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RN - CARELink, Critical Care Transport

Job ID: 1423
Facility:
City: Greensboro

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Job Description

LOCATION: Greensboro, Moses Cone Hospital

WORK TYPE:

Benefit Eligible (12 - 39 hours/week)

Exempt: No

SCHEDULE:

FTE: 0.6 (24 hours/week)

Shift: Weekend

Schedule: Sat/Sun Days

On Call: No

JOB SUMMARY:

Assesses, plans, implements, documents, organizes, prioritize, delegates, supervises and coordinates the care of neonatal, pediatric, adolescent, adult, geriatric patients as prescribed within the parameters of the NC Nurse Practice Act and hospital complex.

MAJOR WORK ACTIVITIES:

Provides nursing care via the nursing process for the development, implementation and evaluation of nursing care. Collects and analyzes patient/significant other data. Completes an admission database and ongoing assessment to include collaboration with patients, significant others and other health care providers. Implements a plan of care for each patient (utilizing clinical pathways where applicable) and individualizes to meet the age specific needs of patients/significant others. Identifies variances and makes adjustments in the plan of care based on evaluation of the plan and effectiveness of nursing interventions. Documents and updates the plan of care, nursing care, nursing interventions and patient response to care, and keeps healthcare team, patients and significant other informed. Contributes to the discharge plan by identifying homecare needs. Recognizes changes in patients conditions and revises the plan of care appropriately. Demonstrates advanced competencies and critical thinking skills in day to day practice. Identifies and implements educational needs for patients/significant others. (30%)

Establishes a caring and therapeutic nurse/healthcare team/patient/significant other relationships. Recognizes communication barriers, identifies resources and establishes plans to resolve barriers to communication. Demonstrates respect for diversity and cultural differences in patient/significant others related to age, ethnicity, gender, religion, socioeconomics, education, personality, or other unique variable. Formulate individualized plans to address individual needs related to diversity, cultural difference or other unique variables. Advocates for the patient/significant other. Demonstrates skillful responses to customer needs based on particular context of the situation. (25%)

Supports an environment of evidence based practice/research/quality improvement. Demonstrates knowledge of Shared Governance accountabilities and principles, supports DSGC directly as a council member or indirectly by keeping informed of council activities/supporting council decisions, brings forth issues to council. Demonstrates knowledge of how to access reference documents containing policies, procedures, standards, and additional resources. Participates in QI/ Research activities based on role and major work activities as outlined in the research point system guidelines. Demonstrates knowledge of department QI plan. Demonstrates understanding of resource management and implements opportunities. Collects QI data and participates in analysis and action plan development, incorporates changes into practice. Facilitates ongoing activities to meet and adhere to regulatory standards (TJC, DFS, OSHA). (20%)

Supervises other members of the team. Contributes to a supportive and healthy work environment. Holds self and others accountable for complying with policies, procedures and standards. Participates in learning needs assessments. Provides input into and supports the precepting and mentoring process. Delegates appropriate tasks to support staff, ensure completion of delegated tasks and provides feedback as needed. Demonstrates team spirit and collegiality. Supervises select personnel in performance/patient care. (15%)

Demonstrates effective conflict resolution/negotiation skills. Promotes positive, supportive, and professional work environment free of disruptive behavior. Practices, in all professional relationships, with compassion and respect for the inherent dignity, worth and uniqueness of every individual. Follows Chain of Command for assistance with issues related to unresolved/problem-solving and/or conflict resolution. Provides, seeks and receives constructive feedback. Provides peer to peer feedback and seeks mediation as necessary. Promotes effective conflict resolution. (10%)

EDUCATION:

Required:

Associates Nursing

Preferred:

Bachelors

Additional Information

Graduate of a School of Nursing. BSN required or with approval of the VP of Nursing, experienced RN's with an AD or Diploma with an active plan to obtain their BSN within four years from date of hire may be considered.

LICENSURE/CERTIFICATION/REGISTRY/LISTING:

Required:

RN - Registered Nurse licensed in North Carolina or a Compact state.

BLS (CPR) - AHA Health Care Provider BLS

Preferred:

Advanced Cardiovascular Life Support

Pediatric Advanced Life Support

KNOWLEDGE, SKILLS, AND ABILITIES:

Required:

Personal Safety - Responds appropriately to emergency situations (Cone Health Codes) and demonstrates knowledge of how to respond. Always uses appropriate safety devices and techniques (examples: using safe lift equipment and needle safe devices; pushing carts; correctly lifting copy paper).

Ability to present information to a group

Oral and Written Communication Skills - Ability to communicate effectively through both oral and written formats.

Leadership Skills

Medical Terminology

Ability to work independently

Accountability - Takes responsibility for own actions, including the impact of own decisions on patients and others. Also takes responsibility for actions of any direct reports, avoiding blame or excuses. Takes appropriate action when anyone in the organization violates standards or regulations, viewing it as unacceptable to "look the other way".

Adaptability - Effectively assesses and adjusts to changes in circumstances, resources, or environment, using the creativity and flexibility required to remain effective. Views change as a constant, accepting and adjusting to twists and turns. Adjusts to the especially unpredictable nature of a healthcare environment, shifting focus as necessary, and taking reasonable action, even when faced with various levels of uncertainty.

Communication - Accepts responsibility for effective two-way communication using clear and well-organized oral and written techniques. Demonstrates self awareness of non-verbal messages, keeping verbal and non-verbal messages consistent. Incorporates recognition of cultural impact on understanding and effectively uses interpreters and language translation devices.

Computer Literacy - Working knowledge of personal computer and communications technology.

Knowledge of Concepts, Procedures and Techniques - Possess knowledge of concepts, procedures and troubleshooting techniques.

Problem Solving - Identifies practices or procedures that are not working effectively and challenges underlying assumptions. Includes a representative number of persons when addressing issues (including patients and their families), resulting in the best resolution from various perspectives. Looks for the root cause of any problem, resulting in solutions that are enduring and sustainable.

Proficiency in Tools and Equipment - Ability to demonstrate proficiency in the application of tools, test equipment and meters to effectively diagnose equipment problems and/or failures consistently.

Responsiveness - Reacts promptly when requests are made or situations clearly call for it. Shifts priorities when a timely response is essential. Actions reflect sensitivity to patient/customer needs and sense of urgency. Balances speed of response with safety concerns.

Time Management - Establishes priorities during routine daily operations, addressing time-sensitive matters first, while also accomplishing day-to-day tasks and duties. Effectively triages tasks and events according to urgency level, impact on patients and outcomes desired under special conditions (e.g., during crises and emergencies). Makes choices that result in maximum completion of essential duties and minimum personal stress.

Ability to work in stressful situations - Ability to remain calm and composed in stressful situations (ie: fast paced environment, meeting deadlines/work quotas, etc.)

Integrity - Demonstrates an unwavering commitment to do what is ethically "right".

Consistently tells the truth unless doing so would violate confidentiality or compromise the safety or privacy rights of patients or others. Behaves in a manner fully consistent with stated intentions and commitments, even when there is no one to witness activities. Stands up for what is right even when there are personal risks or when there are clear rewards for doing otherwise.

Interpersonal skills - Demonstrates an ability to interact with others in a courteous and professional manner and establish good working relationships.

Ability to delegate

Ability to influence others not under direct control

CONDITIONS OF EMPLOYMENT

* Annual flu shot

* Annual TB test (if applicable to your job location)

* Annual HLCs (Healthstream, formerly CBL)-Safety at Work and Corporate Compliance

* Maintain licensure/certification/registry/listing (if applicable to your job)

LOCATION/DEPARTMENT SUMMARY:

CONE HEALTH

CARELINK MOBILE CRITICAL CARE TRANSPORT

Scope of Services

Department CareLink

Established 1994

Department Description - CareLink is comprised of two areas\u2014CareLink Resource Line and CareLink Mobile Critical Care. The CareLink Resource Line is an 800 number provided by the Cone Health System for physician consultations, Code STEMI, Code Stroke, and Code Sepsis activations, and arranging patient admissions and/or transport of patients to/from other healthcare facilities.

The CareLink Transport team generally serves a 150-mile radius from the Greensboro area with occasional prescheduled transports outside this radius. CareLink operates 24 hours a day, 7 days a week with various shifts and crew configurations, depending on call volume.

Population/Clients Served - CareLink serves patients of all age populations from neonates to geriatrics with a multitude of illnesses and injuries. CareLink transports patients within, out of, and into the Cone Health System. CareLink Resource Line serves health care providers by arrangement of patient transfers and coordination with receiving departments. Community Outreach offers medical screenings, community event demonstrations, and community education.

Services Provided - CareLink services are available 24 hours a day, 7 days a week by a group of Communication Specialists, Registered Nurses (RNs), Paramedics (EMT-Ps) and Emergency Medical Technicians (EMTs). The Resource Line staff arranges physician referrals and patient transport for direct admission and/or emergency care. The Resource Line also receives calls via radio or telephone from Guilford, Rockingham, Alamance and other surrounding county EMS systems, with Code STEMI and Code Stroke activations. CareLink staff have the capability of caring for patients requiring the use of ventilators, cardiac monitoring, temporary pacemaker, pressure line monitoring, central line maintenance, and intra-aortic balloon pump. Care includes a complete patient assessment, pharmacologic support to the hemodynamically unstable patient, including newborns and high risk OB patients, and medical interventions to achieve physiologic stability and prevent complications. CareLink transport teams also assist EMS (Emergency Medical Services) agencies in Guilford and Rockingham counties upon their request based upon our availability in disaster situations.

Transport Criteria

For a patient to be considered appropriate for transport, any of the following criteria should be met:

• Patient condition requiring hemodynamic monitoring and/or infusion of vasopressor medications or blood products.

• Patients requiring mechanical ventilation.

• Patients being transferred within the Cone Health System, regardless of patient condition.

• Any patient being transferred into or out of the Cone Health System.

• Any patient being transferred from a referral facility to a tertiary care facility other than the Cone Health System meeting the critical care criteria.

Staffing Plan - The availability of staff to provide services

CareLink is staffed 24 hours a day, 7 days a week by Communication Specialists, RNs, EMT-Ps, and EMTs. During peak hours, the dispatch center has 2 available Communications Specialists assisting with physician to physician consults, dispatching transports, as well as CODE STEMI, CODE STROKE, and CODE SEPSIS activations.

Staff is scheduled for 8-week periods and distributed based upon anticipated transports and staff experience.

Each Specialty Care Transport (SCT) ambulance is staffed with one EMT Driver, one RN, and one EMT-P (may also be EMT/RN/RN). Advanced Life Support (ALS) units can be staffed with EMT/RN or EMT/EMT-P who has had more than 6 months experience past orientation.

Staff competencies and skills to provide services

RN:

• Current RN Licensure

• National Certification within one year of specified timeframe

• Current Healthcare Provider CPR

• Current ACLS

• Within one year: PALS, TNCC (or ITLS), ENPC ( or P-ITLS), and NRP certifications

• Life Safety to include Fire Safety, Infection Control, and general safety

• Basic and Advanced EKG

• Hemodynamic Monitoring of Arterial Lines and Central Venous Lines and Swan- Ganz catheters

• Thorough patient assessment and intervention skills

• Cardiac and Emergency Pharmacology knowledge

• Defibrillation and Cardioversion

• External cardiac pacing

• Maintenance of Thoracotomy Tubes

• Emergency/Code

• Management of Pacemakers

• Vasoactive Drip titration

• IABP maintenance

• LVAD maintainence-Thoratec online training

• Ventilator management

• Intraosseous infusion

• Needle / Surgical cricothyrotomy

• Needle chest decompression

• Orotracheal intubation

• King Airway insertion

• Fetal monitoring

• Use of transport isolette

• Use of truck equipment, i.e. Hare© traction splint, XED© extrication device

• Safe operation of ambulance in non-emergency and emergency traffic; CEVO or EVOC training equivalent (Only RN/EMT driving CareLink ambulance)

Competency/Education Plan - Orientation/Initial Competency - Each transport staff role has a defined orientation pathway or competency validation list that is completed prior to the person being released to ride second person on the ambulance.

Registered Nurse:

All CareLink nurses are required to have a minimum of three years of critical care or emergency department experience and current BCLS and ACLS certification prior to hire. National Certification as CEN, CCRN, CTRN, or CFRN must be accomplished within one year from hire date.

The RN3 or RN4 determines, with input from the preceptor(s) and by observation, when the orientation is complete and communicates this information with the Department Director and/or Assistant Director. The current orientation period for new nursing staff is a minimum of 3 weeks on the ambulance and an additional week for observations. Orientation activities include hospital orientation, observation in labor and delivery, neonatal intensive care, and respiratory therapy, as well as with a CareLink EMT (driver) preceptor. Orientation time may be extended if the preceptor and/or orientee deem more time is needed.

Ongoing Competency - Staff member's ongoing competency to provide care on CareLink ambulances is determined by direct observation and record review by the Department Director, Assistant Director, Educators, or Qualified Observers. Competency is validated during skills fairs, along with routine reviews of high risk/low volume/complex skills and procedures, and EKG revalidation done through on-line testing.

Each CareLink nurse is responsible for required continuing education classes, which include BCLS and ACLS (upon hire). PALS, TNCC (or ITLS), ENPC (or PITLS), and NRP are required within the first year. The new nurse must also complete the next CareLink advanced competency skills fair. The Qualified Observers must verify these competencies. Additionally, each new CareLink nurse must receive a passing score on an advanced competency policy and procedure test and complete five (5) successful intubations in the Moses Cone OR.

Education Plan

• Complete all mandatory CBLs.

• Ongoing pharmacological updates on new medications

• In-services to assist staff in better meeting patient expectations

• EKG Re-validation (on-going for RNs and EMT-Ps)

• Semi-annual CareLink Advanced Competency Skills fair with Qualified Observer

• Attain NIMS (National Incident Management System) IS-100, IS-200, and IS-700 on-line course completion

Recommended Classes:

• IABP class, online training and skill check off

• Ventilator management class

EMT-P:

All CareLink EMT-P's are required to have a minimum of five years of critical care transport or EMS paramedic-level experience and current BCLS and ACLS certification prior to hire. Upon hire, a commitment/contract will be reviewed with each qualified applicant, as to the extensive EMT-P orientation classes, and will be signed stating their commitment to the program.

The RN3 and/or RN4 determines, with input from the preceptor(s) and by observation, when the orientation is complete and communicates this information with the Department Director and/or Assistant Director. The current orientation period for new EMT-P staff is a minimum of 3-4 months, extensive critical care orientation (time on the ambulance, critical care academy classes, ICU orientation with hands on experience, SIM lab mega codes/critical thinking exercises, and additional weeks for observational areas). Orientation activities also include labor and delivery, neonatal intensive care, and respiratory therapy, with a CareLink EMT (driver) preceptor, and Communication Specialist. Orientation time may be extended if the preceptor and/or orientee deem more time is needed.

Ongoing Competency - Staff member's ongoing competency to provide care on CareLink ambulances is determined by direct observation and record review by the Department Director, Assistant Director, Educators, or Qualified Observers/preceptors. Competency is validated during skills fairs, along with routine reviews of high risk/low volume/complex skills and procedures, SIM lab mega codes and critical thinking exercises and EKG revalidation done through on-line testing.

Each CareLink EMT-P is responsible for required continuing education classes, which include BCLS and ACLS (upon hire). PALS, TNCC (or ITLS), ENPC (or PITLS), and NRP are required within the first year. The new EMT-P must also complete the CareLink advanced competency skills fair. The CareLink Department Director, Assistant Director, RN 4, RN 3, or other experienced preceptors/Qualified Observers must verify these competencies. Additionally, each new CareLink EMT-P must receive a passing score on an EKG RN challenge test, advanced competency policy and procedure test and completion and demonstration of all critical care skills and critical thinking. EMT-Ps must also participate in an emergency vehicle operations course. In addition, all EMT-Ps are required to obtain national certification as a Critical Care Paramedic or Flight Paramedic per their contract/commitment, and obtain a degree in EMS or a health-related field within 3 years of hire if the employee did not have upon hire date.

Education Plan

• Complete all mandatory CBLs.

• Ongoing pharmacological updates on new medications

• In-services to assist staff in better meeting patient expectations

• CEVO (Coaching the Emergency Vehicle Operator) course or equivalent

• Viper and Radio Operations

• EKG Revalidation (on-going for RNs and EMT-Ps)

• Semi-annual CareLink Advanced Competency Skills fair with Qualified Observer

• Attain NIMS (National Incident Management System) IS-100, IS-200, and IS-700 on-line course completion

Recommended Classes:

• IABP/LVAD class/on-line training

• Hemodynamic Monitoring

• Ventilator management class

• CCEMT-P course (not required), National Registry EMT-P (not required)

EMT:

All CareLink EMTs must have a current BCLS certification prior to hire, and a valid current North Carolina EMT certification. EMTs must also participate in an emergency vehicle operations course as well recommended to have at least two years of emergency driving experience.

Education Plan

• Complete all mandatory CBLs

• In-services to assist staff in better meeting patient expectations

• Semi-annual CareLink skills fair and EMT Policy and Procedure test

• CEVO (Coaching the Emergency Vehicle Operator) course or equivalent

• Attain NIMS (National Incident Management System) IS-100, IS-200, and IS-700 on-line course completion

• Viper and Radio Operations

Ongoing Competency - Staff member's ongoing competency to provide care on CareLink ambulances is determined by direct observation and record review by the Department Director, Assistant Director, Educators, or preceptors. Competency is validated during skills fairs by RN and OEMS credentialed preceptor observation. Each CareLink EMT is responsible for required continuing education classes.

The new EMT must also complete the next CareLink competency skills fair. An approved OEMS credentialed preceptor must verify the EMT/EMT-P skills. Additionally, each new CareLink EMT must receive a passing score on an advanced competency policy and procedure test.

Telecommunicator:

Each new CareLink telecommunicator must complete an orientation to 800mHz, Viper Interoperability radio operations, Alpha Numeric Paging Systems, Guilford County EMS pager and system operations, RescueNet Dispatch-Billing (RNDB), NC First Weather Center use, LifeNet 12-Lead EKG receiving station, C-soft Radio Console, Sentry Watch Security System, Generator operations, use of multiple line phones including conference calling, use of fax server, CODE STEMI, CODE Stroke activation, CODE Sepsis activation, Web EOC disaster training, AMION, and EPIC-Cone HealthLink charge entry system.

Education Plan

• BCLS certification

• Complete all mandatory CBLs

• Attain NIMS (National Incident Management System) IS-100, IS-200 and IS-700 on-line course completion

• Viper Interoperability training on-line completion

• Radio communications training (C-Soft Console)

• Medical terminology

• RNDB

• Cisco Phone System

• LifeNet 12-Lead EKG receiving station

• Annual Skill Fair competency

Recommended Classes:

• WebEOC class

ABOUT CONE HEALTH:

Cone Health is a state of the art network of facilities providing patients access to the latest developments in medical care from their first moments of life through later years. Our network offers the most breakthrough treatments and technology available in healthcare today. As a teaching hospital, we offer employees the opportunity to become leaders in the industry and continued growth from their first day on. Extraordinary patient care is about being "high-touch" as well as "high-tech". Community service and superior patient care are the cornerstones of our organization, a philosophy that is demonstrated by each and every one of our valued team members. We are proud to be the largest private, not-for-profit employer of choice in the Piedmont, NC area community. Additionally, as one of the region's largest and most comprehensive health networks, Cone Health has more than 100 locations, including six hospitals, three ambulatory care centers, three outpatient surgery centers, four urgent care centers, a retirement community, and more than 100 physician practice sites. Our tagline - "The Network for Exceptional Care" - highlights our commitment to excellence, which is shared by our more than 11,000 employees, 1,300 physicians and 1,200 volunteers.

Cone Health is an equal opportunity employer. If you require assistance with our online job submission process, please contact our Talent Acquisition team at 866-266-3767 to request an accommodation.
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