Clinical Instructor - Satellite Pediatric Emergency Department

Emergency Medicine and Trauma Services (EMTC) is a tertiary care, Level 1 trauma center located on the first floor of the Sheikh Zayed Campus on Michigan Ave NW.

The EMTC-Sheikh Zayed Campus is comprised of six distinct patient care areas:

1. 36 ED patient rooms

2. Two Code Rooms (4 beds)

3. 4 bed area designed for psychiatric patients

4. 18 decontamination showers with ability to utilize psychiatric area for Decontamination Zone.

5. 6-bed Rapid Treatment Unit (RTU)

The Satellite Pediatric Emergency Department is located at the United Medical Center on Southern Ave SE and operates 24 hours per day and 7 days per week. The ED at UMC has 16 beds, including a Crisis Room and a room designed for psychiatric care.

Patient and Family services are provided under a collaborative, shared leadership model. Organizationally the EMTC reports to the Chief Nursing Officer, Vice President of Nursing and operates within a multidisciplinary leadership team.

1. The Chiefs of the Division of Emergency Medicine provide overall medical leadership at both locations. A Medical Director for each campus oversees day to day operations and physician activities. Associate and Assistant Directors report to the Division Chiefs. The Director of Trauma & Burn Services collaborates with the Division Chiefs to assure appropriate care of trauma patients.

2. The Director for Nursing leads the nursing component of the leadership team and works collaboratively with the Division Chiefs and Medical Directors for oversight of EMTC operations and the shared leadership process at both sites. The UMC campus has a Nurse Manager; the SZ campus has a Nurse Manager who are responsible for day to day operations and work collaboratively with the Medical Directors to lead operations and performance improvement initiatives. Other members of the leadership team include Clinical Instructors, Clinical Educators, Shift Coordinators, Lead ED Technician, Clinical Program Coordinator for EMS and Base Station Coordinator, Psychiatry Clinical Program Coordinator, Program Coordinator, Finance and Quality Outcomes Coordinator.

Medical services are provided in this teaching environment under the supervision of board- certified emergency physicians and Registered Nurses consistent with the Standards of Emergency Nursing Practice. The team works collaboratively with other departments that impact EMTC operations. ED patients are registered by Registration/Patient Access/Admission staff who report to the Director of Business Operations.

The EMTC provides medical screening and emergency care to over 120,000 patients and families annually with a wide range of problems. Presenting conditions are triaged and assigned to the appropriate treatment area utilizing the Emergency Severity Index (ESI) tool, which takes into account patient acuity and resources needed for management. Presenting conditions range from mild to life-threatening. Mild to moderate conditions include common pediatric conditions such as: common colds, rashes, strep throat, upper respiratory conditions, lacerations, otitis media, strains and sprains, etc. More complex to life threatening conditions include child abuse/neglect, sexual assault, behavioral emergencies, meningitis, sepsis, burns, acute medical, surgical and trauma conditions, anaphylaxis, respiratory and cardiac arrest. The EMTC can provide emergency stabilization and treatment of adults and arrange for transfer to the appropriate treatment site after medical screening and initial interventions. Medical screening exams and stabilization of any actual or potential life threatening conditions is provided regardless of age, race, sex, gender, color, ethnicity, national origin or ability to pay for services. The EMTC is able to increase resources as needed to meet large influxes of patients (medical alert, trauma state or phased response).

All nursing practice is based on the legal scope of practice, national and specialty nursing standards, CNMC Policies and Procedures, and in accordance with all applicable laws and regulations. The Professional Model of Care requires registered professional nurses to be responsible and accountable for their own practice. CNMC supports the development of RN relationships within the community; specifically those relationships associated with the health and well being of the community at large. Directs, oversees, and maintains responsibility for clinical orientation for nursing clinical fellows. Serves as a "hands-on" direct care giving and teaching role with patients, families and nursing clinical fellows. Directly supervises activities of nursing clinical fellows.

• Discuss with each orientee the role expectations of orientee, Clinical Instructor, Advanced Practice Specialist and Staff Development

• Specialist related to orientation and ongoing education.

• Review individual orientee learning needs and develop an individualized education plan for orientee; Communicate orientation outcomes to

• all involved.

• Use teaching methods that facilitate education using adult learning principles.

• Participate in competency training for Unit.

• Identify patient and family educational needs with orientees.

• Discuss with each orientee the role expectations of orientee, Clinical Instructor, Advanced Practice Specialist and Staff Development

• Specialist related to orientation and ongoing education.

• Review individual orientee learning needs and develop an individualized education plan for orientee; Communicate orientation outcomes to all involved.

• Use teaching methods that facilitate education using adult learning principles.

• Participate in competency training for Unit.

• Identify patient and family educational needs with orientees.

• Provide direct patient care in area of specialty independently or in the role of a preceptor.

• Identify weekly clinical experience goals with each orientee in conjunction with Manager, Coordinator, Advanced Practice Specialist, and/or Staff Development Specialist; plan appropriate assignments and learning experiences according to didactic sequence and needs of each orientee.

• Plan patient care assignments - select experiences a day ahead and be flexible with changes; communicate w/ manager and charge nurse.

• Use individual & dual assignments. Individual – assign orientee to one or more clients–the orientee may be responsible for only certain aspects of care or total care. Dual –the orientee work along w/a staff member or CI to care for one or more clients; define role expectations of the orientee & specific objectives for the assignment (a very directed experience); dual assignments may also be two orientees assigned to one patient (important for clear communication re: aspects of care each will do).

• Develop follow-up activities with orientee after patient care experience.

• Arrange for “other” clinical experience - i.e. clinics, ORs, cath lab, etc., as appropriate for fellows and direct these experiences.

• Participate in planning patient and family education, in collaboration with orientee and nursing staff; select teaching/learning methods appropriate to content and families learning preference.

• Participate in planning patient and family discharge needs, in collaboration with orientee, case manager, nursing staff, and physicians.

• Allow orientee to prepare for the patient care assignment by reviewing the patient's diagnosis, status of the patient, current management plan (meds and nursing care). Prior to patient care the orientee should be able to describe pathophysiology and explain nursing care; develop med cards; describe med action, desired effect, dosage range, side effects; major nursing implications and explain related diagnostic tests (if any had been done).

• Help orientee organize their patient care priorities; role play possible scenarios and provide support to the orientee by asking questions to encourage critical thinking.

• Post Clinical Conference – Facilitate patient care discussions at a post conference; have orientee record experiences related to the case history of the patient in their clinical log, care given, personal response to clinical encounters, and questions for follow-up; document achievement of competencies of each orientee.

• Participate in teaching content in the didactic and lab setting; facilitate socialization of the orientee to the work place; serve as a role model to the orientee in terms of patient care provider, teacher, and leader.

• Participate in providing direct patient care through: assignment with orientee; teaching patients and families utilizing selected teaching/learning methods; implement discharge activities as appropriate to patients and families; what must be done on schedule; what must be done sometime during the shift.

• Speak up when team members appear to exhibit unsafe behavior or performance

• Continuously validate and verify information needed for decision making or documentation

• Stop in the face of uncertainty and takes time to resolve the situation

• Demonstrate accurate, clear and timely verbal and written communication

• Actively promote safety for patients, families, visitors and co-workers

• Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance

• Anticipate and responds to customer needs; follows up until needs are met

• Demonstrate collaborative and respectful behavior

• Partner with all team members to achieve goals

• Receptive to others’ ideas and opinions

• Contribute to a positive work environment

• Demonstrate flexibility and willingness to change

• Identify opportunities to improve clinical and administrative processes

• Make appropriate decisions, using sound judgment

• Use resources efficiently

• Search for less costly ways of doing things

• Speak up when team members appear to exhibit unsafe behavior or performance

• Continuously validate and verify information needed for decision making or documentation

• Stop in the face of uncertainty and takes time to resolve the situation

• Demonstrate accurate, clear and timely verbal and written communication

• Actively promote safety for patients, families, visitors and co-workers

• Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance