The Children's Hospital of Philadelphia
Philadelphia, PA, USA
The Progressive Care Unit is a unit within the critical care complex that cares for trach dependent patients. Most patients also require mechanical ventilation. The Clinical Nurse practices at the level of an advanced beginner to expert practitioner of professional nursing in accordance with, and guided by the CHOP Nursing Professional Practice Model. The nurse at this level demonstrates competence in caring for patients and families and progresses to caring for those with the most complex problems/highest acuity in the designated clinical area. Provides age/developmentally appropriate care. Care is delivered through RN leadership for patient care within the framework of family-centered care.
The Clinical Nurse adheres to the organizational and nursing department mission, vision, and values. S/he practices in accordance with the ANA Code of Ethics; the ANA Standards of Clinical Nursing Practice; practice standards of applicable specialty nursing organizations; and CHOP developed standards of nursing practice. The professional nurse practices within the defined scope of practice designated by the Nurse Practice Acts of Pennsylvania and/or New Jersey, depending on the assigned work site. This posting will fill multiple positions.
Follows the nursing process to deliver safe, compassionate, and culturally effective care.
Gathers and recognizes/synthesizes assessment data to determine the patient/family plan of care, pertinent data to be shared with care team, and tasks to be delegated.
Recognizes and/or seeks resources to recognize clinical changes that are indicative of patient deterioration; utilizes the CAT team when appropriate.
Collaborates with the patient, family and multidisciplinary team to coordinate all facets of patient care.
Develops, implements and/or revises the patient’s plan of care on admission and during the course of the hospitalization. Plans of care are outcomes focused and include goals as well as required interventions. Plans are developed in partnership with the patient, family, and the interdisciplinary care team.
Care is coordinated across the continuum – understands and utilizes case management resources.
Consistently follows evidence based practice bundles and nursing standards/procedures to provide nursing care that eliminates preventable events of patient harm and promotes excellent patient outcomes.
Recognizes and addresses situations which present ethical dilemmas and/or moral distress. Takes steps to actively address the situation. Seeks resources as needed to resolve the situation.
Demonstrates competence in teaching patients/families and progresses to an expert educator of patients/families.
Evaluates and documents the care provided on each assigned shift.
Accountable for the rapid adoption and implementation of clinical practice changes into own practice.
Documents the evaluation of nursing interventions and outcomes of nursing care utilizing hospital standards, policies and procedures.
Consistently follows safe hand-off practices as defined in patient care standards and procedures.
Utilizes and exemplifies safety behaviors for error prevention. Identifies potential safety concerns and communicates with unit leadership as appropriate. Enters safety nets when applicable, including good catch/near miss situations.
Effective verbal and nonverbal communication techniques and good listening skills are used to empathically communicate with patients/ families, and colleagues.
Encourages patient/family self-advocacy.
Job Responsibilities (Continued)
Demonstrates effective teamwork as a member of the interdisciplinary care team, fostering and exemplifying a culture of respect. Recognizes/addresses situations where disrespectful collaboration may impact patient care and/or create non-collaborative relationships. Seeks resources as needed to resolve situations involving incivility and/or disrespect.
Actively participates in interdisciplinary patient care rounds and/or meetings and makes recommendations to the plan of care that reflect nursing goals, interventions, and expected outcomes. Revises the plan of care according to the patient care decisions made on rounds.
Incorporates evidence based practice into direct clinical care in collaboration with other members of the multidisciplinary team.
Develops and implements effective partnerships with members of the ancillary staff; delegates tasks effectively to assure comprehensive nursing care is provided.
Develops and sustains professional, well- boundary, therapeutic relationships with patients and families in which all actions are in the best interest of the patient and family and there is no personal gain at the patient/families expense.
Models appearance and behaviors that promote a positive image of professional nursing.
Expands clinical judgment and critical thinking skills with increased experience
Demonstrates mastery of the principles of Family Centered Care, including dignity and respect, information sharing, participation, and collaboration.
Demonstrates understanding of optimal patient/family experiences and incorporates into care delivery. Has a working knowledge of patient/family experience results (NRC Picker) at the unit and organizational level. Participates and/or leads in initiatives to improve satisfaction scores.
Practices within a shared decision making environment. Familiar with and participates in Shared Governance council activities at the unit and/or department level. Progresses to leading council activities at the unit and/or department levels.
Familiar with Magnet designation and the Magnet Model of transformational leadership, structural empowerment, exemplary professional practice, new knowledge and innovations, and empirical outcomes. Participates in ongoing designation activities such as serving as a unit based Magnet champion.
Demonstrates fiscal stewardship:
Manages own time to accomplish direct/indirect care in a cost-effective manner
Conserves unit and organizational resources; assures supplies are not wasted or misused.
Does not incur incidental overtime.
Understands the implications of the cost of staffing decisions.
Identifies observed opportunities for cost savings.
Job Responsibilities (Continued)
Well informed about the Professional Advancement Program (PEAK) and considers the opportunity to participate.
Demonstrates healthcare informatics competency to manage patient care, outcome data, and current and emerging healthcare technology.
Understands nursing sensitive outcomes and knows how to navigate the nursing scorecard. Participates and/or leads improvement initiatives to improve outcomes.
Identifies own learning needs and actively assures learning needs are met.
Seeks out opportunities to meet needs and attends all required programs.
Maintains CEU’s for nursing licensure.
Maintains compliance with mandatory education and annual nursing competencies.
Recognizes individual preferences regarding an environment of constant change and understands change management. Develops effective methods to cope with and incorporate learning from a fast-paced, ever changing environment.
Understands the principles and methodology of quality improvement; progresses to participating in and/or leading QI initiatives at the unit or organizational level.
Understands and contributes to the science of nursing:
Develops a sense of inquiry.
Reads articles pertinent to the patient population.
Performs literature reviews.
Develops clinical questions and advances understanding and application of evidence based practice.
Understands the nursing research process and utilizes resources to participate in research projects.
Participates in activities that contribute to improving the health of the community.
Required Licenses, Certifications, Registrations CPR Certification issued through an organization that requires a hands-on instructor lead psychomotor skills verification (ex. American Heart Association or Red Cross)Registered Nursing License or active Temporary Practice Permit in the Commonwealth of Pennsylvania or State of New Jersey, depending on the assigned work location.If practicing with an active temporary practice permit, obtains an RN license prior to the expiration of the practice permit. Required Education and Experience
According to the CMS (Centers for Medicaid and Medicare Services) a copy of diploma or transcript is required as proof of academic achievement for all non-laboratory personnel performing non-waived POC testing
Required Experience: At least one (1) year of RN experience.
Preferred Education, Experience & Cert/Lic
Preferred Education: BSN
Preferred Experience: Prior experience in pediatrics or area of specialty.
Preferred Licenses/certificates/registrations: Active membership in a professional nursing organization.
Additional Technical Requirements
Basic use of a computer (mouse, keyboard, printer, USB ports).
Basic use of Microsoft Office (Word processing, spreadsheets, presentations and Skype).
Web browsing, intranet search, document access.
Use of shared network file space.
Basic use of patient facing technology (e.g. IV pumps, point of care devices, CR monitors).
Navigation and use of clinical communication systems.
Determines the nature and extent of clinical information needed and uses the appropriate technology to access it.
Accesses needed information effectively and efficiently.
Evaluates information and its sources critically and appropriately incorporates it into clinical practice.
Evaluates outcomes of the use of information.
Information Management Literacy
Navigation of the electronic health record system.
Ability to locate and review specific patient data in various clinical information systems.
Effectively uses clinical decision support tools.
Understands policies and procedures, confidentiality, security, and privacy regulations regarding the use of clinical information systems.
Ability to collect clinical data using quality improvement tools.