Registered Nurse 2 (E S WSNA)Registered Nurse 2 (E S WSNA) Within the CARDIOLOGY CLINIC we provide clinic support, telephone triage, and coordination of care services to patients with coronary artery disease, valvular heart disease, heart failure, and cardiac arrhythmias. Our Cardiac Services are the regional leaders in cardiology for the WAMI (Washington, Alaska, Montana, Idaho) region. We are the only cardiac transplant facility in the Pudget Sound area. As a teaching hospital and research center, we're deeply committed to the enhancement of care for our patients-as well as the professional growth of our staff. As a testament to this commitment, we're proud to be recognized with Magnet Hospital status by the American Nurses Credentialing Center. In fact, we were the first hospital to receive this designation, and we continue to be the only hospital in the region with such status. We're also consistently named one of the nation's best hospitals, #10 in 2008, as reported by U.S. News and World Report. Such national recognition attests to our commitment to high-quality care, and to the outstanding professionalism and skill that exists at UWMC. As a registered nurse (RN), you can be a part of this highly skilled team, working within a culture that is both innovative and collaborative. Here, you will work in tandem with physicians and other health care practitioners to provide superior, award-winning nursing care. In short, you will not only follow best practice, you will create it! Job Description: Expert Practice
Utilizes and demonstrates understanding of Heart Transplant Protocol as guidefor patient care, monitoring, problem identification and follow-up planning.
Demonstrates ability to maintain work flow and complete work utilizingprioritization, time management and critical thinking skills.
Prioritizes patient care based on acuity/urgency of patient needs, preference, choices and available resources.
Demonstrates knowledge of principles of growth and development over the life span and the skills necessary to provide age appropriate care to the post heart transplant patients. Able to interpret data about the patient's status in order to identify each patient's age specific needs and provide care needed by the patient group.
Demonstrates understanding of immune system function and impact of immunosuppressive medications.
Demonstrates understanding of immunosuppressive medications (Cyclosporine, Tacrolimus, Prednisone, Mycophenolate mofetil, Azathioprine, & Sirolimus) and describe action, side effects, dosing, adverse reactions, drug interactions, monitoring.
Demonstrates understanding and appropriate utilization of UWMC HeartTransplant Protocol for medication management implementation of protocolguidelines when reviewing labs and medications(i.e., Prednisone taper, CMV monitoring/treatment).
Demonstrates understanding of acute rejection, incidence, risk factorsand treatment.
Demonstrates understanding of chronic rejection, incidence, risk factorsand treatment.
CMV: Demonstrates understanding of pathophysiology, clinical symptoms,monitoring, diagnosis and treatment protocols.
Aspergillus: Demonstrates understanding of pathophysiology, clinical symptoms,monitoring, diagnosis and treatment protocols.Nursing Process – Systematically assesses the need for and the delivery of nursing services that meet patient care requirements, whether delivered directly or by the other nursing staff.
Ability to perform a systematic assessment on post heart transplant population.
Ability to adequately assess and reassess pain. Develops appropriate plans for pain management.
Meets documentation standards and policies, including UNOS.
Perform and document patient assessment including review of systems and medications to identify patient concerns, physiologic and/or psychosocial issues, complications, learning needs.
Incorporate recent inpatient data into assessment and plan.
Review clinical information and assessment findings with patient's cardiologist.
Review diagnostic studies with patient's cardiologist within a clinically appropriate timeframe, including indentification of abnormaland significant findings.
Participate in developing action plan and follow-up steps to address issues identified.
Review drug levels and laboratory results, identify significant abnormalitiesand/or changes and communicate within an appropriate timeframe with patient'scardiologist.
Develop and implement plan with cardiologist for medication adjustmentsand changes in other therapies and follow-up monitoring(labs, BP readings, glucose monitoring, etc).
Provides and maintains comprehensive documentation of patient's progressand education per UWMC Policy and Procedures, i.e, ORCA note.
Complete medication reconcilation.
Complete FOB after completion of patient visit.
Accurately record patient data onto heart transplant flowsheet.
Reviews and completes TIEDI forms initiated by Program Coordinator
Assists with collating required data for program inquiries.Patient Care Coordination:
Completes requests for pharmacy refills accurately according to patient's current medication list.
Document medication refills per protocol.
Review refills with physician.
Facilitate referral to other transplant team members or UW providers if indicated (i.e., diabetes care center, social work, financial counseling).
Communicate scheduling needs to Program Coordinator or PSR.
Maintains communication with referring physician(s) and other health care providers.
Collaborates with nursing staff, social workers, nutritionists, respiratory therapists, pharmacists and other health team members to establish and implement patient care plan according to current standards of care.
Coordinate urgent procedures or admission.
Treats patients and their families with respect and dignity. Identifies and addresses psychological,cultural, ethnic and religious/spiritual needs ofpatients and their families. Functions as liason between administration, patients,physicians and other healthcare providers.
Interacts professionally with patient/family and involves patient/family in theformation of the plan of care.Telephone Communications
Conducts phone triage with patients including comprehensive review of symptoms, medications and psychosocial factors affecting patient.
Utilizes understanding of heart transplant physiology and complications to guide interview questions.
Communicates patient situation with physician with clear, complete details in a timely fashion.
Participates in developing plan with physician.
Implements plan including appropriate calls to patient, caregivers, pharmacy, home infusion, admitting, social work, etc.
Provides and maintains comprehensive documentation of patient's progress and education per UWMC Policy and Procedures, i.e. ORCA note.
Communicates with other team members regarding patient situation and follow-up plan..
Utilizes and demonstrates understanding of Heart Transplant Protocol as guide for patient care, monitoring, problem identification and follow-up planning.
Consistently follows policies and procedures for providing telephone medicaladvice.Client Teaching
Utilizes patient and family teaching materials including: Heart Transplant Patient Manual.
Provide patient and/or family teaching during post heart transplant phase including: Post operative f/u (wounded care, bowel function, activity level, safety, cough/deep breathing), Medication, Signs/symptoms of rejection and infection, Home monitoring, Diabetes monitoring, Activity, Diet, Frequency of f/u visits and lab studies, Reporting abnormalities to Tx center and Explanation of procedures.
Identify education needs and create plan to address patient's individual needs.
Communicate all adjustments and follow-up monitoring plans to patients and/or family members
Founded in 1861, the University of Washington is one of the oldest public institutions in the west coast and one of the preeminent research universities in the world. The University of Washington is a multi-campus university comprised of three different campuses: Seattle, Tacoma, and Bothell. The Seattle campus is made up of sixteen schools and colleges that serve students ranging from an undergraduate level to a doctoral level. The university is home to world-class libraries, arts, music, drama, and sports, as well as the highest quality medical care in Washington State and a world-class academic medical center. The teaching and research of the University’s many professional schools provide undergraduate and graduate students the education necessary toward achieving an excellence that will serve the state, the region, and the nation. As part of a large and diverse community, the University of Washington serves more students than any other institution in the Northwest.