating changes; may take charge of a unit in the absence of a Registered Nurse Supervisor 1 (T&RC).
• Resolves individual relation issues. Identifies and reports issues related to individual care, operation, and quality outcomes. Identifies potential conflict situations and facilitates solutions.

Registered Nurse Supervisor 1 (T&RC):

Plans, directs, and supervises nursing services on an assigned unit, including direct supervision of Registered Nurse 1 (T&RC) and other staff. Directs the development and implementation of nursing care plans on a unit. Provides individual care, and functions as an educator and nursing services expert. Assesses work methods of nursing staff and provides feedback to improve the efficiency and effectiveness of care delivered. Coordinates medical and nursing care needs with other health care providers and departments. Ensures proper functioning of equipment and unit compliance with safety and environmental standards. Monitors nursing care quality standards, and implements corrective actions as needed. Attends and participates in medical committees to represent nursing staff needs and the individual population, and participates in writing of care standards. Identifies staff training needs and collaborates with unit educators to develop and implement educational programs. Develops and implements orientation plans for new employees and participates in staffing decisions.

Graduate Nurse (T&RC) Open Competitive: possession of limited permit as a graduate nurse in New York State; or eligible to enter examination for licensure as a registered professional nurse in New York State.

Registered Nurse 1 (T&RC) Open Competitive: possession of a license and current registration as a registered professional nurse in New York State.

Registered Nurse 2 (T&RC)

Promotion: possession of a license and current registration as a registered professional nurse in New York State and one year of service as a Registered Nurse 1 (T&RC). Open Competitive: possession of a license and current registration as a registered professional nurse in New York State; and two years of post-licensure clinical nursing experience