Sample Position Description—Critical Care Transport Nurse

Position Description

• Practices in accordance with philosophy, policies, procedures, and stan­dards of the hospital; functions within the guidelines of the protocols for the transport program that are reviewed and agreed on by medical and nursing directors.

• Functions include the identification, planning, implementation, and evaluation of emergency care for acutely ill neonates, infants, children, and/or adolescents in collaboration with the medical control physician (MCP; sometimes called medical control officer, or MCO). This person is responsible for obtaining pertinent maternal, neonatal, and childhood histories, performing physical examinations (neonates through adoles­cents), and formulating differential diagnoses and care management plans. Responsibilities include performing necessary diagnostic and therapeutic procedures as indicated for identification and management of problems, including, but not limited to, umbilical line placement, peripheral or cen­tral venous access, endotracheal tube placement, needle aspiration, chest tube placement, and interpretation of laboratory and radiographic data.

• Also important is the need to provide family-centered care, including psychosocial support, education, and transfer planning in conjunction with referral staff.

• Represents the hospital to health care professionals in referring hospitals.

• Maintains effective communication with referral staff and families.

• Educates referral staff through informal teaching and planned educational conferences.

• Initiates and participates in educational, research, professional, and orga­nizational activities that contribute to improving patient care, the transport program operation, and the individual’s own professional development.

Reporting Relationship

Reports to:

• Medical director of the transport program for supervision and guidance in expanded role function.

• MCP as designated for medical supervision concerning the management of individual neonatal and pediatric patients during transport.

• Nursing (or program) director or designee for care and administrative aspects of practice.

Requirements

1. Requires a minimum of 3 years of neonatal intensive care unit (NICU) or pediatric intensive care unit (PICU) or pediatric emergency depart­ment experience within the last 5 years. Critical care transport experience preferred.

2. Current in Basic Life Support for the Health Care Provider, Advanced Cardiac Life Support, and Pediatric Advanced Life Support. Certification in Neonatal Resuscitation Program (NRP) and Trauma Nursing Core Course (TNCC) or Advanced Trauma Life Support (ATLS) preferred.

3. BSN-prepared at a minimum.

4. State licensure as a registered nurse.

5. Computer literacy.

6. Holds current passport or is eligible to apply for one if program will be doing international transports.

7. Demonstrates strong written and verbal communication skills at staff, patient, and family levels.

Major Responsibilities and Duties

I. Patient care activities

A. Obtains pertinent maternal, neonatal, and pediatric histories with emphasis on risk factors and their implications for problems.

B. Performs pertinent physical examination using techniques of observation, inspection, auscultation, palpation, and percussion.

C. Assesses patient weight for use in calibration of medication and fluid management.

D. Formulates differential diagnosis and a plan for management of existing and potential problems in collaboration with the MCP.

E. Performs necessary diagnostic and therapeutic procedures as indi­cated for identification and management for problems as indicated by protocol, including (but not limited to):

1. Peripheral percutaneous arterial sampling and line placement

2. Umbilical venous and arterial catheterization

3. Airway management, including assessment, stabilization, bag­mask oxygenation and ventilation, endotracheal intubation, tracheostomy management, and rescue airways

4.

5. Interpretation of routine laboratory and radiographic data

6. Insertion of central venous catheters (femoral vein only)

7. Insertion of intraosseous needle for emergency vascular access

8. Spinal immobilization

9. Trauma triage care

10. Blood drawing (venous and arterial) and insertion of periph­eral catheters

F. Provides clinical management for resuscitation of the neonatal, pediatric, and/or adolescent patient, including necessary pharma­cologic support.

G. Performs in accordance with standing orders and accurately docu­ments delivery of care.

H. Communicates information about the patient's “working” diagno­sis, plan of management, and prognosis to the referring physician, parents, and other members of the health care team.

I. Assesses parents' psychosocial needs and initiates referral to appropriate consultants.

J. Obtains informed consent from parent(s)/guardian(s).

K. Provides ongoing monitoring, assessment, and appropriate inter­ventions in transit.

L. Ensures patient safety in the transport process.

M. Completes documentation in an accurate and timely manner, and transfers care of the patient to the receiving hospital staff.

II. Education

A. Contributes to community outreach and education.

B. Assists in the assessment of staff developmental needs, and parti­cipates actively in plans to meet those needs.

C. Participates in teaching or coordination of in-service classes or workshops for the transport staff.

D. Serves as a preceptor in the training of future transport team members.

III. Operation of transport equipment

A. Demonstrates knowledge of operation and troubleshooting of all transport equipment. Ensures proper functioning and availability of equipment before transport.

B. Participates in the ongoing evaluation of transport equipment needs. Reports and documents transport equipment repairs as needed to biomedical engineering.

C. Demonstrates knowledge of aircraft and ambulance operating pro­cedures and safety practices.

IV. Special assignments/project responsibilities

A. Assists with medical procedures in the NICU/PICU or emergency department on request.

B. Performs the following transport quality improvement activities:

1. Maintains, supports, and documents evidence of a planned, systematic quality improvement program that includes effec­tive mechanisms for monitoring and evaluating the patient care provided by the transport service.

2. Ensures appropriate and adequate response to findings from quality improvement activities.

3. Maximizes the efficient use of resources available to provide neonatal-pediatric transports.

4. Identifies opportunities to improve care.

V. Leadership

A. Initiates and participates in the implementation of change in transport nursing policy, procedures, and/or practice to enhance the quality of patient care.

B. Participates with transport staff in problem identification, goal setting, and transport care delivery evaluation.

C. Uses previous clinical experience and knowledge to identify potential patient care problems related to transport.

D. Serves as a resource or consultant to nursing and medical staff regarding neonatal and pediatric transport.

VI. Professional accountability

A. Demonstrates continued professional growth through continuing education and review of current literature pertaining to neonatal- pediatric transport.

B. Maintains licensure, certifications, and competency through required training and/or education.

C. Maintains professional relationships with community physicians, nurses, and other health care professionals.

D. Participates in peer review of the transport team members and case reviews with the medical director.

VII. Research

A. Identifies researchable patient and nursing care problems related to transport.

B. Uses evidence-based research findings in patient care.

C. Cooperates and/or collaborates with other health care team mem­bers in the conduct of research studies.

VIII. Physical capabilities

A. Frequently requires sitting, standing, and walking for long periods. Requires bending, crouching, and kneeling. Requires use of hands, keyboarding, fine motor skills, frequent lifting up to 50 lb, occa­sional moving up to 250 lb. Must be able to work in small confined spaces and be able to work in a mobile environment, either ground or air.

B. There is a potential for regular exposure to patients with infectious diseases requiring observance of appropriate precautions.

C. Flexible working hours required to provide 24 hour/day, 7 day/week coverage, including rotating shifts, weekends, holidays, and on call.

D. Dependability in regard to attendance at work, team meetings, nursing meetings, committee meetings, etc.

IX. Environmental conditions

Indoor and outdoor environments with possible exposure to infec­tious, biological, and chemical agents. Occasionally requires work­ing in proximity to sources of radiation. Work area includes riding in enclosed spaces, such as ambulances, helicopters, and airplanes. Work environment commonly provides exposure to high noise levels.

2.