Licensed Practical Nurse II (FT, PT, PRN) - Emergency Medicine and Trauma Center

Evergreen Requisition - Based on experienced, applicants will be matched to appropriate requisitions.  

EMERGENCY MEDICINE AND TRAUMA SERVICES 
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 1310 Southern Ave SE and operates 24 hours per day and 7 days per week. The Children’s Satellite ED has 16 beds, including a Crisis Room and a room designed for psychiatric care. We provide urgent and emergent services to the growing pediatric population in wards 7 & 8 averaging 37,000 visits/year. 

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, Children's National 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. Children's National supports the development of RN relationships within the community; specifically those relationships associated with the health and well being of the community at large.

Minimum Education
High School Diploma or GED HS Diploma, GED or equivalent in addition to completion of a 1-year (minimum length) vocational/technical training program in a related field. (Required)

Minimum Work Experience
1 year Related experience (Required)

Required Skills/Knowledge
Ability to perform technical functions interacts with children and families and has good verbal and written communication skills.
Demonstrates competence in obtaining accurate vital signs, assessment and documentation of patient care
Successfully complete Division of Nursing & Patient Services LPN Medication Administration test.
Successfully complete the hospital and nursing orientation
Identify resources and know when to ask for help or escalate
Identify self-learning needs and seek resources to meet those needs
Demonstrate the basic knowledge , judgement, and skill in the delivery of the nursing process, secondary assessment, diagnosis, planning , implementation, education , and evaluation
Successfully completed LPN l role if applicable.

Required Licenses and Certifications
Licensed Practical Nurse Upon Hire (Required)Basic Life Support for Healthcare Provider (BLS) Upon Hire .
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Functional Accountabilities
Clinical Process

• Differentiate a new problem from a long term problem at the time of admission/clinic visit; conduct a patient history in order to elicit information and establish child's normal baseline routine; respond to inquiries from families by answering questions; explain information clearly and thoroughly .

• Accurately take TPR, BP , height & weight, head circumference, and intake and output measurements according to procedure

• Recognize physical and behavioral changes for groups of patients usually cared for in the assigned area; perform basic nursing care which may include bath, personal hygiene, dressing, linen change, positioning, assisting in the use of bedpan, urinal, diaper change, and ambulation or holding; perform therapeutic interventions including tube care, gastrostomy, chest tubes, urinary catheters, IV starts (IV solution without additives)/veni puncture, trach care per protocol, and skin care (wound, ostomy) and all associated procedures (i.e. chest physiotherapy , oral/nasal/pharyngeal auctioning, central line dressing change, PD catheter exit site care); exception: Naso-tracheal/Endotracheal auctioning, insertion of oral/nasal airway .

• Immediately respond to and assess the child whose feeding MV pump or monitor is alarming to determine cause of alarm; troubleshoot the alarm system and follow through on directives; inform Registered Nurse as needed; recognize basic changes in child such as: apnea, wheezing, retractions, changes in behavior or LOC, seizure activity, skin lesions, and poor tissue perfusion.

• Collect and test specimens, pass NG tubes and catheters according to procedure and unit policy.

• Prepare for the set up of monitors and D.C.'s peripheral IV's after directed by a Registered Nurse.

Organizational process

• Follow infection control protocols and plans

• Follow protocols for all organizational emergency plans

• Follow nursing practice guidelines and protocols

• Complete a patient assignment and/or assigned task related to Screening, intake, Admission, Discharges & Transfers for an assigned unit/clinic; accept patient assignments and participate with the registered nurse to implement and document care;

• Organize workload in collaboration with a coassigned registered nurse that must administer a medication or perform an assessment/care procedure. Contribute to the plan of care for the patient/family in collaboration with the health care team.

• Follow physician's orders and nursing directives precisely; carry out STA T orders immediately within the parameters of the LPN Job Description.

Transformational leadership

• Orient children and families to the geography and regulations of the area and expected routines for the child; prepare all assigned children for examination, procedure, or surgery according to the standards and incorporate principles of growth and development.

• Review the medical record (progress notes and care plans) and reinforce teaching that has been outlined by the Registered Nurse.

• Teach families how to administer routine medications at home including effects, side effects, and dosage according to preprinted sheets or guidelines outlined by the primary nurse.

• Implement aspects of the education plan throughout hospitalization/clinic visit under the direction of the Registered Nurse or physician as appropriate; provide feedback to RN regarding patient/family's to teaching.

• Recognize and escalate patient care via the chain of command

• Contributes to Magnet re-designation as evidenced by timely completion of education and participation in relevant councils, committees, task forces and community outreach

• Utilize the current identified process to ensure accurate hand off

• Demonstrate the ability to work cohesively with the team to meet patient care needs

Structural empowerment

• Refer to physicians and registered nurses as indicated.

• Performs actions of preventive health care, health maintenance and care of patients at the direction of the delegating registered nurse.

• Offer extra attention to a child who is alone by sitting with him/her , talking, or playing.

• Complete all mandatory education and regulatory requirements

• Develop annual goals and a personal education program with the Supervisor to increase understanding of disease, treatments, etc.

• Assist a float or an orientee if he/she appears uncomfortable with a procedure within the scope of the LPN job description.

• Work in a collaborative manner with all members of the the healthcare team

• Participates in ongoing professional development

Exemplary Professional Practice

• Immediately and accurately document observations, interventions, teaching and the child/family response on the correct form according to established policy and procedure.

• Participate in the admission/clinic unit data collection and document on appropriate forms.

• Document medication administration including time, route, signature, and patient responses, as appropriate, on the correct form.

• Accepts patient assignment and participates with the nurse to implement and document care

• Gathers physical and psychological data on patient and family , complete accurate and timely patient assignment and required screening. Docuuments accordingly

• Demonstrate competency in clinical skills within scope of practice

• Develops and demonstrates assessment, organizational and prioritization skills necessary to care for patients whose clinical needs change

• Completes documentation in accordance with polisies and procedures

• Assess and plan proactively for educational needs throughout the patient's hospital/clinic visit

• Provide medications safely as ordered following the five rights

• Organize care to complete assignment

• Demonstrate caring behaviors

• Propose medication refills after successful completion of medication test based on the departmental or clinical policies and procedures.

Safety

• Place safety first utilizing the safety axioms

• Recognize and remain with any patient in distress, institute BLS when necessary

• Continuously validates and verifies information needed for decision making or documentation

• Demonstrate competency in basic math calculations and conversions

• Demonstrate accurate , clear and timely verbal and written communication

• Promotes safety for patients, families, and coworkers

• Recognizes and escalates abnormal clinical findings and ensures reassessment of all abnormal vital signs and assessments; documents findings appropriately

Organizational Accountabilities
Organizational Accountabilities (Staff)
Organizational Commitment/Identification

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

Teamwork/Communication

• Demonstrate collaborative and respectful behavior

• Partner with all team members to achieve goals

• Receptive to others’ ideas and opinions

Performance Improvement/Problem-solving

• 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

Cost Management/Financial Responsibility

• Use resources efficiently

• Search for less costly ways of doing things

Safety

• 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