LOCATION : Moses Cone Hospital, Cardiovascular ICU
CITY : Greensboro
JOB DETAILS :
Exempt: No | FTE: 0.9 (36 hours/week) | Schedule: 12 hr nights | 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.
Associates Nursing Required
Bachelors Nursing Preferred
Additional Information: Graduate of a School of Nursing. BSN required or with approval of the hiring manager, 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.
RN Registered Nurse licensed in North Carolina or a Compact state.
BLS (CPR) AHA Health Care Provider BLS
ABOUT CONE HEALTH :
Cone Health is an equal opportunity employer. If you require assistance with our online job submission process, please contact our team at 866-266-3767 to request an accommodation.
MOSES CONE HEALTH SYSTEM
Scope of Services
2H/ Cardiovascular Intensive Care (CVICU) Unit
1. Department Description - 2 Heart CVICU is a 26 bed patient care department with 26 private, hard-wired monitored beds with telemetry capability that provides care primarily to cardiovascular/thoracic intensive care patients, 7 days a week, 24 hours a day. The patient rooms are located on the perimeter of a rectangular shaped department with 7 nursing stations around the department. Supply storage is in between the nursing stations in the center of the department. Each nursing station contains a patient call system and 3 nurse stations with central cardiac monitoring system at the center and at each end of the department.
2. Population/Clients Served - High volume patient populations include those experiencing an acute myocardial infarction (MI) with complications, complex arrhythmias, heart failure, undergoing Cardiac Surgery, Aortic Abdominal Aneurysm Repair, Thoracic Abdominal Aneurysm Repair, Esophagectomy patients, Thoracotomy, multiple trauma, sepsis, Shock, acute respiratory failure, renal failure, hypertensive crisis, and CVVH. Low volume populations include head trauma, stroke, pneumonia, drug overdose, diabetic ketoacidosis, GI bleed, and long term ventilator patients. The average length of stay is 34.71 days based on admissions. Age groups served are adult and geriatric.
3. Services Provided - Nursing care is provided 24 hours a day, 7 days a week by an RN staff that is supported by ancillary staff of Nurse Technicians and a Nursing Secretary. Nursing care includes cardiac and respiratory assessment and monitoring, pharmacological support to the hemodynamically unstable patient and medical and nursing interventions to achieve physiologic stability and prevent complications. Services also include patient education related to the surgical procedure, disease process, other procedures, and support services for diagnostic purposes and rehabilitation.
The medical and nursing directors are responsible for triage of patient admissions. They are supported by and collaborate with the Assistant Director (AD), Charge Nurse (CN) and RN IV. Triage is determined by using admission and discharge criteria approved by the Critical Care Committee.
4. Staffing Plan/Ratios - The availability of staff to provide services
Registered Nurses, Nursing Technicians, and Nursing Secretary. Registered Nurses, Nursing Technicians are scheduled 7 days a week, 24 hours a day and Nursing Secretary are scheduled 7 days a week, 16 hours a day. Patient assignments are based upon patient acuity and staff skill. We budget for a ratio of 1.72 patients per RN 24 hours a day. The goal is two Nursing Technician each shift and one Nursing Secretary from 0700 to 2330 each day.
Staff are scheduled for 6-week periods and distributed based upon anticipated daily census, shift census, and staff experience.
Staff competencies and skills to provide services
(* Indicates key competencies)
• Current Licensure
• Current CPR
• Current ACLS
• Life Safety, Fire safety, Infection Control, and general safety to meet OSHA, state and facility requirements; Corporate Compliance
• Basic and Advance EKG*
• 12 Lead ECG interpretation
• Cardiac assessment
• Hemodynamic Monitoring of Arterial Lines and Central Venous Lines and Swan Ganz catheters with cardiac output and wedge measurements
• Cardiac Output measurement, pulmonary wedge pressures and the manipulation of cardiac invasive catheters*
• Defibrillation and Cardioversion*
• Medical emergency/Code/ Resuscitation care
• Cardiac and Emergency Pharmacology knowledge
• Management of Pacemakers for epicacardial and transvenous pacing*
• Care and management of acute coronary syndrome to include chest pain, MI, and post PCI
• Arterial and venous sheath removal
• Post cardiac arrest therapeutic hypothermia care
• Pericardial drain care
• Aquapheresis therapy
• IV management and titration of medications
• Vasoactive Drip titration*
• Cardiac and Respiratory assessment and intervention skills
• Administration of oxygen delivery systems including Bipap, mechanical ventilation, and oscillator*
• Ventilator management*
• Pulmonary management to include chest tubes, pleurex drain, and trach care
• Maintenance of and Discontinuation of Thoracotomy Tubes*
• Stroke ( Identification, care, and management)
• IV Conscious Sedation*
• Discontinuation of Central Venous Lines*
• Discontinuation of Arterial Lines*
• IABP therapy*
• Obtaining blood from an existing arterial line/ central line*
• CRRT ( Continuous Renal Replacement Therapy)
• LVAD Therapy*
• CentriMag Therapy*
• ECMO (Extracorporeal membrane oxygenation)
• Impella 2.5, CP, and 5.0 Therapy*
5. Competency/Education Plan - Orientation/Initial Competency - Each role has a defined orientation pathway or competency validation list that is completed prior to the person taking an independent assignment. Key competencies are validated by direct observation by the individual preceptor or experienced staff. The Department Director determines, with input from the preceptor(s) and by observation, when the orientation is complete.
Ongoing Competency - Staff member's ongoing competency to provide care on CVICU is determined by direct observation and record review by the Department Director, Assistant Director, Educators, and Shift Leadership. Competency is maintained by skills fairs, routine reviews of low volume and problem-prone procedures, and EKG revalidation.
ACLS is required for all RNs working in the following departments across the MCHS: PACU, outpatient surgery, adult critical care, step-down, telemetry departments in which standing emergency orders are utilized, maternity admissions unit, emergency departments, and Endoscopy. ACLS is required for family practice and internal medicine residents, Carelink staff, Administrative Coordinators, Cardiac cath lab techs and cardiac rehab RNs.
1. ACLS certification completed within 12 months of hire date
2. Recertification is required every two years
• Joint Commission Compliance
• Magnet Recertification
• Real-time huddle updates
• Hemodynamic Monitoring within the first 12 months
• Policy and Procedure updates
• Ongoing pharmacological updates on new medications
• Inservices to assist staff in better meeting patient expectations
• Academic presentations
• EKG Revalidation (on-going for RNs and NS-MTs)
• Ventilator management class within the first 12 months
• Specialty education programs, i.e. Impulse, Transitions
Recommended Classes after the first 6 to 24 months:
• IABP class
• CVVH class