Respiratory Therapist/ECMO Specialist

Cardiac Center Respiratory Therapist/ECMO Specialist

Nemours is seeking a Cardiac Center Respiratory Therapist/ECMO Specialist to join our Nemours Children's Health team in Orlando, FL. This is a part-time position.

The Cardiac Center Respiratory Therapist/ECMO Specialist serves in a dual function role to:

Provides all routine and emergency respiratory care in all patients admitted to the Comprehensive Cardiac Care Unit under the direction of the Cardiac Critical Care attending physician. The therapist/ECMO specialist provides clinical direction for respiratory care trainees. The therapist/ECMO specialist provides consultation and education to other healthcare professionals. The therapist/ECMO specialist is in routine contact with patients during the provision of hands-on care and in frequent contact with patients' families. The therapist/ECMO specialist may need to work in other areas of the hospital based on patient census and acuity.

Ensure appropriate patient care through the continuous monitoring and assessment of the patient, ECMO circuit and related technology. The therapist/ECMO specialist identifies and corrects problems associated with ECMO processes and initiates and evaluates interventions consistent with protocol. Consults with the ECMO physician when patient condition and/or protocol limits or directives are in question. As a member of the ECMO team, this position collaborates closely with other team members and health care providers to provide patient care in accordance with the patient's individualized care plan. This position requires flexibility with schedule changes, shifts scheduled and number of hours, due to the emergency nature of ECMO and inability to predict timing and volumes.

Respiratory Therapist Essential Functions:

1. Provide all functions of mechanical ventilation to include high frequency, critical care and home care equipment.
2. Provide all functions of airway clearance and respiratory medication administration.
3. Provide advanced medical gas delivery with appropriate equipment. To include, but not be limited to: Nitric Oxide, Helium oxygen; carbon dioxide; nitrogen and diagnostic gases (5% carbon dioxide).
4. Perform intra-hospital transport of critically ill patients; to include patients with artificial airways.
5. Perform point-of-care blood testing, including arterial blood gas testing and clotting time.
6. Contribute to multidisciplinary care rounding with care team.

ECMO Specialist Essential Functions:

1. Maintains ECMO competencies with annual training and simulation as well as ongoing education as best practice changes.
2. Monitors and adjusts ECMO circuit settings (e.g. heat exchanger temperature, pump flow, sweep gas) to maintain parameters established by the ECMO physician.
3. Recommends administration of blood products, fluids, and/or medications as warranted by ECMO status.
4. Assesses the cardiopulmonary status of the patient through test results (e.g. ABGs, CBC, etc.) and physical assessment findings.
5. Performs patient assessment to anticipate and prevent potential problems (e.g. variances in blood pressure, perfusion, ventilation, and heart rate).
6. Monitors and manages intake and output records to ensure appropriate fluid levels.
7. Monitors coagulation results to assess clotting status; adjusts heparin infusion per ECMO Heparin protocol.
8. Evaluates chest x-rays for endotracheal tube placement, cannulae position, and status of the lung fields in determining patient status and weaning guidelines; supports and maintains patency of the cannulae while patient is undergoing ECMO in collaboration with the ECMO physician.
9. Supports ECMO team research through the collection of ECMO-related data, preparation, and presentation of research abstracts and/or other documentation.
10. Demonstrates expertise in neonatal, and/or pediatric care including patient assessment, technical skills, and psychosocial aspects of care.
11. Actively participates in the evaluation of new equipment. Effectively identifies and troubleshoots equipment problems

Quality:

1. Provides a clear and concise end of shift report for oncoming Respiratory Therapist/ECMO Specialist.
2. Participates in Interdisciplinary case reviews and in-service to share information and determine appropriateness of patient care plans.
3. Problem solves through critical evaluation of clinical and databased information and continuous improvement efforts that lead to effective quality-based outcomes.
4. Provides family/parental education and reinforces medical counseling initiated by physician care team.
5. Utilizes Epic to document flow sheets and other clinical information to ensure accurate information is available to care team

Qualifications:

• Graduate of a Commission on Accreditation for Respiratory Care (CoARC) accredited School for Respiratory Care Required.
• Associate's degree required; Baccalaureate degree preferred.
• Holds the "Certified Respiratory Therapist" or the "Registered Respiratory Therapist" credential issued by the National Board for Respiratory Care (NBRC), or an equivalent credential acceptable to the Board; or
• The applicant holds certification, or the equivalent, to deliver respiratory care in another state and such certification was granted pursuant to requirements determined to be equivalent to, or more stringent than, the requirements in Florida.
• Clear and Active Florida License.
• American Heart Association: Basic Life Support (BLS) required, PALS (Required within the first six months), ACLS (Required within the first six months)
• One to three years of experience required

Nemours Children's Hospital Orlando