Just like the children we serve, Children's is growing quickly and hiring a Staff RN-ECMO Specialist to coordinate professional nursing and individualized, family-centered care to pediatric patients/families through the use of the nursing process and clinical skills in accordance with standards and hospital policies and procedures. As an ECMO Specialist at Children's you will perform neonatal, pediatric and adult ECMO.
% of Time
1 (A) Conducts individualized age-specific patient/family assessments according to defined unit scope and nursing practice standards, appropriate collaborative problems (CPG's)/nursing diagnoses(ND's), or protocols. (Individualized refers to the patients developmental, cognitive, cultural, psychosocial, spiritual, and educational/family influences and physical/medical care needs.)
* Collects and documents data related to patients individualized care. * Demonstrates age-specific competency in assessment of patients by the ability to obtain and interpret information in terms of the patient needs, knowledge of growth and development, and understanding of the range of treatment needed by these patients. * Assesses patient/family need for education and uses an individualized approach in delivery style. * Assesses family expectations for, and involvement in the assessment and continuous care or treatment of the patient. * Identifies nursing diagnoses, collaborative problems, and/or protocols for each patient, based on assessment, at the time of admission.
* Performs reassessment based on unit standards, CPG's/ND's, protocols and changes in patient condition. Communicates changes to appropriate persons (MD, CNC, family) as indicated
1 (B) Manages the ongoing process of healthcare delivery to ECMO patients and families:
Assessment and Planning:
* Participates in the evaluation of patients as potential ECMO candidates. * Works in collaboration with Perfusion to manage ECMO cannulation, decannulation and stabilization procedures. * Prepares and operates clinical equipment and circuitry per ECMO procedures/policies. * Accurately assess and review with physician and ECMO team, pathophysiological changes within the patient and ECMO circuit. Differentiates patient versus circuit problems and intervenes appropriately. * Based on clinical assessments, contributes to the development of individualized age and developmental appropriate plan of care with patient and family.
* Participates in ECMO case review and assists team members in defining learning outcomes. * Participates in the collection/review of quality improvement initiatives and data for the ECMO program and ELSO data.
2. Develops individualized patient/family plan of care using CPG/NDs, and practice guidelines/protocols to meet identified needs. (Plan of Care includes current and anticipated actions focused on care, education, discharge needs.)
* Utilizes assessment data from the healthcare team to individualize appropriate goals and actions for the patient, including collaboration with the family and the healthcare team. * Utilizes individualized assessment data to develop the patient/familys plan of care. * Formulates goals and outcomes based on assessment data. * Revises plan of care based on patients condition, interdisciplinary input, and family needs. * Demonstrates ability to prioritize patient interventions based on assessments/reassessments. Uses available child care partners to support patient care needs as appropriate.
3(A) Implements and evaluates nursing actions in accordance with the individualized patient/family plan of care and patient condition/needs.
* Oversees that the nursing and interdisciplinary plan of care/goals are coordinated, implemented, evaluated, and revised as needed. Identifies the need for interdisciplinary involvement/outside resources and follows through. Uses appropriate resources (CNC, CNS/Educator, PCM, MD, etc) to ensure that clinical outcomes are achieved. * Incorporates critical thinking into the delivery of clinical skills and in analyzing patient response to orders, tests, labs, medications, and treatments. * Demonstrates clinical competence in administering interventions according to identified standards and age specific needs. * Provides and/or coordinates with other disciplines patient/family education according to identified care needs, considering assessment of patient/familys readiness to learn
3(B) Implements Plan of Care to ECMO patients and families:
* Works in collaboration with ECMO Team to assess clinical status and related lab results (ACT levels, blood gases and metabolic status). Notifies ECMO physician of clinical status/lab values, performing appropriate interventions and implementing physician orders within established guidelines/ECMO policy and procedures. * Manages ECMO flow in relationship to established clinical parameters. Reviews daily parameters with the ECMO Team.
* Demonstrate proper blood sampling techniques from the ECMO circuit.
* Perform, manage and troubleshoot activated clotting times (ACT) as per ECMO protocol including management and administration of heparin drip per ECMO protocol. * Administers all blood products/medications appropriately when ordered to be given through the ECMO circuit.
* Maintains and effectively assesses ECMO circuit function. Performs all circulatory technical skill with efficiency, accuracy and safety while anticipating, troubleshooting, intervening and managing crises/emergency situations according to policy and procedure maintaining professional composure. * Role models proficiency in documenting appropriately by assimilating information related to interventions, plan of care and anticipated outcomes accurately into all ECMO records and teaching documents. * Participates in patient management discussions to include: communicating anticipated patient needs/plan of care, suggesting clinical management options and providing feedback for interventions that improve patient outcomes.