Registered Nurse Complex Care- Per Diem

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A Brief Overview

This RN position requires 12 months of previous Pediatric RN work experience. This is a per diem position that requires 24 hours in a 6 week graph. It includes days/eves/nights weekends and holidays.

Complex Care is a 16-bed inpatient unit for medically complex pediatric patients that are followed by 3 or more subspecialties and general pediatric population. Our unit primarily provides care for the infant and toddler population (ages 2mth-3yrs) but can also see patients that are generally under the ages of 10-12. The complex care service is typically comprised of ex-NICU patients that are stable enough to no longer require intensive care but require more care than the needs of a general pediatrics service. We see a multitude of diagnoses, but our primary complex care population consists of infants and toddlers with variations of chronic lung disease, bronchopulmonary dysplasia, short bowel syndrome, endocrine issues, and ophthalmology. The general pediatric population includes patients with bronchiolitis, RSV, gastroenteritis, malnutrition and more. Our unit typically has 10 patients on the complex care service and 6 patients on the General Pediatrics service.

The UP2 Clinical Nurse meets the established staffing and scheduling expectations for the position. Maintenance of all competencies and required educational programs relevant to the unit patient population is required. UP2 Clinical Nurses practice as Clinical Nurses in accordance with the following, which is consistent for all RNs with this job title:

The Clinical Nurse practices at the level of an advanced beginner to expert practitioner of professional nursing in accordance with, and guided by the CHOP Nursing Professional Practice Model. The nurse at this level demonstrates competence in caring for patients and families and progresses to caring for those with the most complex problems/highest acuity in the designated clinical area. Provides age/developmentally appropriate care. Care is delivered through RN leadership for patient care within the framework of family-centered care.

The Clinical Nurse adheres to the organizational and nursing department mission, vision, and values. S/he practices in accordance with the ANA Code of Ethics; the ANA Standards of Clinical Nursing Practice; practice standards of applicable specialty nursing organizations; and CHOP developed standards of nursing practice. The professional nurse practices within the defined scope of practice designated by the Nurse Practice Acts of Pennsylvania and/or New Jersey, depending on the assigned work site.

What You Will Do

• Clinical Practice
• Follows the nursing process to deliver safe, compassionate, and culturally effective care.
• Gathers and recognizes/synthesizes assessment data to determine the patient/family plan of care, pertinent data to be shared with care team, and tasks to be delegated.
• Recognizes and/or seeks resources to recognize clinical changes that are indicative of patient deterioration; utilizes the CAT team when appropriate.
• Collaborates with the patient, family and multidisciplinary team to coordinate all facets of patient care.
• Develops, implements and/or revises the patient's plan of care on admission and during the course of the hospitalization. Plans of care are outcomes focused and include goals as well as required interventions. Plans are developed in partnership with the patient, family, and the interdisciplinary care team.
• Coordinates care across the continuum - understands and utilizes case management resources.
• Consistently follows evidence based practice bundles and nursing standards/procedures to provide nursing care that eliminates preventable events of patient harm and promotes excellent patient outcomes.
• Recognizes and addresses situations which present ethical dilemmas and/or moral distress. Takes steps to actively address the situation. Seeks resources as needed to resolve the situation.
• Demonstrates competence in teaching patients/families and progresses to an expert educator of patients/families.
• Evaluates and documents the care provided on each assigned shift.
• Accountable for the rapid adoption and implementation of clinical practice changes into own practice.
• Communication
• Documents the evaluation of nursing interventions and outcomes of nursing care utilizing hospital standards, policies and procedures.
• Consistently follows safe hand-off practices as defined in patient care standards and procedures.
• Utilizes and exemplifies safety behaviors for error prevention. Identifies potential safety concerns and communicates with unit leadership as appropriate. Enters safety nets when applicable, including good catch/near miss situations.
• Uses effective verbal and nonverbal communication techniques and good listening skills to empathetically communicate with patients/ families, and colleagues.
• Encourages patient/family self-advocacy.
• Collaboration
• Demonstrates effective teamwork as a member of the interdisciplinary care team, fostering and exemplifying a culture of respect. Recognizes/addresses situations where disrespectful collaboration may impact patient care and/or create non-collaborative relationships. Seeks resources as needed to resolve situations involving incivility and/or disrespect.
• Actively participates in interdisciplinary patient care rounds and/or meetings and makes recommendations to the plan of care that reflect nursing goals, interventions, and expected outcomes. Revises the plan of care according to the patient care decisions made on rounds.
• Incorporates evidence based practice into direct clinical care in collaboration with other members of the multidisciplinary team.
• Develops and implements effective partnerships with members of the ancillary staff; delegates tasks effectively to assure comprehensive nursing care is provided.
• Develops and sustains professional, well-boundaried, therapeutic relationships with patients and families in which all actions are in the best interest of the patient and family and there is no personal gain at the patient/families expense.
• Professional Development
• Models appearance and behaviors that promote a positive image of professional nursing.
• Expands clinical judgement and critical thinking skills with increased experience.
• Demonstrates mastery of the principles of Family Centered Care, including dignity and respect, information sharing, participation, and collaboration.
• Demonstrates understanding of optimal patient/family experiences and incorporates into care delivery. Has a working knowledge of patient/family experience results (NRC Picker) at the unit and organizational level. Participates and/or leads in initiatives to improve satisfaction scores.
• Practices within a shared decision making environment. Familiar with and participates in Shared Governance council activities at the unit and/or department level. Progresses to leading council activities at the unit and/or department levels.
• Familiar with Magnet designation and the Magnet Model of transformational leadership, structural empowerment, exemplary professional practice, new knowledge and innovations, and empirical outcomes. Participates in ongoing designation activities such as serving as a unit based Magnet champion.
• Demonstrates fiscal stewardship:
• Manages own time to accomplish direct/indirect care in a cost-effective manner.
• Conserves unit and organizational resources; assures supplies are not wasted or misused.
• Does not incur incidental overtime.
• Understands the implications of the cost of staffing decisions.
• Identifies observed opportunities for cost savings.
• Well-informed about the Professional Advancement Program (PEAK) and considers the opportunity to participate.
• Demonstrates healthcare informatics competency to manage patient care, outcome data, and current and emerging healthcare technology.
• Understands nursing sensitive outcomes and knows how to navigate the nursing scorecard. Participates and/or leads improvement initiatives to improve outcomes.
• Identifies own learning needs and actively assures learning needs are met.
• Seeks out opportunities to meet needs and attends all required programs.
• Maintains CEU's for nursing licensure.
• Maintains compliance with mandatory education and annual nursing competencies.
• Recognizes individual preferences regarding an environment of constant change and understands change management. Develops effective methods to cope with and incorporate learning from a fast-paced, ever changing environment.
• Understands the principles