Registered Nurse- NICU-NMC PORTSMOUTH

Description

HCW GENERAL DUTIES: Contractor personnel shall perform a full range of duties consistent with their labor category, education, training, experience, clinical privileges(as applicable), and assigned position.

General duties that apply to all personnel or across certain labor categories are given below.

• Maintain a level of productivity comparable with that of other individuals performing similar services.
• Participate in peer review and performance improvement activities.
• Practice aseptic techniques as necessary. Comply with infection control guidelines to include the proper handling, storage, and disposal of infectious wastes, and the use of universal precautions to prevent the spread of infection.
• Function with an awareness and application of safety procedures.
• Perform efficiently in emergency patient situations following established protocols, remaining calm, informing appropriate persons, and documenting events. Anticipate potential problems/emergencies and make appropriate interventions. Notify supervisor, director, or other designated person regarding problems that the HCW is unable to manage.
• Apply an awareness of legal issues in all aspects of patient care and strive to manage situations in a reduced risk manner.
• Participate in the implementation of the Family Advocacy Program as directed. Participation shall include, but not be limited to, appropriate medical examination, documentation, and reporting.
• Exercise awareness and sensitivity to patient/significant others' rights, as identified within the MTF.
• Maintain an awareness of responsibility and accountability for own professional practice.
• Participate in continuing education to meet own professional growth.
• Attend and/or comply with all annual training classes required by the MTF, to include but not limited to online annual training provided by the MTF: disaster training, infection control, Sexual Harassment, Blood-borne Pathogens, Fire and Safety, Chemical, Biological, Radiological, Nuclear and Explosives (CBRNE), MHS Genesis, and all other required training.
• Actively participate in the MTF’s Performance Improvement Program. Participate in meetings to review and evaluate the care provided to patients, identify opportunities to improve the care delivered, and recommend corrective action when problems exist.
• Participate in the provision of in-service training to clinic staff members. Provide training and/or clinical direction as applicable to supporting government employees (e.g., hospital corpsmen, students, etc.).
• Attend and participate in various meetings as directed.
• Perform timely, accurate, and concise documentation of patient care.
• Operate and manipulate automated systems such as ADS, Essentris, MHS Genesis and Clinical Information System (CIS), participate in clinical staff Performance Improvement (PI) and Risk Management (RM) functions, as prescribed by the MTF Director. Maintain DOD email account as directed. The HCW shall be responsive to all email and voicemail communications.
• Exercise appropriate clinical delegation of tasks and duties in the clinical direction and coordination of health care team members, patient care, and clinic activities.
• Maintain documentation of all treatment provided in accordance with clinic directives and prepare such records and reports as may be required. All records and reports must be legible. Abbreviations must be only those listed in local instructions.
  
  

Duties

Task/Duties – Specific. Registered Nurse. The HCW shall provide services within the scope of the clinical privileges granted by the MTF Director, the applicable duties provided in the basic contract, and the following:

• Perform a full range of RN - NEONATAL INTENSIVE CARE duties in accordance with assignment under the task order, including triage; patient assessment and monitoring; use of patient monitoring and treatment equipment; appropriate nursing care, procedures, and treatments; execution of physicians’ orders within the guidelines of standard nursing practice; documentation of patient care and observations; and patient education and emotional support.
• Assess each patient and perform triage duties as assigned.
• Provide treatment and discharge instructions upon patient release.
• Perform assessment/data collection in an ongoing and systematic manner, focusing on physiological, psychological, and cognitive status.
• Provide a safe and clean environment for each patient.
• Identify patient/significant other learning needs and implement appropriate measures to meet identified needs.
• Provide clinical guidance and instruction to LPNs/LVNs, nursing assistants and ancillary personnel.
• Demonstrate sound knowledge base and action in the care and decision making for designated patient populations. If weaknesses or deficiencies are identified either by peer reviews, quality control reports (QCRs), or evaluations the HCW will be required to complete refresher training (in- services, competency reviews, continuing education, etc.) at Contractor expense.
• Perform documentation (manually and/or by use of computer) duties on unit and in-patient record that are timely, accurate, and concise.
• Implement care in a knowledgeable, skillful, consistent, and continuous manner.
• Demonstrate competency in medication and intravenous (IV) administration to include blood products and Total Parental Nutrition (TPN) intramuscular (IM) and subcutaneous (SQ) administration and demonstrate competency in phlebotomy as specific to the position.
• Safely administer prescribed medications to include intravenous drips and intravenous push drugs.
• Identify patient/significant other learning needs and implement appropriate measures to meet identified needs.
• Perform documentation (manually and/or by use of computer) duties on unit and in-patient record which are timely, accurate, and concise.
• Demonstrate self-directed learning.
• Demonstrate effective and professional communication methods, and skills, using lines of authority appropriately.
• Formulate and use effective working relationships with all health care team members, patients, and significant others. Refer unsolved complaints or infractions to the Division Head with recommendations for appropriate action.
• Practice effective problem identification and resolution skills as a method of sound decision making.
• Provide individual, group, and family/significant other counseling and health teaching in relation to the patient's condition and his/her ability for self-care. Provide for accessibility to various literature resources dealing with subjects related to specific patient health problems. Provide physical and psychological support to patients and significant others, explain procedures and treatments, and promote cooperation among staff, patients, and significant others.
• Participate in the orientation and training of newly assigned unit personnel. Participate in cross-training initiatives.
• Provide input into competency assessments of newly assigned unit personnel.
• Collaborate in the review of clinic standing operating procedures.
• If directed, perform phone triage based on accepted protocols and assist as needed in accessing appropriate ambulatory/emergency care for beneficiaries.
• Administer a wide variety of rapid-acting, highly potent medications (direct intravenous and other routes) according to unit policies, procedures, and protocols. Utilize a broad knowledge of drugs and fluid and electrolyte intravenous therapy, including properties, indications, dosages, rates, and side effects. Closely monitor and document the infant’s response and adjust therapy accordingly. The HCWs shall:
• Successfully complete the Military Treatment Facility (MTF) medication administration test, and successfully complete the MTF Medication Personal Study Instruction (PSI).
• Successfully complete the MTF intravenous line (IV) placement test.
• Successfully complete the MTF IV therapy PSI.
• Administer and monitor oxygen therapy, ventilator support, and intensive pulmonary care techniques as needed.
• Administer immunizations, oral, intramuscular, and parenteral medications.
• Administer specific medications at designated times and in designated manner. Receive, report, and count narcotics with nurse going off duty.
• Chart nursing observations and ensure record is complete with all procedures and test results recorded. Maintain required clinic records, patient charts, forms, logs, records, registers, census reports and collect required statistics. Maintain access (proper log-in) to all electronic health records utilized for charting and ordering system to include (but not limited to) Essentris, MHS, and PYXIS.
• Order diagnostic and therapeutic services as directed.
• Explain procedures and treatments to patients and significant others to allay apprehension and gain cooperation and support.
• Provide clinical oversight and technical direction to assigned staff members including civilian and military professionals, paraprofessional staff, and primary nurse responsible for direct patient care.
• Utilize knowledge of a wide variety of laboratory procedures and protocols to accurately interpret multiple findings and notify appropriate provider to take corrective action to alter current treatment within medical and nursing plan of care.
• Maintain accurate, current, and complete nursing records which reflect pertinent and factual observations of the infant’s treatment and progress, plan of care, response to medications, discharge planning, parent education and follow-up as well as other records including statistical records of workload.
• Coordinate and participate in the transfer of critically ill infants from other hospitals or to higher care facilities.
• Provide complex physiological and psychosocial assessment of patient and family needs in order to function as primary liaison/advocate for patient and family. Provide referral to in-patient social work and/or follow-up with assigned medical officer utilizing clinical nursing judgment and critical thinking.
• Obtain and document pertinent patient and family history. Orient families to NICU routine and physical layout.
• Operate, troubleshoot, and monitor the performance of sophisticated equipment used in the care of critically ill neonates, including but not limited to mechanical ventilation, hemodynamic monitoring equipment, cardiac monitors, electrocardiogram (EKG) machines, infant resuscitation equipment, infusion pumps, radiant warmers, isolettes, and transport incubators. Interpret and respond to complex technological data generated by such equipment. Maintain passwords and access to essential equipment required to carry out nursing duties.
• Assist with Neonatal Intensive Care Courses.
• Provide input to Government Personnel in the evaluation process, inspection and maintenance of all emergency equipment and supplies in assigned clinical areas.
• Prepare equipment and assist providers with treatments and procedures.
• Provide appropriate crisis intervention to families. Initiate discharge planning utilizing wide variety of resources and referral mechanisms for patient and family.
• Maintain crash cart. Report discrepancies to the shift charge nurse.
• Respond to life-threatening changes in the neonates’ condition, providing immediate appropriate emergency measures according to Neonatal Resuscitation Program (NRP) Certification protocols. Promote staff competency and efficiency in emergent situations through formal/informal classes.
• Use in-depth knowledge of nursing process to provide highly specialized nursing care to critically ill and convalescing neonates who require cardio-pulmonary and hemodynamic monitoring and close observation for subtle changes in their condition.
• Interact with patients, families, and visitors in a kind and professional manner.
  
  

Place of Performance : The work to be performed under this contract will be at Naval Medical Center Portsmouth, VA. HCWs shall receive notification two weeks prior to the reassignment to another location within a 40-mile commuting radius of their assigned MTF.

Hours of Performance : The Neonatal Intensive Care Unit (NICU) is open 365 days per year, 24 hours per day.

Work Schedule: Shifts may be required for twenty-four (24), sixteen (16), twelve (12), and eight (8) hours. Specific days, hours, and shift length will be scheduled by the designated Government representative. The specific hours will be determined by the supervisor depending on patient volume and clinical scheduling needs 6 weeks prior to services being rendered.

Shifts will normally be scheduled any day Sunday through Saturday for a 12.5-hour period, to include an uncompensated meal break. Typical daytime shifts are 0645 – 1915; typical nighttime shifts are 1845 – 0715. In no instance will each HCW exceed 80 hours per two-week period.

On-Call Hours: Each HCW will be required to complete one (1) on-call shift every two (2) weeks. On-call shifts are typically for an 8-hour period when not on duty. Typical shifts are 0700-1500, 1500-2300 and 2300-0700. HCWs must respond to calls within one hour, and must report to the MTF, as required, within 30 minutes of response to the call. On-call hours shall be separately priced and invoiced to the appropriate on-call contract line item.

Call-Back Hours : HCWs will be required to report in-person to the MTF during on-call hours if needed. The number of call-back hours and timeframe is as follows:

HCWs must report to the MTF within 30 minutes of the response to the call. It is estimated that 1872 total hours (or 208 hours per FTE) of call back will be required each year.

Qualifications

Degree/Education

• Bachelors of Science in Nursing from a college or university accredited by National League for Nursing Accrediting Commission (NLNAC), or The Commission on Collegiate Nursing Education (CCNE).
• Have successfully completed at least twelve (12) contact hours of continuing NNP education within the preceding twenty-four (24) months which maintains skills and knowledge as an RN.
  
  

As an alternative to the education requirements, the HCW may be a graduate of a state accredited professional nursing program OR a program accredited by Accreditation Commission for Education in Nursing (ACEN) or the Commission on Collegiate Nursing Education (CCNE) and a minimum of two (2) years of level III NICU experience within the past three (3) years.

Certifications

• Possess and maintain Basic Life Support (BLS)
• Possess and maintain current certification as a Neonatal Nurse from the National Certification Corporation (NCC). Possess and maintain a Neonatal Resuscitation Certification (NRP) certification as recognized by the American Board of Pediatrics. Possess and maintain a Pediatric Advanced Life Support (PALS) certification
• Possess and maintain certification in Sugar, Temperature, Airway, Blood Pressure, Labs, and Emotional Support (S.T.A.B.L.E.)
  
  

Experience: Possess a minimum of one (1) year of level III NICU experience within the past three (3) years .

Licensure/Registration: Possess and maintain a current unrestricted license to practice as a registered nurse in anyone (1) of the 50 States, the District of Columbia, the Commonwealth of Puerto Rico, Guam or the U.S. Virgin Islands

Legal Authorization to Work in the United States : HCWs performing under this contract must be a U.S. Citizen

Additional Requirements: Provide two (2) letters of recommendation written within the last two (2) years attesting to the HCW’s clinical skills. At least one (1) letter must be from a physician or nurse who has personally observed and evaluated the HCW and who can attest to the HCW’s clinical competence in the care of patients. The other letter may be from a clinic or hospital administrator, physician or nurse who has personal knowledge of the HCW’s patient care skills in a similar clinical environment. Reference letters shall attest to the HCW’s communication skills and ability to relate to patients as well as professional and other interpersonal skills among staff members and must include name, title, phone number, date of reference, address and signature of the individual providing reference. Letters of recommendation must have been written within the preceding three (3) years. Recommendation letters must include name, title, phone number, date of reference, address and signature of the individual providing reference.

Computer Skill Competency : Each HCW shall demonstrate competency as required in the contract and as follows:

Skills

This level of skills is sufficient to perform daily word processing tasks, such as, producing routine letters, memorandums, and informal reports. A person with this level of skills is able to use basic formatting, editing, printing functions, and understands the document page setup. The person has the skills to:

Create a new document, enter text, and save it.

Open and edit existing documents.

Navigate in a document and perform a search.

Select and move text.

Format characters and paragraphs; work with tabs, indents, margins, lists, breaks, spacing.

Use AutoCorrect and Help tools.

Create and edit tables.

Control page and document appearance.

Print documents, envelopes, and labels.