RN/RPN, Electroconvulsive Therapy Treatment (ECT) Program - Royal Columbian Hospital

Fraser Health•New Westminster, BC

3d•Onsite

About The Position

In accordance with the British Columbia College of Nurses and Midwives (BCCNM) standards of practice and the Mission and Values of Fraser Health, and working collaboratively and in partnership with the interprofessional care team in the provision of person-centered and recovery oriented care, provides and coordinates the delivery of Electroconvulsive Therapy to patients, including the following: ensures completion of ECT treatment booking and pre-ECT anaesthetic consults prior to treatment; assists in the ECT procedure as directed; clinically assesses pre and post ECT patients; documents the ECT treatment and outcomes; coordinates transfer of care back to assigned nurse on return to the IPU. Demonstrates nursing expertise and provides clinical leadership in evidence-based practices through direct care activities including nursing assessments, crisis intervention, patient and family education and health promotion activities. Sets priorities and assigns and delegates tasks to support staff. Maintains regular communication with Regional ECT Coordinator and ECT Medical Director as needed.

Requirements

Graduation from an approved School of Nursing with current practicing registration as a Registered Nurse / Registered Psychiatric Nurse with the British Columbia College of Nurses and Midwives (BCCNM).
Two years recent, related experience in psychiatry and one year recent related experience in the use of ECT, or an equivalent combination of education, training and experience.
Applied knowledge of MHSU client assessment and appropriate / prescribed technical, therapeutic, safety and crisis interventions.
Demonstrated knowledge of mental illness and substance use disorders and their treatments.
Demonstrated knowledge of psychopharmacology indications and side-effects.
Demonstrated ability in de-escalation techniques and management of acute behavioural and psychiatric emergencies.
Demonstrated ability in counselling and interview techniques.
Knowledge of legislation and government policies and procedures that relate to mental health and substance use practices.
Ability to communicate effectively verbally and in writing with clients, families/caregivers, the public, medical staff and members of the interprofessional care team.
Ability to promote person-centered care and empathize with clients/families/care givers, demonstrate sensitivity to diverse cultures and preferences, and advocacy for special populations.
Ability to effectively educate clients and families/care givers about ECT and other topics essential to their health care and well-being.
Ability to be self-directed and act in an independent manner.
Ability to organize and prioritize work.
Ability to collaborate with and promote cooperation among members of the interprofessional care team.
Ability to apply relevant research-based evidence/evidence-informed practice and knowledge of basic principles and procedures to support nursing decisions and actions.
Ability to set up and/or operate related equipment including relevant computer applications.
Physical ability to perform the duties of the position.

Responsibilities

Participates and assists in the clinical assessment of pre and post ECT patients by assessing and evaluating in accordance with the current Standards of Professional Practice, in alignment with regional practices, and in collaboration with other members of the health care team.
Reviews new ECT referrals to ensure they are complete and accompanied by supporting collateral information such as history, cognitive tests, list of current medications/MAR, follow-up home care, and previous ECT treatment records. Ensures coordination of scheduling and booking of all ECT treatments.
Facilitates ECT consultation with/referral to an ECT Psychiatrist as needed, arranges pre-ECT anesthesiology consults and other requested consultations, and ensures appropriate investigations regarding items such as lab work, x-ray and ECG are arranged and completed by communicating with the patient, family, and care team.
Liaises with case managers and psychiatrists of outpatients to obtain orders and consents for treatment as required.
Verifies transportation has been arranged for inpatients to and from ECT treatments.
Conducts assessments including standardized rating scales to assess patient's symptom severity and cognitive status throughout the ECT course, and pre- and post-treatment nursing assessments, communicating results to the patient's treatment team and ECT Psychiatrist as applicable.
Provides education and support to patients and their families regarding information such as the nature of ECT treatment, overview of the typical patient experience and navigation of logistical issues; responds to questions or consults with the ECT psychiatrist as appropriate to address concerns. Acts as an advocate to protect and promote the patients'' rights to autonomy, respect, privacy, dignity and access to information.
Conducts and completes pre-ECT nursing checklists, including ensuring serviceable ECT device, components and adequate supplies, and ensuring appropriate patient documentation accompanies the patient to the treatment area. Liaises with biomedical engineering or supplies services as needed when problems are identified, and brings any issues of concern to the attention of the ECT Psychiatrist.
Prepares the patient by providing services such as offering emotional support and information prior to each treatment, performing skin preparation for EEG and electrode sites, and connecting EEG leads to patient.
Participates in the ECT treatment session by providing direct or indirect nursing assistance to other members of the interdisciplinary health care team during the ECT procedure.
Identifies and helps in the management of any difficulties the patient experiences immediately post-treatment such as delayed emergence from anesthetic, confusion, or agitation; assists in re-orienting patients and communicates post-ECT difficulties to the ECT Psychiatrist and/or attending physician.
Provides patient status and treatment report when the patient is fully recovered and ready for transfer to inpatient nursing staff, outpatient family or responsible adult, as applicable. Advises relevant care team members on issues arising such as from ECT treatments, the patient's inpatient/outpatient care, or on questions regarding pre- or post-ECT nursing care and assessments. Suggests modifications to the patient's care plan as appropriate.
Participates in development of patient education materials, orientation and training activities to support the continuous development of ECT Nursing expertise. Identifies self-learning needs and attends educational programs to maintain and enhance clinical competency.
Liaises and coordinates with clinical suppliers and Purchasing regarding orders and maintenance of ECT supplies, as required.
Maintains a safe environment for patients and staff by adhering to established safety and emergency practices and procedures.
Participates in continuous quality improvement, research, and program evaluation activities to support alignment of care delivery with regional practices and standards by methods such as contributing to Fraser Health task groups and committees as required regarding ECT, and through regular communications and meetings with the Regional ECT Coordinator and ECT Medical Director.
Shares information in a timely manner to ensure nursing and other health care staff follow ECT standards of care for patient preparation for treatment and patient monitoring after treatment.
Participates in the development and evaluation of the standards and protocols for the ECT program in collaboration with the Regional ECT Coordinator, as required. Assists in maintenance of program-based clinical protocols and procedures, and collection and maintenance of records required for Program reviews. Shares professional knowledge through collegial sharing of information or through formal in-services, for example.
Performs other related duties as assigned.