Status:  Full Time

Shift:     M-F, 8a-5p

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) and Loop Recorder interrogation and reprogramming. The nurse provides direct nursing care to young adult 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 assessments according to practice standards. Identifies and prioritizes patient and family needs. Develops, implements and evaluates the nursing plan of care, and modifies plan to meet clinical outcomes. Requires autonomy and critical thinking skills. Responsible for patient care limited to scope of practice established by the LSBN.

Other information:

A. Experience, Knowledge and Skill

a. 1-3 year’s previous nurse experience preferred, preferably in a clinic setting.

b. Cardiology experience (especially device experience) strongly desired.

c. Must be a graduate of an accredited nursing school, and be currently licensed by the Louisiana State Board of Nursing and maintain licensure.

d. Certifications such as Certified Cardiac Remote Monitoring Specialist and/or Certified Cardiac Device Specialist preferred. Those who complete this additional certification are eligible for one additional pay grade.

B. Physical Effort Required:

Strength: Medium Push: Occasionally Pull: Occasionally

Carry: Frequently Lift: Occasionally Sit: Occasionally

Stand: Frequently Walk: Frequently

Responsibilities:

GMission Enhancement: Demonstrates behaviors that reflect understanding and support of the organizational values and mission.

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

Competency & Job Knowledge: Acquires, maintains, and shares current competencies in performance of job responsibilities.

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

b. 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.

3. Call in medication refills and return calls in response to patient’s messages.
4. Independently perform routine nursing duties including phlebotomy, EKG, medication administration, measurement of vital signs, preparation of lab specimens, starting IVs, etc.
5. Document all assessments, interventions, phone conversations, etc. in the patient medical record as appropriate. Ensure that all documentation is clear, complete and legible.
6. Manage urgent/emergent medical situations as appropriate and in accordance with the organizations protocols for medical emergencies and cardiac arrests. Obtain and/or operate emergency equipment according to relevant standards.
7. Schedule hospital tests 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.
8. Call patients regarding test results as directed by a provider.
9. Assist in the retrieval, logging and stocking of medications.
10. Complete required forms, including workers’ compensation, laboratory reference forms, FMLA, Return to Work/School.
11. Assist with cleaning the patient treatment area and used equipment after the patient visit is completed to comply with infection prevention requirements.

l. Participates in appropriate education and on-the-job learning situations in order to develop necessary job skills.

m. Completes necessary continuing education to maintain licensure.

n. Demonstrates the ability to perform multiple tasks as required.

15. Assists in the movement of patients, as necessary.
16. Procedure Expertise:
17. 1. Coordination of scheduling patients for Cardiology Cath Lab Procedures
    2. Assist in authorization of cardiology procedures
    3. Cath Lab education for patients
    4. Prepping patients prior to day of cath lab procedure, which may include instructions on NPO, holding medications, etc.

q. Device Role:

a. Acquires a complete working knowledge of cardiology implantable devices used within our services.

b. Performs visual inspection of equipment, identifies problems, and communicates to appropriate parties for attention.

17. 3. Perform in office interrogation of pacemakers, ICDs, and implantable loop recorders. This will entail complete assessment and programming of the device to include function of leads, any arrhythmias and troubleshooting as issues arises. This position is responsible for initial device analysis and preliminary report generation, as well as alerting practitioners to urgent issues requiring further actions.
    4. Assessment of post device implant wound checks.
    5. Manage remote interrogations daily for alerts and other transmissions, and contacts patients when necessary.
    6. Provide education for patient and families regarding cardiac disease, meds, device function and remote monitoring. Use return demonstration methods when necessary.
    7. Facilitate device remote equipment maintenance as needed.

h. Assist with aseptic and sterile dressing application.

18. AMC Clinic Role:
19. 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.
20. Heart Failure Clinic Role:
21. 1. Obtain vitals to assess patients heart failure status
    2. Communicate with provider 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 patient to prevent return or readmission for heart failure exacerbation.
    8. Remote monitoring of patients who are able to be medically managed with implantable device.
    9. Follow up to all heart failure group patients monthly via group support or educational meetings.

Quality & Safety: Demonstrates a commitment to quality, safety and customer satisfaction in all aspects of the job.

1. 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).
2. Recognizes emergency situations and administers first aid or CPR as needed.
3. Ability to listen to complaints and offer apologies and/or resolutions or manages up to manager/director when appropriate.
4. Perform daily quality control and clinic checklist functions as assigned.

Teamwork, Leadership and Interpersonal Skills: Performs effectively as a team member. Maintains a positive attitude, treats co-workers, patients, and visitors, with respect and dignity. Leads by Example.

1. Promotes leadership, teamwork, and professionalism within the organization by action and example.
2. Develops interdisciplinary relationships that foster 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.
3. Trains new and current employees, students, and/or volunteers by discussion and demonstration.
4. Communicate effectively by expressing ideas clearly, actively listening and always following appropriate channel of communication. Ability to identify and use appropriate information routes - may include written and oral expression.
5. Demonstrate responsiveness to others ensuring a complete follow up on matters requiring additional attention.
6. Serves on committees as requested.
7. Assist providers and other staff members, as needed.

Policies & Procedures: Demonstrates knowledge of and compliance with established organizational, departmental, and regulatory policies, procedures, regulations, and guidelines.

1. Adheres to hospital policy on: attendance and tardiness, hospital dress code, infection control standards, environmental standards, quality improvement activities, and other pertinent department policies.
2. Maintains and promotes confidentiality per hospital policy
3. Completes annual hospital mandatory educational requirements.
4. Follows North Oaks Health System’s Compliance Program and Federal and State Regulatory guidelines.
5. Consistently attend staff meetings.
6. Report all incidents, injuries, medication errors, etc. Report to supervisor/director as indicated.
7. Assist clinic leaders in maintenance of policies and procedures as designated.
8. 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.
9. 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.