Clinical Intern - Stepdown
- Req #: 7901
- Address: 2139 Auburn Ave
- City, State: Cincinnati, OH
- Zip: 45219
- Type: Full time
- Shift: Night
Job Description
The practice of nursing requires specialized knowledge, judgment, and skills to provide care to groups and individuals. The RN utilizes knowledge derived from the principles of biological, physical, behavioral, social, and nursing sciences to assess, plan, implement, and evaluate patient care. All care is provided based on the concepts inherent in the model of care for TCH which promotes an on-going partnership between patients and families and the team of healthcare providers. The care is culturally based and age specific. The RN adheres to American Nursing Association (ANA) code of ethics and to the scope of practice described in the Ohio Nurse Practice Act.
The Stepdown Clinical Interns are primarily night shift team members.
The Stepdown Clinical Intern units include:
Comprehensive Medical Stepdown (Comp Med): 3 South is a 29-bed medical stepdown unit specializing in the care of stroke and geriatric patients. The unit offers care to all types of patients requiring cardiac monitoring including cardiology, renal, endocrinology, general medicine, pulmonology, gastroenterology, and oncology. Family Practice Providers are our main source of patients. 3 South Patient Care Assistants are EKG trained and have a Point of Care certification. Health Unit Coordinators (HUC) on 3 South manage the patient flow, patient requests, and physician consults along with many other duties. They also complete training as a Cardiac Monitor Reader (CMR) and share time in both roles as a HUC and CMR. Registered Nurses on 3 South are NIH Stroke certified in the first 6 months. Our nurses have opportunity to become charge nurses and preceptors. All 3 South team members participate in annual education days and are supported by a Professional Development Specialist, in addition to the Clinical Manager and two Assistant Clinical Managers.
Cardio-Pulmonary Stepdown: The Cardio-Pulmonary Stepdown/4 South unit is a 20-bed medical stepdown unit specializing in the care of patients diagnosed with acute MI, cardiac arrhythmias, cardiomyopathy, CHF and other low risk cardiac/chest pain diagnoses. Cardiopulmonary Stepdown also cares for patients who are long-term ventilator dependent. We offer general medical services to all types of patients requiring cardiac monitoring including cardiology, renal, endocrinology, general medicine, pulmonology, gastroenterology, and oncology. Staff on this unit undergo special training and education regarding non-invasive positive pressure ventilation (Bi-PAP, C-PAP, and A-PAP). They also provide infusion therapy, transfusions, injections, and central line care. Patient care assistants on this unit provide support with ADLs, POC glucose testing, and 12 Lead EKGs. 4 South is a dedicated stroke unit and all RNs are NIH stroke scale certified.
Telemetry Stepdown (Cardiology): The Cardiac Medical Stepdown/6 South unit is a 28-bed unit specializing in the recovery of patients following vascular and electrophysiology procedures. In addition, they specialize in providing care to patients with acute MI, cardiac arrhythmias, syncope, cardiomyopathy, and heart failure. They offer medical services to all patient populations requiring cardiac monitoring. Other services provided within this unit include titration of multiple intravenous medications and conscious sedation for cardioversions. All nurses are ACLS certified and have successfully completed an ECG interpretation course. This is an excellent unit for nurses interested in transitioning to an ICU setting.
Heart & Vascular Medical Stepdown (Heart Failure): The Heart Failure/7 South consists of 28 private medical stepdown beds in a family-centered environment. In addition to caring for heart failure patients, the unit specializes in the care of patients diagnosed with MI, cardiac arrhythmias, syncope and cardiomyopathy as well as the recovery of patients following ablation, pacer placement/ICD and PTA. Medical services are offered to all types of patient populations requiring cardiac monitoring, including renal, endocrine, pulmonary, oncologic, general medicine and geriatric. Other services provided within this unit include titration of multiple intravenous medications and conscious sedation for cardioversions. In addition, a select group of nurses complete special training to provide ultrafiltration for decompensated heart failure patients and left ventricular assist device (LVAD). All nurses are ACLS certified and have completed an EKG interpretation course. This is an excellent unit for nurses interested in transitioning to an ICU setting.
Cardiovascular Stepdown (CVSU): The Cardiovascular Step-Down Unit is a 32-bed, surgical step-down/progressive care unit. The primary focus of this unit is cardiothoracic surgery and interventional cardiology. Patient populations include LVAD, innovative valve replacement, pectus excavatum and post STEMI. Nursing care includes management of cardiac arrhythmias, titration of multiple intravenous medications and conscious sedation for cardioversions. All nurses on this unit are ACLS certified, have successfully completed an ECG interpretation course and follow the AACN Progressive Care Guidelines. Nursing staff possess and maintain specialty skills including chest tube removals, femoral arterial line removals, complex external pacing, ACT and iSTAT point of care testing and much more. CVSU staff includes a clinical manager, clinical assistant managers, clinical educator, registered nurses, patient care assistants, health unit coordinators, cardiac monitor readers and exercise physiologists. Specialty certification and minimum BSN education for staff on this unit are highly encouraged.
Responsibilities
The Nursing Process
Assessment - Demonstrates the nursing skills to complete a holistic assessment of the patient's physical, psychosocial, spiritual, and education needs utilizing The Christ Hospital Professional Practice Model.
1. Understands signs and symptoms and data related to the patient's presenting needs and actual or potential nursing diagnosis.
2. Recognizes and appropriately reports to the physician and charge RN pertinent abnormal data and changes in the patient's condition.
3. Utilizes appropriate handoff methods to collaborate with other healthcare team members to communicate pertinent data regarding patient's physiological and psychological data.
4. Assesses patient, family, and environment for safety risks, proactively seeks out and performs safety initiatives.
Diagnosis and Planning - Utilizes collected data to establish and prioritize a list of actual, and potential, individualized patient problems and needs.
1. Prepares, coordinates, and revises multidisciplinary plan of care in collaboration with the patient and family to be supportive of the TCH model of care/Patient and Family Centered care. For each problem a measurable goal is set.
2. Communicates the plan of care utilizing SBAR and handoff processes with all team members.
3. Establish priorities of care, discusses plan of care during shift report, and participates in care conferences.
4. Initiates discharge planning upon admission, makes appropriate referrals consistent with the anticipated length of stay.
Implementation - The method of providing evidence based, quality care is based on assessed needs and standards of care while adhering to hospital policy and procedures to achieve set goals.
1. Performs and delegates nursing actions based on appropriate orders demonstrates critical thinking and accountability for appropriate implementation.
2. Provides ongoing, individualized holistic patient and family education based on needs and plan of care in collaboration with the multidisciplinary team.
3. Demonstrates critical thinking upon review of physician orders, making appropriate referrals, & contacts other health team professionals.
4. Responds to emergency situations that require an immediate, controlled precision in a skillful manner.
5. Implements measures to prevent contamination and/or transmission of disease to include the use of appropriate protective devices and equipment to prevent injury and maintain a safe environment.
Evaluation - Continuously evaluates nursing practice related to the plan of care in relation to the standards of care established through evidence-based literature and standards established by professional organization that have been built into order sets in the electronic medical record, the individual plan of care, and patient outcomes and goals.
1. Evaluates effectiveness of nursing care interventions, adjusts or continues with plan of care based on patient and family response.
2. Maintains continuity of care by continuous evaluation during "handoff" report, rounding, and upon transfers to other specialty units and post care facilities.
Documentation
Nursing process is accurately and concisely documented in the patient's electronic medical record reflecting the plan of care as implemented by the patient, family, and multidisciplinary team.
Documents information in a timely manner, according to hospital policy, to include the plan of care, accurate updates, teaching and the patients' and family response to care.
Leadership and Professional Development
Demonstrates leadership skills such as the ability to motivate, educate, delegate, and mentor peers and other members of the healthcare team while effectively managing the care of patients and family members.
Assumes responsibility and accountability for professional growth and development. Contributes to the professional development of peers, colleagues, and others.
1. Participates in 75% of staff meetings and 75% of council meetings as appropriate.
2. Participates in unit based activities/initiatives for performance improvement, evidence based projects, and research as needed.
3. Participates in council activities and task forces to improve competencies of self, co-workers, and staff members related to patient care.
4. Supports self and peers in professional growth and development utilizing resources and opportunities within and outside of The Christ Hospital.
5. Participates in self and peer review activities to include the positive recognition of peers and staff on a regular basis.
6. Acts as a resource, educator and preceptor for multidisciplinary team members, staff and nursing students, continuously evaluating and documenting competency. .
7. Maintains competency in POC (point of care) testing for unit specific nursing practice.
8. The following are strongly encouraged:
a. Participation in the professional advancement program.
b. Certification specific to work area of professional practice when eligible.
c. Participation in chosen professional organizations and conferences.
d. Participation in development and maintenance of research activities.
e. Participation in community service activities.
Employee Responsibilities
Complies with organization and department policies and required training.
Completes all educational requirements to maintain competency related to specific population of patient and/or regulatory agencies (Healthstream education 100% on-time completion and attendance for annual education day).
Submits required tests and paperwork in a timely manner without management interventions.
Attendance
Follows the time and attendance policy; reports to work on time, maintains a good attendance record, has badge and uses it to clock in and out, makes requests for tie off as far in advance as possible, etc.
Qualifications
KNOWLEDGE AND SKILL:
Please describe any specialized knowledge or skills, which are REQUIRED to perform the position duties. Do not list personal credentials of the current jobholder that would not be required if the job were being filled. List any special education required for this position.
EDUCATION:
• TCH does hire AD and Diploma nurses; however all nurses hired after January 2010 must receive their BSN within 5 years of the date of hire. RN's who were employed at TCH prior to January 2010, and have more than 20 years of experience as an RN are permitted to pursue their BSN on a voluntary basis.
YEARS OF EXPERIENCE: None required
REQUIRED SKILLS AND KNOWLEDGE: The RN demonstrates the knowledge, abilities, and skills to provide age and culturally specific patient care and education. The RN effectively communicates with peers, utilizes appropriate channels of communication and maintains absolute confidentiality. The RN maintains competence and demonstrates evidence of continuing professional growth. The RN demonstrates the ability to accept and implement change and the ability to work in a culturally diverse setting.
LICENSES & CERTIFICATIONS:
The RN holds a current licensure to practice nursing in Ohio. Membership in professional organizations is desirable. BLS certification is required prior to patient contact. ACLS is required within 6 months of hire in step-down and ICU areas. Certification in area of clinical specialty is expected within five years of eligibility.
About Us
For more than 130 years, The Christ Hospital been the beacon for exceptional healthcare in the Greater Cincinnati community. We're industry pioneers, always pushing the boundaries and reimagining the future of healthcare.
Our culture promotes collaboration, diversity and innovation. Together, as a team, we work tirelessly to enhance healthcare quality, accessibility and safety.
The practice of nursing requires specialized knowledge, judgment, and skills to provide care to groups and individuals. The RN utilizes knowledge derived from the principles of biological, physical, behavioral, social, and nursing sciences to assess, plan, implement, and evaluate patient care. All care is provided based on the concepts inherent in the model of care for TCH which promotes an on-going partnership between patients and families and the team of healthcare providers. The care is culturally based and age specific. The RN adheres to American Nursing Association (ANA) code of ethics and to the scope of practice described in the Ohio Nurse Practice Act.
The Stepdown Clinical Interns are primarily night shift team members.
The Stepdown Clinical Intern units include:
Comprehensive Medical Stepdown (Comp Med): 3 South is a 29-bed medical stepdown unit specializing in the care of stroke and geriatric patients. The unit offers care to all types of patients requiring cardiac monitoring including cardiology, renal, endocrinology, general medicine, pulmonology, gastroenterology, and oncology. Family Practice Providers are our main source of patients. 3 South Patient Care Assistants are EKG trained and have a Point of Care certification. Health Unit Coordinators (HUC) on 3 South manage the patient flow, patient requests, and physician consults along with many other duties. They also complete training as a Cardiac Monitor Reader (CMR) and share time in both roles as a HUC and CMR. Registered Nurses on 3 South are NIH Stroke certified in the first 6 months. Our nurses have opportunity to become charge nurses and preceptors. All 3 South team members participate in annual education days and are supported by a Professional Development Specialist, in addition to the Clinical Manager and two Assistant Clinical Managers.
Cardio-Pulmonary Stepdown: The Cardio-Pulmonary Stepdown/4 South unit is a 20-bed medical stepdown unit specializing in the care of patients diagnosed with acute MI, cardiac arrhythmias, cardiomyopathy, CHF and other low risk cardiac/chest pain diagnoses. Cardiopulmonary Stepdown also cares for patients who are long-term ventilator dependent. We offer general medical services to all types of patients requiring cardiac monitoring including cardiology, renal, endocrinology, general medicine, pulmonology, gastroenterology, and oncology. Staff on this unit undergo special training and education regarding non-invasive positive pressure ventilation (Bi-PAP, C-PAP, and A-PAP). They also provide infusion therapy, transfusions, injections, and central line care. Patient care assistants on this unit provide support with ADLs, POC glucose testing, and 12 Lead EKGs. 4 South is a dedicated stroke unit and all RNs are NIH stroke scale certified.
Telemetry Stepdown (Cardiology): The Cardiac Medical Stepdown/6 South unit is a 28-bed unit specializing in the recovery of patients following vascular and electrophysiology procedures. In addition, they specialize in providing care to patients with acute MI, cardiac arrhythmias, syncope, cardiomyopathy, and heart failure. They offer medical services to all patient populations requiring cardiac monitoring. Other services provided within this unit include titration of multiple intravenous medications and conscious sedation for cardioversions. All nurses are ACLS certified and have successfully completed an ECG interpretation course. This is an excellent unit for nurses interested in transitioning to an ICU setting.
Heart & Vascular Medical Stepdown (Heart Failure): The Heart Failure/7 South consists of 28 private medical stepdown beds in a family-centered environment. In addition to caring for heart failure patients, the unit specializes in the care of patients diagnosed with MI, cardiac arrhythmias, syncope and cardiomyopathy as well as the recovery of patients following ablation, pacer placement/ICD and PTA. Medical services are offered to all types of patient populations requiring cardiac monitoring, including renal, endocrine, pulmonary, oncologic, general medicine and geriatric. Other services provided within this unit include titration of multiple intravenous medications and conscious sedation for cardioversions. In addition, a select group of nurses complete special training to provide ultrafiltration for decompensated heart failure patients and left ventricular assist device (LVAD). All nurses are ACLS certified and have completed an EKG interpretation course. This is an excellent unit for nurses interested in transitioning to an ICU setting.
Cardiovascular Stepdown (CVSU): The Cardiovascular Step-Down Unit is a 32-bed, surgical step-down/progressive care unit. The primary focus of this unit is cardiothoracic surgery and interventional cardiology. Patient populations include LVAD, innovative valve replacement, pectus excavatum and post STEMI. Nursing care includes management of cardiac arrhythmias, titration of multiple intravenous medications and conscious sedation for cardioversions. All nurses on this unit are ACLS certified, have successfully completed an ECG interpretation course and follow the AACN Progressive Care Guidelines. Nursing staff possess and maintain specialty skills including chest tube removals, femoral arterial line removals, complex external pacing, ACT and iSTAT point of care testing and much more. CVSU staff includes a clinical manager, clinical assistant managers, clinical educator, registered nurses, patient care assistants, health unit coordinators, cardiac monitor readers and exercise physiologists. Specialty certification and minimum BSN education for staff on this unit are highly encouraged.
Responsibilities
The Nursing Process
Assessment - Demonstrates the nursing skills to complete a holistic assessment of the patient's physical, psychosocial, spiritual, and education needs utilizing The Christ Hospital Professional Practice Model.
1. Understands signs and symptoms and data related to the patient's presenting needs and actual or potential nursing diagnosis.
2. Recognizes and appropriately reports to the physician and charge RN pertinent abnormal data and changes in the patient's condition.
3. Utilizes appropriate handoff methods to collaborate with other healthcare team members to communicate pertinent data regarding patient's physiological and psychological data.
4. Assesses patient, family, and environment for safety risks, proactively seeks out and performs safety initiatives.
Diagnosis and Planning - Utilizes collected data to establish and prioritize a list of actual, and potential, individualized patient problems and needs.
1. Prepares, coordinates, and revises multidisciplinary plan of care in collaboration with the patient and family to be supportive of the TCH model of care/Patient and Family Centered care. For each problem a measurable goal is set.
2. Communicates the plan of care utilizing SBAR and handoff processes with all team members.
3. Establish priorities of care, discusses plan of care during shift report, and participates in care conferences.
4. Initiates discharge planning upon admission, makes appropriate referrals consistent with the anticipated length of stay.
Implementation - The method of providing evidence based, quality care is based on assessed needs and standards of care while adhering to hospital policy and procedures to achieve set goals.
1. Performs and delegates nursing actions based on appropriate orders demonstrates critical thinking and accountability for appropriate implementation.
2. Provides ongoing, individualized holistic patient and family education based on needs and plan of care in collaboration with the multidisciplinary team.
3. Demonstrates critical thinking upon review of physician orders, making appropriate referrals, & contacts other health team professionals.
4. Responds to emergency situations that require an immediate, controlled precision in a skillful manner.
5. Implements measures to prevent contamination and/or transmission of disease to include the use of appropriate protective devices and equipment to prevent injury and maintain a safe environment.
Evaluation - Continuously evaluates nursing practice related to the plan of care in relation to the standards of care established through evidence-based literature and standards established by professional organization that have been built into order sets in the electronic medical record, the individual plan of care, and patient outcomes and goals.
1. Evaluates effectiveness of nursing care interventions, adjusts or continues with plan of care based on patient and family response.
2. Maintains continuity of care by continuous evaluation during "handoff" report, rounding, and upon transfers to other specialty units and post care facilities.
Documentation
Nursing process is accurately and concisely documented in the patient's electronic medical record reflecting the plan of care as implemented by the patient, family, and multidisciplinary team.
Documents information in a timely manner, according to hospital policy, to include the plan of care, accurate updates, teaching and the patients' and family response to care.
Leadership and Professional Development
Demonstrates leadership skills such as the ability to motivate, educate, delegate, and mentor peers and other members of the healthcare team while effectively managing the care of patients and family members.
Assumes responsibility and accountability for professional growth and development. Contributes to the professional development of peers, colleagues, and others.
1. Participates in 75% of staff meetings and 75% of council meetings as appropriate.
2. Participates in unit based activities/initiatives for performance improvement, evidence based projects, and research as needed.
3. Participates in council activities and task forces to improve competencies of self, co-workers, and staff members related to patient care.
4. Supports self and peers in professional growth and development utilizing resources and opportunities within and outside of The Christ Hospital.
5. Participates in self and peer review activities to include the positive recognition of peers and staff on a regular basis.
6. Acts as a resource, educator and preceptor for multidisciplinary team members, staff and nursing students, continuously evaluating and documenting competency. .
7. Maintains competency in POC (point of care) testing for unit specific nursing practice.
8. The following are strongly encouraged:
a. Participation in the professional advancement program.
b. Certification specific to work area of professional practice when eligible.
c. Participation in chosen professional organizations and conferences.
d. Participation in development and maintenance of research activities.
e. Participation in community service activities.
Employee Responsibilities
Complies with organization and department policies and required training.
Completes all educational requirements to maintain competency related to specific population of patient and/or regulatory agencies (Healthstream education 100% on-time completion and attendance for annual education day).
Submits required tests and paperwork in a timely manner without management interventions.
Attendance
Follows the time and attendance policy; reports to work on time, maintains a good attendance record, has badge and uses it to clock in and out, makes requests for tie off as far in advance as possible, etc.
Qualifications
KNOWLEDGE AND SKILL:
Please describe any specialized knowledge or skills, which are REQUIRED to perform the position duties. Do not list personal credentials of the current jobholder that would not be required if the job were being filled. List any special education required for this position.
EDUCATION:
• TCH does hire AD and Diploma nurses; however all nurses hired after January 2010 must receive their BSN within 5 years of the date of hire. RN's who were employed at TCH prior to January 2010, and have more than 20 years of experience as an RN are permitted to pursue their BSN on a voluntary basis.
- A MSN or DNP are not required but supersede the requirement for the BSN.
YEARS OF EXPERIENCE: None required
REQUIRED SKILLS AND KNOWLEDGE: The RN demonstrates the knowledge, abilities, and skills to provide age and culturally specific patient care and education. The RN effectively communicates with peers, utilizes appropriate channels of communication and maintains absolute confidentiality. The RN maintains competence and demonstrates evidence of continuing professional growth. The RN demonstrates the ability to accept and implement change and the ability to work in a culturally diverse setting.
LICENSES & CERTIFICATIONS:
The RN holds a current licensure to practice nursing in Ohio. Membership in professional organizations is desirable. BLS certification is required prior to patient contact. ACLS is required within 6 months of hire in step-down and ICU areas. Certification in area of clinical specialty is expected within five years of eligibility.
About Us
For more than 130 years, The Christ Hospital been the beacon for exceptional healthcare in the Greater Cincinnati community. We're industry pioneers, always pushing the boundaries and reimagining the future of healthcare.
Our culture promotes collaboration, diversity and innovation. Together, as a team, we work tirelessly to enhance healthcare quality, accessibility and safety.
