GENERAL SUMMARY:

Coordinates professional nursing and individualized, family centered care to NICU/PICU/ECMO pediatric patients/families, as well as to critically ill neonates during transport, through the use of the nursing process and clinical skills in accordance with standards and hospital policies and procedures. Varied schedules to include weekend and holiday patterns, 7am-7pm or 7pm-7am.

ESSENTIAL FUNCTIONS/COMPETENCIES

• 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 patient’s developmental, cognitive, cultural, psychosocial, spiritual, and educational/family influences and physical/medical care needs.) Admission Assessment:
• Collects and documents data related to patient’s 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.
• Assess and interprets patient data upon arrival at the referring hospital. Shift Assessment/Reassessment:
• 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.
• Performs reassessments on transports after interventions and as needed. Communicates changes to transport NP or medical control physician.

• Develops individualized patient/family plan of care using CPG/ND’s, 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/family’s plan of care.
• Formulates goals and outcomes based on assessment data.
• Revises plan of care based on patient’s 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.
• While on transport, develops and initiates a plan of care incorporating current and potential problems requiring intervention, expected response and the medical plan of care in collaboration with the transport NP and the medical control physician. Communicates the plan to the receiving charge nurse prior to arrival at Children’s Hospital or receiving facility.

• 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/family’s readiness to learn.
• During the transport process, prioritizes and organizes care based on patient acuity, time limitations and consultation with transport NP and medical control physician. Initiates action to prevent current or potential risk to a patient in an emergency situation

• Documentation reflects accurate assessment/evaluation, modification, and patient’s response to therapy, changes in condition, and therapeutic interventions/procedures.
• Entries in the medical record follow hospital policy (i.e., date, time, use of appropriate abbreviations, and legibility).
• Documentation is completed within established timeframes including, but not limited to: Admission Assessment form, daily Patient Flowsheet, Peripheral IV Flowsheet, Family Education Record, and Interdisciplinary Goals.
• Reviews and updates computerized careplan to accurately reflect the plan of care.
• Completes computerized documentation within established timeframes, including, but not limited to: Medication Administration Record, Allergies, Patient Information, etc.
• Completes and verifies accurate order entry in the computerized careplan.
• Ensures that discharge instructions clearly state patient care needs after discharge.
• Uses the Infant Transport Record to document all assessments, interventions, and demographic data related to the transport process.

• Demonstrates responsiveness to the organizational functions of the transport process.
• Response Times are within 20 minutes when on primary call to the ambulance bay. Response times are 30 minutes when on back-up call to the hospital.
• Complies with ambulance operation safety in accordance with current guidelines.
• Check, cleans, and stocks transport packs, transport equipment and ensures equipment is functioning.
• Maintains all transport equipment in a state of constant readiness by checking all equipment at the beginning of each shift, noting any discrepancy and make or arrange for the repair.
• Cleans equipment and restocks packs after a transport in a timely manner.
• Demonstrates knowledge of transport equipment location, function and restocking procedures. Demonstrates the ability to troubleshoot all equipment and ensures that all malfunctions are promptly reported.
• Completes weekly, daily and ongoing equipment checklists.
• Follows up on progress of transported patients and communicate appropriate information to the referring hospital staff.

SECONDARY FUNCTIONS/COMPETENCIES

• Performs other duties assigned.
• Equally committed to PICU/NICU units, utilizing clinical skill sets and appropriate resources, delegating when appropriate. Professionally supports the assigned unit, as seen through interactions with patients, families, area staff, colleagues and others.
• Accepts assignment to mentor student nurse observation experience in unit.
• Accepts assignments to share/teach knowledge and provide clinical support as a relief preceptor for new staff.
• Professionally seeks opportunities to help teammates during shift as needed.
• Accepts and completes other assigned tasks in a professional manner.
• If designated compensated preceptor, add competencies Addendum B.

KNOWLEDGE, SKILLS AND ABILITIES:

• Must possess a current valid Nebraska RN license/RN compact license.
• Must be certified in Basic Cardiac Life Support
• A minimum of one year recent (in the past year) Level III NICU or PICU nursing experience or equivalent critical care experience
• Must be able to perform a variety of duties, often changing from one task to another of a different nature, without loss of efficiency or composure, and be able to perform under stressful conditions when confronted with multiple requests, demonstrating prioritizing skills.
• Must be able to work in an environment which includes the use of ambulance patient transport vehicles and is exposed to non-conventional motions, noise, vibration, fumes, and extreme heat/cold

EDUCATION AND EXPERIENCE:

• Graduate of an accredited school of nursing.
• Previous experience in pediatric intensive care or neonatal intensive care required.

FIT FOR TRANSPORT DUTY:

Physical demands and strength:

• Must be able to wear seat belts installed in ambulance.
• Must be able to perform chest compressions for 10 continuous minutes using a CPR simulation device.
• Must be able to carry the transport bag up and down two flights of stairs.

Medical Conditions:

• Transport team members may not donate blood within 24 hours of a work shift.
• Under no circumstances are transport personnel allowed to smoke or use smokeless tobacco products during the transport period.
• Any medical condition that may interfere with transport assignments must be reported to the Transport Patient Care Manager.
• A signed statement from a personal physician must be submitted to the Transport PCM and Employee Health if a health condition develops that prevents the transport personnel from participating in the program.
• The pregnant transport person is not required to remain on active transport status any longer than she or her private physician feels she may safely do so. At 35 weeks gestation, the transport team member will not participate in transport.