RRT

Registered Respiratory Therapist-ECMO Specialist

Boston Medical Center (BMC) is more than a hospital. Its a network of support and care that touches the lives of hundreds of thousands of people in need each year. It is the largest and busiest provider of trauma and emergency services in New England. Emphasizing community-based care, BMC is committed to providing consistently excellent and accessible health services to all and is the largest safety-net hospital in New England. The hospital is also the primary teaching affiliate of the nationally ranked Boston University School of Medicine (BUSM) and a founding partner of Boston HealthNet an integrated health care delivery systems that includes many community health centers. Join BMC today and help us achieve our Vision 2030 which is a long-term goal to make Boston the healthiest urban population in the world.

Position: Registered Respiratory Therapist-ECMO Specialist

Department: Respiratory Therapy

Schedule: Full Time, 36 Hours, Days

Position Summary:

The registered respiratory therapist-ECMO specialist (RRT-ES) provides respiratory care services in accordance with department policies. Administers, monitors, controls and evaluates complex life support systems that ventilate acute or chronically ill patients. An RRT-ES is the technical specialist educated and trained to manage the ECMO system including blood pump, tubing, artificial oxygenator, and related equipment. The ECMO Specialist, under qualified medical direction and supervision, is also educated to be responsible for the clinical needs of the patient on ECMO which can include:

(1) maintenance of normal acid-base balance, oxygenation, and ventilation,

(2) administration of blood and blood by-products,

(3) medication delivery,

(4) maintenance of appropriate anticoagulation. Participates in hospital initiatives and projects.

Essential Responsibilities / Duties:

• Conducts Respiratory Care services according to department policy and procedure, as assigned, to ensure the quality of care provided to patients.
• Reviews the patient chart and accurately interprets the physicians orders.
• Sets up appropriate equipment and medication needed for each test and therapy treatment correctly, as observed by observation and documentation.
• Administers all tests, treatments and therapy as ordered, as evidenced by hospital documentation, self-audit, and supervisory review. Such therapy includes but is not limited to oxygen administration, humidity therapy, airway management, resuscitation and mechanical ventilation.
• Documents every patient treatment and/or interaction administered in patient charts, noting response to therapy as evidenced by review of patient documentation and assessment.
• Delivers, sets up, and safely operates mechanical ventilators and monitors patients receiving mechanical ventilation. Performs endotracheal suctioning and tracheal suctioning as needed. These standards will be reviewed by supervisory observation and hospital documentation.
• Makes patient rounds according to assigned department schedules. Observes patient condition, checks operation of equipment, and makes adjustments as necessary. Resolves problems and discontinues therapy as ordered.
• Removes equipment from patient rooms and disassembles equipment following department policies.
• Recognizes medical problems (i.e., adverse reactions to therapy), discontinues treatment if indicated, and notifies physician immediately.
• Applies emergency protocols as needed, and alerts Lead Respiratory Therapist on shift. Proceeds to location and assists physicians with establishment and maintenance of patient airway in the event of a cardiac arrest.
• Demonstrates the knowledge and skills necessary to provide care appropriate to the age groups of neo-natal, pediatric, adolescent, adult, and geriatric patients regularly served.
• Notifies Lead RRT when patients in age groups not regularly served are present, and seeks assistance from individuals with the knowledge of the specialized needs of such patient age groups.
• Performs advanced Respiratory Therapy assignments.
• Attends and participates, as directed, in activities of collaborative clinical committees.
• Assists in development and implementation of protocols, clinical pathways, policies and procedures.
• Provides in-service education to members of the healthcare team as needed.
• Assists in development of quality improvement indicators, collecting data, analyzing results, and suggests corrective action.
• Performs advanced clinical and technical assignments with critical care patients.
• Attends, as directed, and completes Advanced Cardiac Life Support. Assists with bronchoscopy following department policy and procedure.
• Performs pulmonary function testing as directed.
• Performs tracheotomy tube changes.
• Performs Arterial Blood Gases punctures and/or arterial line samples.
• Analyzes blood gas samples according to policy. Reports results and problem with results and/or equipment to the appropriate personnel.
• Performs endotracheal intubation following department policy and procedure.
• Maintains clinical competency in areas of Respiratory Care to ensure ability to utilize up to date methods in care giving (the following standards will be reviewed based on self audit, hospital documentation, and supervisory review).
• Maintains current Massachusetts License as a Respiratory Therapist and registration by the National Board of Respiratory Care as a Respiratory Therapist.
• Attends all mandatory continuous education classes as assigned during the year.
• Assumes Lead RRT responsibilities when and as directed by department Manager.
• Participates in non-assigned service related continuing education classes to ensure professional development and license requirements.
• Attends all scheduled staff meetings or, if unable, accepts responsibility for reading staff meeting minutes.
• Accepts membership in all assigned department or hospital committees or task forces.
• Demonstrates knowledge of patients clinical needs and contacts appropriate personnel to meet identified needs as documented by problem reporting and QI system.
• Manages work time in a generally productive and reliable manner.
• Ensures maintaining work area clean and organized daily.
• Operates assigned equipment and performs all procedures in a safe manner as instructed.
• Demonstrates proper body mechanics in all functions as required.
• Conforms to hospital standards of conduct so that the best possible customer service and patient care may be provided.
• Conducts interpersonal relationships with patients, visitors, physicians and fellow employees in a courteous, professional and friendly manner. Supports department operations by working harmoniously with coworkers and management when other occasional management intervention is required.
• Maintains confidentiality of all personal/health sensitive information.
• Utilizes hospitals cultural beliefs as the basis for decision making and to support the hospitals mission and goals.
• Follows established hospital infection control and safety procedures.

Essential Responsibilities and Duties: DUTIES- ECMO Specialist:

Performs other duties pertaining to Extracorporeal Membrane Oxygenation (ECMO) as described below.

The position of ECMO Specialist exists to support and train staff on ECMO procedures and devices and to ensure all of the equipment associated with the ECMO is properly maintained. The ECMO Specialist demonstrates the knowledge and skills necessary to support patients, physicians, respiratory therapists and nursing staff to ensure the effective utilization of ECMO services. The ECMO Specialist works independently and collaboratively, while exercising judgment and initiative to be sure that all ECMO patients needs related to the equipment are met.

• Coordinates activity needs of clinical resources for use of ECMO in patient care areas with an emphasis on safety.
• Operates ECMO devices in the clinical environment. Participates in device support from implantation through removal. Maintains equipment and supplies in a complete state of readiness and assures that all routine maintenance and calibrations are performed as scheduled.
• Acts as a consultant/resource for physicians, nurses, respiratory therapists and other health care team members on the ECMO devices. Is an active partner with the multidisciplinary team in the evaluation of care delivered.
• Trains clinical staff involved in the care of ECMO patients in the operation and care of the ECMO devices; includes operation and trouble-shooting.
• Assists with the transport of patients with ECMO devices.
• Assists the nursing staff with patient care responsibilities at the bedside and crisis interventions.
• Records/collects data and prepares documentation required by the FDA, device manufacturers, and ELSO registry.
• Contacts vendors regarding equipment-related issues.
• Serves as a consultant regarding new product evaluation and purchases.
• Maintains current knowledge of regulations, laws, and standards, which apply to ECMO instrumentation. Remains current in application of technology through personal study, individual contacts or professional organizations, and attending conferences and training sessions
• Provides 24/7 coverage to support ECMO patients in the hospital.
• Follows all safety rules and reports accidents/patient safety incidents promptly and accurately.
• Performs moderately complex testing with ACT analysis and interpretation.