Advanced Practice Registered Nurse (APRN) - Hematology/Oncology

Summary

Manages and coordinates nursing care for medical oncology and hematology patients. Under general supervision of the medical oncologist or nurse practitioner, the Registered Nurse assesses, analyzes, plans, implements, evaluates, and documents nursing care for the patient and provides direct patient care. The RN also assists with tasks necessary for the general operation and organization of the Nursing unit.

Essential Duties and Responsibilities

Clinical Practice

Assessment:

Assists patients as needed with completion of history and physical form.

Assesses patient vital signs, as needed.

New Patients: height, weight, blood pressure, pulse, respirations, and temperature.

Rechecks: height, weight, and blood pressure.

As needed, checks pulse oximetry and blood sugar per glucose monitor.

Documents and reconfirms in each visit the patient’s current medications and allergies.

Utilizes the electronic medical record (EMR) system to accurately chart all patient visit information.

Assesses physical, psychological and educational needs of patients according to guidelines, standards of care and individual needs.

Assesses patient care needs and/or changes in condition throughout treatments and procedures and communicates findings to the provider.

Planning

Coordinates plan of care for patients, including follow up treatments and appointments.

Coordinates scheduling of chemotherapy and other treatments, facilitates processing of provider orders, and coordinates with pharmacy staff on provider orders.

Assists in preparation and transfer of patients within the facility or for transfer to other facilities.

Implementation

Provides professional nursing care to patients based on patient needs and plan of care.

Assists the provider as needed in complex interventions, examinations, and procedures.

Completes or coordinates with laboratory or hospital staff to collect specimens, label, and transport specimens to laboratory.

Administers treatments as ordered by the provider, including fluids, antibiotics, chemotherapy treatments, and other treatments as indicated.

Administers injections, including subcutaneous and intramuscular injections.

Accesses, draws blood samples, and provides routine maintenance care for all types of central lines, including infusaports, Hickman’s, Groshong’s, PICC’s and any other tunneled or non-tunneled catheter.

Monitors, evaluates and documents patient responses to treatments.

Communicates any changes in patient condition during treatments to the provider and implements revised plan of care as needed.

Revises patient medication profiles and assists provider with medication refill orders as needed.

Ensures documentation is complete and accurate and entered into the EMR or Pharmacy systems or in paper charts.

Utilizes the EPIC system to document all clinical data.

Patient Education

Provides and reinforces patient and family/significant other teaching, such as providing appropriate brochures on treatment, potential side effects, etc. and answering questions.

Documents patient and family/significant others educational needs and documents intervention and understanding.

Refers to other members of the healthcare team as necessary for assistance to meet patient and family / significant others’ needs.

Evaluation and Documentation

Documents all observations, interventions, and patient responses to interventions.

Witnesses’ patient or authorized person’s signature on consent forms, as needed.

Takes, records and follows-through on provider orders as needed.

Follows-through on provider messages, “PANIC”-level reports, “STAT” orders, etc.

Other

Rooms patients and enters visit documentation into the EMR or pharmacy systems or into paper charts for providers, as needed.

Directs patients, families, significant others to exam and/or procedure rooms and treatment areas as needed.

Cleans exam and infusion rooms, disinfects surfaces, and ensures exam rooms are ready for patients, as needed.

Inspects oxygen tanks, oximeter and glucometer monitors and documents results.

Stocks supplies in nursing areas and patient rooms and arranges with the appropriate individual to replenish stock.

Provides nursing support to the radiation oncology department on an as-needed basis, including: patient assessment, administration of pre-medications, and coordination of patients’ treatments with medical and radiation services.

Complies with all applicable safety and health regulations, policies and procedures. Complies with established personal protective equipment requirements necessary for protection against exposure to chemotherapeutic agents, blood and body fluids, other potentially infectious material, chemical disinfectants, and other hazardous substances.

Performs all duties in a safe, responsible manner using required safety devices and personal protective equipment and following appropriate safety guidelines, including use of Universal Precautions, proper hand washing technique, and other work practice controls which minimize occupational exposure.

Professional Communication

Maintains confidentiality in matters relating to all aspects of employment, including patient/family/significant other confidentiality.

Interacts with patients/family/significant others with a variety of developmental and sociocultural backgrounds in appropriate manner.

Provides information to patients and family/significant others that reduces anxiety and conveys an attitude of acceptance, sensitivity and caring.

Maintains professional relationships and conveys relevant information to other members of the health care team.

Internal Contacts: Physicians, nurse practitioners, other RNs, LPNs, Medical Assistants, laboratory staff, pharmacy staff, secretaries, scheduling, billing representatives, etc., and staff at other CCSI facilities.

External Contacts: Research staff, home health care staff, hospice staff, blood banks, hospitals, same day surgery, x-ray departments, couriers, pharmacies, laboratories, floor nurses, other provider offices, etc.

Communicates and coordinates with other healthcare professionals to obtain and follow through on provider orders, such as blood orders, occupational therapy, physical therapy, medical equipment, etc; Hospice consults; case management, such as pre-certifications for drugs or tests; and, provider referrals.

Relays information appropriately over computers, telephones, facsimiles, pagers, and other communication devices, and follows-through as needed.

Maintains and prioritizes messages, gathers appropriate information needed to respond (such as patient chart, lab results, etc.), communicates appropriate information to providers, and follows-through on provider orders and requests as needed. In provider’s absence, checks and assesses provider messages regularly and addresses as needed.

Initiates / coordinates with insurance companies to obtain pre-certifications and pre-authorizations for patients’ medications and procedures.

Will be proficient on the electronic medical records system and accurately and completely document patient information utilizing the system.

Teamwork

Works collaboratively as a health care team member.

Reports on patient conditions as needed to those who require information, including providers, supervisors, and other professional staff as appropriate while maintaining patient confidentiality.

Assists with tasks necessary for the general operation and organization of the Nursing unit.

Maintains positive attitude with patients, family/significant others and coworkers.

Professional Development

Attends staff meetings and mandatory in-services.

Participates in continuing education opportunities and maintains licensure.

Maintains necessary certification(s) and licensure(s).

Contributes to the quality of patient care and participates in quality improvement initiatives.

Other Duties

Performs other duties as assigned.

Education/Qualifications

Graduate of an accredited school of professional nursing. Current licensure in the State of Illinois for practice as a professional nurse. Prefer current chemotherapy certification or willingness to become certified. Current CPR certification. Must take EPIC training and successfully pass required tests.

Knowledge/Skills/Abilities

Knowledge of nursing processes and the ability and willingness to demonstrate and maintain clinical competency (cognitive knowledge and technical skills) as required for the limit of assignment. Ability and willingness to work with patients’ growth and development needs, particularly to patients diagnosed with cancer (newly diagnosed, receiving treatment and terminal care) or immunosuppressed. Ability to manage a sometimes demanding and fast-paced work environment related to changing patient needs, including work with patients with acute, chronic, and complex disease processes and those who are dying. Verbal and written English communication skills for safe and effective patient care and to meet documentation standards. Must be organized, be able to multi-task and have good interpersonal skills. Understands and practices patient confidentiality and follows HIPAA and CCSI/POMS policies. A positive attitude towards health care team members and diverse patient populations.

Physical Requirements

Standing, walking, sitting, carrying, pushing, pulling, balancing, bending, stooping, squatting, crouching, twisting, reaching, handling, kneeling, and wrist and digital dexterity. Must be able to move patient by lifting, ambulating, and transfer of patients in wheelchairs, on gurneys and beds. Speaking, hearing, and visual acuity to perform tests on patients; receive and interpret instructions; hearing to take blood pressure and hear breath, heart, and bowel sounds; chart; and operate equipment. Able to support persons (possibly 200 pounds or more) in emergency situations. Able to move quickly from place to place on occasion. Possible driving.

Mental Demands

Must be able to work under stress and adapt to changing conditions.

Working Conditions

Job duties involve the potential for exposure to blood, body fluids, and chemotherapeutic agents. Normal patient care environment.

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