CLINIC RN/CARDIAC CARE SPECIALTY - CARDIOLOGY

Status: PRN - As Needed

Shift: Varies

Exempt: No

Summary:

The Cardiac Care Nurse provides nursing care to cardiac patients in need of assessment and monitoring for all cardiac disease processes.

This position will be responsible for knowledge of heart failure care, anticoagulation monitoring, medication and health assessments post discharge or acute cardiac event, as well as providing pacemaker, implantable cardiac defibrillator (ICD), Loop Recorder interrogation and reprogramming, and other device monitoring tasks.

The nurse provides direct nursing care to young adults through geriatric patients and adjusts methods appropriately to accommodate the needs specific to each age group.

This position will be tasked with using clinical reasoning and conducting accurate clinical ass

Other information:

A. Experience, Knowledge, and Skill

1. Registered Nurse with 2 years cardiovascular nursing, electrophysiology nursing, telemetry nursing, critical care nursing, or cardiac disease nursing experience required.

2. American Heart Association (AHA) BLS and ACLS certification required

3. Clinic experience strongly desired

4. Must be a graduate of an accredited nursing school with either associate or bachelor’s degree and be currently licensed by the Louisiana State Board of Nursing and maintain licensure.

5. Certifications such as Certified Cardiac Remote Monitoring Specialist and/or Certified Cardiac Device Specialist required and must complete within 2 years after hire.

B. Physical Effort Required:

• Strength: Medium
• Push: Occasionally
• Pull: Occasionally
• Carry: Frequently
• Lift: Occasionally
• Sit: Occasionally
• Stand: Frequently
• Walk: Frequently

Responsibilities:

Mission Enhancement:

1. Demonstrates behaviors that reflect understanding and support of the organizational values and mission.

• Understands the corporate goals and objectives and helps North Oaks Cardiology meet these goals.
• Promotes and exudes actions that follow the 4C’s mentality.
• Strives with every action to improve lives every time, with every touch.

Competency & Job Knowledge:

1. Pleasantly greets patients, confirming their correct identification and correct visit type.

2. Obtains and records patient weight, height, and vitals and escorts patient to exam room and continues to prep patient for appropriate visit type including recording chief complaint(s) and completing appropriate medication reconciliation per hospital policy. Obtains patient history and clinical data.

• Call in medication refills and return calls in response to patient’s messages.
• Independently perform routine nursing duties including phlebotomy, EKG, medication administration, measurement of vital signs, preparation of lab specimens, starting IVs, etc.
• Document all assessments, interventions, phone conversations, etc. in the patient medical record as appropriate. Ensure that all documentation is clear, complete, and legible.
• Manage urgent/emergent medical situations as appropriate and in accordance with the organization’s protocols for medical emergencies and cardiac arrests. Obtain and/or operate emergency equipment according to relevant standards.
• Call patients regarding test results as directed by a provider.
• Adhere to infection prevention and cleanliness standards.
• Participates in appropriate education and on-the-job learning situations to develop necessary job skills.
• Attends required meetings and completes necessary continuing education to maintain licensure.
• Assists in the movement of patients, as necessary.

16. Demonstrates knowledge of and compliance with established organizational, departmental, and regulatory policies, procedures, regulations, and guidelines.

• Adheres to hospital policy on attendance and tardiness, hospital dress code, infection control standards, environmental standards, quality improvement activities, and other pertinent department policies.
• Maintains and promotes confidentiality per hospital policy
• Completes annual hospital mandatory educational requirements.
• Follows North Oaks Health System’s Compliance Program and Federal and State Regulatory guidelines.
• Assist in maintaining inventory. Check for expired items on a monthly basis. Notify manager when numbers are low and need to be replaced. Clean and stock exam rooms as needed.
• Personal responsibility/Integrity/ Financial Responsibility: Each person is responsible for his or her actions, and individually accountable for satisfied patients/customers, confidentiality or patient and hospital information, quality outcomes, efficient operations, and the overall success of North Oaks Health System.
• Other tasks as necessary in the service line.
• Schedule hospital tests and procedures as directed by a provider. Ensure procedures meet medical justification, if applicable, or have an ABN signed. Coordinate referrals, hospital procedure testing, and admissions with appropriate personnel as required.
• Assist in authorization of cardiology procedures.
• Prepping patients prior to day of procedures, which may include instructions on NPO, holding medications, etc.

Device Role:

1. Acquires a complete working knowledge of cardiology electronic implantable devices and various manufacturers used within our services.

2. Demonstrates autonomous direct cardiac rhythm management care for patients with CIEDs by integrating knowledge from physiology, pathophysiology, and the basics of analysis of device function for in person evaluations and remote monitoring.

3. Recognizes abnormal functions of pacemakers, ICDs, Implantable Loop Recorders (ILRs), and Cardiac Resynchronization Therapy (CRT) devices trough in-person evaluation and remote monitoring. Employs strategies to address and correct issues.

4. Utilizes critical thinking skills and knowledge of electrophysiology concepts to safely and autonomously program device parameters to optimize system function, ensure patient device timing cycles, and support the electrophysiological needs of the patient.

• Perform in office interrogation of pacemakers, ICDs, implantable loop recorders, and other cardiac devices. This will entail complete assessment and programming of the device to include function of leads, any arrhythmias and troubleshooting as issues arise. Accurately identifies heart rhythms including cardiac arrhythmias. Provides appropriate triage and immediate communication of life-threatening and other critical arrhythmias to provider. Provides guidance and support to the patient and family in critical instances.
• Assessment of post device implant wound checks.

7. Conduct interviews with patients, family, and other health care agencies to obtain past medical records and social and medical history to assess their understanding of the plan of care regarding cardiac monitoring devices.

8. Manage remote interrogations daily for alerts and other transmissions, and contacts patients when necessary.

9. Problem solves device function, settings, arrhythmia episodes, and interventions. Collaborate closely with cardiologists, electrophysiology team, and other multidisciplinary teams, ensuring quality CIED and medical follow up care.

10. Analyze clinical data and compose written CIED management summaries, clinic visit notes, and letters.

11. Communicate and problem solve with multidisciplinary team to solve complex patient care issues and CIED function.

12. Educate patient and family regarding all aspects of disease management and diagnostic and device management follow up.

13. Proactively review patient schedules to ensure efficiency in clinical workflows and identify and resolve potential conflicts.

14. Educate patient and family on signs and symptoms that require a follow up telephone call or triage RN or MD Clinic visit as well as education for patient and families regarding cardiac disease, meds, device function and remote monitoring.

15. Assist with accurate data collection and analysis to support Device Clinic charting platform, national registries, process improvement, and quality initiatives.

16. Assessment of post device implant wound checks. Facilitate device remote equipment maintenance as needed.

17. Assist with aseptic and sterile dressing application.

18. Work with leadership to create and optimize new technology within the program and to develop protocols.

AMC Clinic Role:

1. Follow AMC policy for assessment guidelines.

2. Knowledge of the normal physiological process of homeostasis and thrombosis and the etiology, risk factors and clinical manifestations of pathologic thrombus formation.

3. Knowledge of the pharmacological properties of antithrombotic drugs.

4. Knowledge, skills, and ability necessary to manage and monitor patients receiving antithrombotic therapies. This includes assessment of efficacy and potential toxicity, achievement of therapeutic goals and evaluation of patient-related-variables that affect therapy management.

5. Ability to describe the expected impact of and identify the medications, disease states, dietary and lifestyle changes that alter anticoagulation therapy.

6. Ability to interpret INR and related laboratory values and adjust warfarin/Coumadin dose accordingly.

7. Perform venipuncture for INR testing.

8. Interpret INR results for dose adjustment, if necessary, and scheduling future visits. Dosage adjustment will follow established protocol guidelines.

9. Triage for complications of anticoagulation or other clinical problems, and appropriate tests, consultation, and referrals made for any problems encountered. Assess for bleeding (gingival bleeding, epistaxis, ecchymosis, hematuria, melena, blood per rectum, etc.) and thromboembolic complications (SOB, pain/swelling of extremity, numbness, tingling, headache, etc.).

Assess for signs and symptoms of drug intolerance (nausea/vomiting, diarrhea, rash, skin necrosis, etc.).

10. Responsible for following the Patient Inclusion/Exclusion protocol.

11. Responsible for following the eligibility criteria for admission into the AMC.

12. Facilitate continuity of care for patients during brief interruptions to therapy.

13. Provide in-depth patient/family education on anticoagulation therapy.

Heart Failure Clinic Role:

1. Obtain vitals to assess patients heart failure status

2. Communicate with provider the patient’s heart failure status based on patient presentation.

3. Assist provider in adjusting medications per orders given.

4. Perform IV therapy for patients in acute heart failure under direction of provider.

5. Monitor patients once receiving intervention for recommended time based on guidelines.

6. Assess inpatient and emergency department patient list twice daily to identify heart failure patients.

7. Provide education and resources for patients to prevent return or readmission for heart failure exacerbation.

8. Remote monitoring of patients who are able to be medically managed with implantable devices.

9. Follow up to all heart failure group patients monthly via group support or educational meetings.

Quality & Safety:

1. Demonstrates a commitment to quality, safety, and customer satisfaction in all aspects of the job.

• Assists team members in quality efforts in the objectives of the organization (services that are free from error, efficient, connected to the customer, and well planned).
• Recognizes emergency situations and administers first aid or CPR as needed.
• Ability to listen to complaints and offer apologies and/or resolutions or manages up to manager/director when appropriate.
• Perform daily quality control and clinic checklist functions as assigned.

Teamwork, Leadership, and Interpersonal Skills:

• Performs effectively as a team member by promoting leadership, teamwork, and professionalism within the organization by action and example. Assist providers and other staff members, as needed.
• Develops interdisciplinary relationships that foster positive atmosphere, effective planning, teamwork, mutual respect, collaboration, and integration of services with other departments and providers for coordinated provision of services and/or support of patient care.
• Trains new and current employees, students, and/or volunteers by discussion and demonstration.
• Communicate effectively using both written and oral expression by relaying ideas clearly, actively listening and always following appropriate channel of communication.
• Demonstrate responsiveness to others ensuring a complete follow-up on matters requiring additional attention.
• Serves on committees as requested.