Critical Care Transport Registered Nurse (RN) - Maryland Express Care, Easton

General Summary:

The Maryland ExpressCare (MEC) Transport Nurse Specialist (TNS) is a Registered Nurse with an expanded scope of practice who provides high acuity critical care and emergency ground/surface transportation for the following patient populations; Stroke, STEMI, trauma, medical, surgical, cardiac, neurologic, high-risk obstetrics, neonatal, and pediatric transport emergencies. TNS works with physician medical directors and consultants to provide high acuity medical therapies and interventions. The TNS functions under the authority of (1) MEC clinical guidelines, (2) Maryland Institute for Emergency Medical Services Systems (MIEMSS) protocols when appropriate, and (3) Maryland Board of Nursing. The TNS works closely with healthcare providers at sending and receiving facilities to articulate and implement a comprehensive patient centered medical transport plan. Finally, the TNS provides care to patients across the life span, and appropriate age based clinical care.

Principal Responsibilities and Tasks:

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

Clinical Practice/Care Delivery:

• Competent in care of patients across the life span; independently practices with solid critical care clinical knowledge and skills
• Independent learner, who is engaged in advancing their own transport clinical practice and knowledge. Implement evidence-based practice as part of daily work.
• Independently provides, directs and coordinates clinical care within the critical care transport environment. Is accountable for the processes and outcomes of care delivered to patients.
• Conducts comprehensive patient assessment, integrating multiple data sources, which forms the basis for identification of patient/family needs and problems.
• Implements MEC clinical guidelines based on synthesis of clinical information and patient care needs during transport.
• Independently identifies need for escalation of patient care activities, and escalates appropriately
• Ability to work in a non-traditional clinical care setting (i.e. ambulance) and is able to implement effective care with the limited resources available.
• Escalates clinical concerns to MEC medical direction
• Observes patients in a systematic way for both overt and covert clinical signs and symptoms.
• Assess patient's needs throughout transport process, and implements a patient specific plan of care to address noted needs
• Facilitates effective and efficient patient transfer between referring and receiving institutions.
• Works effectively with the University of Maryland Access Center & multidisciplinary teams at both sending and receiving create and implement patient's plan of care
• Under orders from the base station attending physician and/or established MEC medical guidelines, initiates immediate life support therapies including but not limited to parenteral administration of approved medications; intravenous/intraosseous therapies with and without ultrasound; arterial line placement under ultrasound; EKG monitoring; arrhythmia interpretation; CPR; defibrillation; external cardiac pacing; airway management; endotracheal intubation; cricothyrotomy (needle or surgical); ventilator operation; needle chest decompression; thoracostomy (finger or tube), high acuity transports with advanced life-sustaining equipment, including but not limited to management of patients with Extracorporeal Membrane Oxygenation (ECMO) and Intra-Aortic Balloon Pumps (IABP); altered neurological status; including cervical spine immobilization; application of splints and devices needed for transport.
• Consistently gives a comprehensive report to medical team that reflect patient's status during transport, which accurately reflect patient status to other team members.
• Utilizes available resources within and outside the institution for the purpose of providing comprehensive care to patients and families.
• Evaluates and revises individualized plan of care appropriately reflecting current and changing status of the patient and/or family.
• Continuously assesses, monitors, intervenes, and stabilizes critically ill patients during transport and offers additional or alternate plans of care as needed.
• Uses chart review sessions as a forum for patient care evaluation and learning.
• Maintains transport unit in a state of readiness; maintains a safe transport environment by ensuring that all equipment is secured and that the ambulance systems are operationally safe, per MIEMSS requirements and safety regulations
• Serves as Clinical Resource for others
• Functions effectively in roles specific to practice setting/service
• Responds emergently to scenes as part of the R Adams Cowley Shock Trauma Center's Go Team- to provide care to critically ill patients at scene, who are unable to be transported secondary to extenuating circumstances.

Practice Focus Areas:

1. Active participant in MEC Clinical Practice governance activities
2. Assists in team developing/evaluating clinical protocols and intrahospital critical care models and suggesting methods for improvement
3. Develops patient education materials and overall process for practice setting-based patient education
4. Assists in the development of clinical practice protocols and standards for practice setting

Education and Experience:

Transport nurses need a mechanism by which competence in the knowledge base is essential for safe, high-quality critical care transport nursing practice.

Required Upon Hire:

• Graduation from an accredited school of nursing. BSN Preferred
• Licensure as a Registered Nurse in the state of Maryland, or eligible to practice due to Compact state agreements outlined through the MD Board of Nursing, is required.
• Minimum three years of relevant clinical work experience in critical care or academic emergency department with ICU skill set experience
• Active and valid certifications required in the following certifications required:
• Basic Cardiac Life Support (BCLS)
• Advanced Cardiac Life Support (ACLS)
• Maintenance of 10 contact hours of education/year.
• Member of a professional organization.
• Critical Care Nurse Certification (CCRN) is required or must be obtained within one year of employment. Management may grant a six-month extension for special circumstances.

Preferred Upon Hire/Obtained After Hire:

• Pediatric Advanced Life Support (PALS) must be completed within 3 months of hire
• Critical Care Nurse Certification (CCRN) required within one year of employment
• Certified Flight Registered Nurse Certification (CFRN), or Certified Transport Registered Nurse (CTRN) required within 18-24 months of employment
• NRP (Neonatal Resuscitation Program) must be completed within 3 months of hire
• Annual Maryland Institute for Emergency Medical Services Systems (MIEMSS) Protocol Updates
• Annual Infection Control, Fire Safety, FEMA (Federal Agency Management Agency Training), and Novel Pathogen training
• Annual Employee Health requirements

Compensation:

• Pay Range: $37 - $51.81
• Up to $15,000 sign-on bonus
• Shift differentials