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RN--Cardiovascular ICU, 36 hours/week, Nights, Moses H. Cone Hospital

Job ID: 6821
Facility: Moses Cone Hospital, Cardiovascular ICU
City: Greensboro

Date Posted: 2019-02-01 12:15:09 UTC
2019-01-29 07:07:12 UTC

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Job Description

LOCATION: Moses Cone Hospital, Cardiovascular ICU
CITY: Greensboro

JOB DETAILS:
Exempt: No | FTE: 0.9 (36 hours/week) | Schedule: 12 hr Night | 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.

EDUCATION:
Associates, Nursing, Required
Bachelors, Nursing, Preferred
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.

LICENSURE/CERTIFICATION/REGISTRY/LISTING:
REQUIRED
RN | Registered Nurse licensed in North Carolina or a Compact state.
BLS (CPR) | AHA Health Care Provider BLS

PREFERRED
ACLS | Advanced Cardiovascular Life Support
PALS | Pediatric Advanced Life Support

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

Scopeof Services

2H/ Cardiovascular Intensive Care (CVICU) Unit

1. DepartmentDescription - 2 Heart CVICU is a 26bed patient care department with 26 private, hard-wired monitored beds withtelemetry capability that provides care primarily to cardiovascular/thoracicintensive care patients, 7 days a week, 24 hours a day. The patient rooms arelocated on the perimeter of a rectangular shaped department with 7 nursingstations around the department. Supplystorage is in between the nursing stations in the center of the department.Each nursing station contains a patient call system and 3 nurse stations withcentral cardiac monitoring system at the center and at each end of thedepartment.

2. Population/ClientsServed - High volume patient populations include those experiencing anacute myocardial infarction (MI) with complications, complex arrhythmias, heartfailure, undergoing Cardiac Surgery, Aortic Abdominal Aneurysm Repair, ThoracicAbdominal Aneurysm Repair, Esophagectomy patients, Thoracotomy, multipletrauma, sepsis, Shock, acute respiratory failure, renal failure, hypertensivecrisis, and CVVH. Low volume populations include head trauma, stroke,pneumonia, drug overdose, diabetic ketoacidosis, GI bleed, and long term ventilatorpatients. The average length of stay is34.71 days based on admissions. Age groups served are adult and geriatric.

3. ServicesProvided - Nursing care is provided 24 hours a day, 7 days a week by an RNstaff that is supported by ancillary staff of Nurse Technicians and a NursingSecretary. Nursing care includes cardiac and respiratory assessment andmonitoring, pharmacological support to the hemodynamically unstable patient andmedical and nursing interventions to achieve physiologic stability and preventcomplications. Services also include patient education related to the surgicalprocedure, disease process, other procedures, and support services fordiagnostic purposes and rehabilitation.
The medical and nursing directors are responsible for triageof patient admissions. They are supported by and collaborate with the AssistantDirector (AD), Charge Nurse (CN) and RN IV. Triage is determined by usingadmission and discharge criteria approved by the Critical Care Committee.

4. StaffingPlan/Ratios - The availability of staff to provide services

Registered Nurses, Nursing Technicians, and NursingSecretary. Registered Nurses, NursingTechnicians are scheduled 7 days a week, 24 hours a day and Nursing Secretaryare scheduled 7 days a week, 16 hours a day. Patient assignments are based uponpatient acuity and staff skill. We budget for a ratio of 1.72 patients per RN24 hours a day. The goal is two Nursing Technician each shift and one NursingSecretary from 0700 to 2330 each day.

Staff are scheduled for 6-week periods and distributed basedupon anticipated daily census, shift census, and staff experience.

Staff competenciesand skills to provide services
(* Indicates key competencies)
RN
• Current Licensure
• Current CPR
• Current ACLS
• Life Safety, Fire safety, InfectionControl, 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 ArterialLines and Central Venous Lines and Swan Ganz catheters with cardiac output andwedge 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 Pharmacologyknowledge
• Management of Pacemakers forepicacardial and transvenous pacing*
• Care and management of acute coronary syndrome toinclude chest pain, MI, and post PCI
• Arterial and venous sheath removal
• Post cardiac arrest therapeutichypothermia care
• Pericardial drain care
• Aquapheresis therapy
• IV management and titration ofmedications
• Vasoactive Drip titration*
• Cardiac and Respiratory assessmentand intervention skills
• Administration of oxygen deliverysystems including Bipap, mechanical ventilation, and oscillator*
• Ventilator management*
• Pulmonary management to includechest tubes, pleurex drain, and trach care
• Maintenance of and Discontinuationof Thoracotomy Tubes*
• Stroke ( Identification, care, andmanagement)
• IV Conscious Sedation*
• Discontinuation of Central VenousLines*
• Discontinuation of Arterial Lines*
• IABP therapy*
• Obtaining blood from an existingarterial line/ central line*
• CRRT ( Continuous Renal ReplacementTherapy)
• LVAD Therapy*
• CentriMag Therapy*
• ECMO (Extracorporeal membraneoxygenation)
• Impella 2.5, CP, and 5.0 Therapy*

5. Competency/EducationPlan - Orientation/Initial Competency - Each role has a defined orientationpathway or competency validation list that is completed prior to the persontaking an independent assignment. Key competencies are validated by directobservation by the individual preceptor or experienced staff. The DepartmentDirector determines, with input from the preceptor(s) and by observation, whenthe orientation is complete.

Ongoing Competency - Staff member's ongoing competency toprovide care on CVICU is determined by direct observation and record review bythe Department Director, Assistant Director, Educators, and Shift Leadership.Competency is maintained by skills fairs, routine reviews of low volume andproblem-prone procedures, and EKG revalidation.

ACLS is required for all RNs working in the followingdepartments across the MCHS: PACU, outpatient surgery, adult critical care,step-down, telemetry departments in which standing emergency orders areutilized, maternity admissions unit, emergency departments, and Endoscopy. ACLSis required for family practice and internal medicine residents, Carelinkstaff, Administrative Coordinators, Cardiac cath lab techs and cardiac rehab RNs.
1. ACLScertification completed within 12 months of hire date
2. Recertification isrequired every two years

Education Plan
• Joint Commission Compliance
• Magnet Recertification
• Real-time huddle updates
• Hemodynamic Monitoring within thefirst 12 months
• Policy and Procedure updates
• Ongoing pharmacological updates onnew medications
• Inservices to assist staff in bettermeeting patient expectations
• Academic presentations
• EKG Revalidation (on-going for RNsand NS-MTs)
• Ventilator management class withinthe first 12 months
• Specialty education programs, i.e.Impulse, Transitions

Recommended Classes after the first 6 to 24 months:
• IABP class
• TNCC
• CVVH class
• VAD
• CentriMag
• Impella
• ECMO

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