Transport Registered Nurse (RN), Maryland Express Care, $15K Sign On-Bonus

University of Maryland Medical Center Baltimore Washington•Baltimore, MD

43d•$37 - $54

About The Position

The Maryland ExpressCare (MEC) Transport Nurse Specialist (TNS) is a Registered Nurse with an expanded scope of practice who provides high acuity critical care and emergency ground/surface transportation for the following patient populations; Stroke, STEMI, trauma, medical, surgical, cardiac, neurologic, high-risk obstetrics, neonatal, and pediatric transport emergencies. TNS works with physician medical directors and consultants to provide high acuity medical therapies and interventions. The TNS functions under the authority of (1) MEC clinical guidelines, (2) Maryland Institute for Emergency Medical Services Systems (MIEMSS) protocols when appropriate, and (3) Maryland Board of Nursing. The TNS works closely with healthcare providers at sending and receiving facilities to articulate and implement a comprehensive patient centered medical transport plan. Finally, the TNS provides care to patients across the life span, and appropriate age based clinical care.

Requirements

Graduation from an accredited school of nursing. BSN Preferred
Licensure as a Registered Nurse in the state of Maryland, or eligible to practice due to Compact state agreements outlined through the MD Board of Nursing, is required.
Minimum three years of relevant clinical work experience in critical care or academic emergency department with ICU skill set experience
Active and valid certifications required in the following certifications required: A. Basic Cardiac Life Support (BCLS) B. Advanced Cardiac Life Support (ACLS)
Maintenance of 10 contact hours of education/year.
Member of a professional organization.
Critical Care Nurse Certification (CCRN) is required or must be obtained within one year of employment. Management may grant a six-month extension for special circumstances.
Didactic and High-fidelity Simulation Training is required in an effort to maintain the TNS's scope of practice and the patient population served. The frequency of the simulation training will be at the discretion of the nurse manager and medical director.
Required training includes but are not limited to: rapid sequence intubation (RSI), advanced mechanical ventilation and adjustment of vent settings to meet patient needs, high risk obstetrics, trauma, proned patient transports, Intra-Aortic Balloon Pump (IABP), extracorporeal membrane oxygenation (ECMO), invasive hemodynamic monitoring, Cardiac assist devices (VADs), and Intracranial Pressure (ICP) monitoring.
Advanced Airway High Fidelity Simulation and Skills Lab, which includes didactic and skills completion in Cadaver Lab, held at UM School of Medicine for intubation, surgical and needle cricothyrotomy, needle decompression, finger and tube thoracotomy and other resuscitation-based skills. Maintenance of 15 contact hours of education/year.
Competency Validations specific to MEC
Demonstrates and documents highly effective interpersonal and verbal and written communication skills.
Demonstrates competency in the following skills, bi-annually: endotracheal intubation, needle and surgical cricothyrotomy, needle chest decompression, finger and tube thoracotomy, intraosseous insertion
Demonstrates ability to act in a clinical leadership role.
Demonstrates ability to promote professionalism through acts such as involvement in professional organizations, teaching, research, publishing, and/or certification in area of specialty.
Demonstrates ability to lead others, such as effectiveness as MEC charge, preceptor, or clinical resource.
Demonstrates effectiveness as a multidisciplinary team member.
Ability to learn and use computer systems in order to manage patient information.
Ability to demonstrate knowledge and skills necessary to provide care appropriate to the patient population(s) served. Ability to demonstrate knowledge of the principles of growth and development over the life span and ability to assess data reflective of the patient's requirements relative to his or her population-specific and age specific needs.

Nice To Haves

Pediatric Advanced Life Support (PALS) must be completed within 3 months of hire
Critical Care Nurse Certification (CCRN) required within one year of employment
Certified Flight Registered Nurse Certification (CFRN), or Certified Transport Registered Nurse (CTRN) required within 18-24 months of employment
NRP (Neonatal Resuscitation Program) must be completed within 3 months of hire
Annual Maryland Institute for Emergency Medical Services Systems (MIEMSS) Protocol Updates
Annual Infection Control, Fire Safety, FEMA (Federal Agency Management Agency Training), and Novel Pathogen training
Annual Employee Health requirements

Responsibilities

Competent in care of patients across the life span; independently practices with solid critical care clinical knowledge and skills
Independent learner, who is engaged in advancing their own transport clinical practice and knowledge. Implement evidence-based practice as part of daily work.
Independently provides, directs and coordinates clinical care within the critical care transport environment. Is accountable for the processes and outcomes of care delivered to patients.
Conducts comprehensive patient assessment, integrating multiple data sources, which forms the basis for identification of patient/family needs and problems.
Implements MEC clinical guidelines based on synthesis of clinical information and patient care needs during transport.
Independently identifies need for escalation of patient care activities, and escalates appropriately
Ability to work in a non-traditional clinical care setting (i.e. ambulance) and is able to implement effective care with the limited resources available.
Escalates clinical concerns to MEC medical direction
Observes patients in a systematic way for both overt and covert clinical signs and symptoms.
Assess patient's needs throughout transport process, and implements a patient specific plan of care to address noted needs
Facilitates effective and efficient patient transfer between referring and receiving institutions.
Works effectively with the University of Maryland Access Center & multidisciplinary teams at both sending and receiving create and implement patient's plan of care
Under orders from the base station attending physician and/or established MEC medical guidelines, initiates immediate life support therapies including but not limited to parenteral administration of approved medications; intravenous/intraosseous therapies with and without ultrasound; arterial line placement under ultrasound; EKG monitoring; arrhythmia interpretation; CPR; defibrillation; external cardiac pacing; airway management; endotracheal intubation; cricothyrotomy (needle or surgical); ventilator operation; needle chest decompression; thoracostomy (finger or tube), high acuity transports with advanced life-sustaining equipment, including but not limited to management of patients with Extracorporeal Membrane Oxygenation (ECMO) and Intra-Aortic Balloon Pumps (IABP); altered neurological status; including cervical spine immobilization; application of splints and devices needed for transport.
Consistently gives a comprehensive report to medical team that reflect patient's status during transport, which accurately reflect patient status to other team members.
Utilizes available resources within and outside the institution for the purpose of providing comprehensive care to patients and families.
Evaluates and revises individualized plan of care appropriately reflecting current and changing status of the patient and/or family.
Continuously assesses, monitors, intervenes, and stabilizes critically ill patients during transport and offers additional or alternate plans of care as needed.
Uses chart review sessions as a forum for patient care evaluation and learning.
Maintains transport unit in a state of readiness; maintains a safe transport environment by ensuring that all equipment is secured and that the ambulance systems are operationally safe, per MIEMSS requirements and safety regulations
Serves as Clinical Resource for others
Functions effectively in roles specific to practice setting/service
Responds emergently to scenes as part of the R Adams Cowley Shock Trauma Center's Go Team- to provide care to critically ill patients at scene, who are unable to be transported secondary to extenuating circumstances.
Active participant in MEC Clinical Practice governance activities
Assists in team developing/evaluating clinical protocols and intrahospital critical care models and suggesting methods for improvement
Develops patient education materials and overall process for practice setting-based patient education
Assists in the development of clinical practice protocols and standards for practice setting
Responsible for maintaining competencies required for the patient care setting; focus on advancing own professional development
Attends required educational offerings and in-services independently
Serves as preceptor, coach, mentor to new nurses, paramedics, students and students to the transport role
Contributes to ancillary personnel skills and development
Serves as expert resource in the delivery of clinical care to patients.
Keeps self current with regard to the following mandatory trainings and/or certifications as listed under job requirements.
Active participant in practice setting based Professional Development governance activities
Contributes to practice setting-based education and learning activities (2/year that could be posters, storyboards, presentation, in-service, group project)
Assists with developing/evaluating practice setting-based orientation program
Serves as Super-user or assists in competency validation
Provides health-related contributions through community services, such as health fairs, and participates in public relation activities
Models customer service behaviors; supports "Best Practices" for customer service; learning service recovery skills
Participates in implementation efforts addressing Nursing Sensitive Quality Indicators (NSQI) , as applicable, and other clinical quality indicators related to transport
Participates in practice setting-based Process Improvement (PI) efforts; assists in development of action plans and supports implementation
Participates in some or all elements of research
Active participant in practice setting-based Process Improvement governance activities
Participates in practice setting-based research activities and/or research council or team
Assists with readiness for MIEMSS and other regulatory bodies
In collaboration with MEC Management, participates in day-to-day practice setting management, including staffing, scheduling, incorporation of professional practice activities, multidisciplinary collaboration, quality performance and improvement monitoring, and staff development.
Performs charge role for assigned shifts as needed; supports MEC charge's decisions
Participates in teambuilding efforts on practice settings; supports and models effective teamwork
Fully participates in practice setting level governance
Accountable for compliance with regulatory requirements and holds others accountable
Participates and supports the AACN guidelines for Healthy Work Environment (communication, collaboration, effective decision making, recognition, leadership, staffing)
Runs charge on more consistent basis (in areas without permanent charge nurse role).
Participates in practice setting-based Reward and Recognition activities.
Leads efforts that support practice setting operations such as equipment maintenance, scheduling, etc.
Orients MEC team members to practice setting level governance structure and councils.
Contributes to development of practice setting-based peer review processes; actively participates in individual peer review feedback.
Identifies areas impacting practice setting operations and assists in developing/implementing action plans.
Participates as member of a team focusing on elements within the Healthy Work Environment.
Ensures patient safety in the performance of job functions and through participation in hospital, department or practice setting patient safety initiatives.
Follows MEC's policies and procedures which reference Patient Securing Guidelines while in transport with MEC
Remain patient safety focused on all times while performing critical care to patients in a moving vehicle during transport.
Takes action to correct observed risks to patient safety.
Reports adverse events and near misses to appropriate management authority.
Identifies possible risks in processes, procedures, devices and communicates the same to those in charge.