Registered Nurse - Per Diem

Per Diem Incentive:

Per diem employees are eligible for an incentive above base pay based on shift commitment. Incentive percentages are applied to all hours worked and are determined as follows:

• No minimum shift commitment: 10% above base rate
• Commitment of 3 shifts per month: 15% above base rate
• Commitment of 4 or more shifts per month: 20% above base rate

Incentive eligibility and commitment levels are subject to change and must be maintained to receive the applicable rate.

SUMMARY AND ESSENTIAL FUNCTIONS

The Oncology/Infusion Staff Nurse is a professional registered nurse who functions as a patient advocate and care coordinator, collaborating with the other patient healthcare providers to provide appropriate care as effectively and efficiently as possible. The Oncology/Infusion nurse acts as a resource to the patient and family and is accountable for the safe delivery of care within the framework of the nursing process. Oncology/Infusion staff nurses are responsible for the safe delivery of various kinds of intravenous medications for the treatment of numerous diseases not limited to the specialty of Oncology. The Oncology/Infusion nurse is responsible for proper assessment and reassessment of patients in their care throughout the course of treatment. The Oncology/Infusion nurse helps the Oncologist in the performance of exams and procedures when asked to do so. The Oncology/Infusion nurse administers intravenous medications according to the standards set by the Oncology Nursing Society, the Infusion Nursing Society, and LRH.

Clinical: Professional Development/Self Governance

• Employee will complete Health Stream assignments and 2 minute compliance quizzes as required by the education department and department leader.
• Employee will complete yearly department specific competencies as assigned by education department and department leader.
• Employee will complete/attend continuing education programs specific to specialty at least 1 per quarter and submit documentation of programs attended. Education funds are available for reimbursement of approved educational offerings. See reimbursement requirements in education policies.
• Employee will be expected to cross train to appropriate areas within the facility to meet the cross training requirement and will be expected to willing cross cover in other departments when appropriate.
• The Oncology Nurse will maintain ONS provider certification while employed in the oncology /Infusion department. This can count as one of the required quarterly educational programs.

Ancillary Duties

• Responsible for ordering and restocking supplies throughout the unit as well as the patient care areas. Nurse is responsible for maintaining appropriate supply levels to reduce delays in care.
• Checking expiration dates on all medications and supplies are current and removal of all expired items from current stock.
• Cleaning of equipment and rooms after each patient and at the end of the shift every day.
• Verifying prior authorizations for treatments being given in the infusion clinic prior to administration of medications as needed related to staffing and necessity.
• Securing and removing full sharps and full chemotherapy waste containers from the work areas and placing in the utility room for removal by EVS.
• Scheduling patient appointments as needed related to staffing and availability.
• Oncology/Infusion nurse will be able to enter appropriate information into the Tumor Registry website as needed.

Required Skills

The position requires well-developed communication and interpersonal skills, with an emphasis on promoting customer service. Basic computer skills are required, paragon and Epic experience preferred. The Oncology/Infusion staff nurse must be self-directed and self-motivated in performing daily tasks as well as possess the ability to work as a team member. The Oncology/Infusion staff nurse must be able to respond appropriately with alertness and adaptability to changes in patient condition. The Oncology/Infusion staff nurse must have highly developed time management and decision making skills to function efficiently in this busy patient care setting. The Oncology/Infusion staff nurse must have proficient IV skills and a willingness to learn new skills when necessary. Experience with central venous access devices highly preferred.

Essential Functions

• Performs initial and ongoing assessment of patient and accurately records in electronic medical record:

This may include but are not limited to:

• Prevention and early detection
• Client’s current knowledge of diagnosis, treatment, resources, predictable problems, participation in care
• Coping mechanisms
• Comfort measures/management
• Nutritional status
• Mobility
• Preventive mechanisms
• Elimination
• Ventilation
• Circulation
• Sexuality
• Communicates nursing assessment and brief history to responsible physician and/or nursing team members.
• Identifies psychosocial problems and provides patients and families with counseling and emotional support.
• Provides patients education regarding therapy and disease management that is in concert with the medical plan of care.
• Monitors care and self-management of patients as they relate to home needs, toxicity to drugs, problems with pain management, nutrition, etc.
• Assesses patient response to therapy and initiates appropriate systemic and/or local interventions when necessary, guided by existing protocols or physician orders.
• Administers chemotherapeutic agent, molecularly targeted therapies, biologic response modifiers and blood replacement products in accordance with physician orders, being cognizant of usual dose, routes and rate of administration, actions and side effects.
• Evaluated and documents patient’s response to chemotherapy by applying clinical judgment and utilizing results of laboratory diagnostics.
• Documents all actions and outcomes in the patient’s medical record(s) as appropriate.
• Observes and participates in history taking conducted by the physician when time and census allows, to expand knowledge base regarding the patient unique needs, facilitating, effectiveness as a care giver.
• Recommends/initiates specific interventions to provide continuity of care between inpatient and outpatient
• Coordinates treatment of patients receiving infusion therapy, including orders.
• May have to coordinate patient referrals to other physicians, health care facilities and/or agencies.
• Triages patients’ telephone calls, providing recommendations according to protocols and/or physician recommendations.
• Provides information to other health care professionals regarding patients’ requirements; serves as a patient advocate.
• Communicates with patients regarding follow-up care and necessary referrals.
• Schedules patients’ for maintenance of Venous Access Devices.
• Serves as a resource to other Littleton Regional Healthcare Staff.
• Maintains current knowledge base by providing documentation of certificate of attendance for educational programs completes.
• Reviews and utilizes current nursing and medical literature with a goal of increasing knowledge and expertise.

Internal and External Contacts

Works closely with medical Oncologist, primary care provides, patients and families, various hospital departments, as well as many outside healthcare facilities and agencies to ensure the safe, appropriate delivery of care to all patients. The Oncology/Infusion Nurse works collaboratively with other departments within the facility to ensure that patient care is completed safely and comfortably for the patient.

QUALIFICATIONS

Education: Graduate of an accredited school of nursing, BSN preferred.

Experience: 2-3 years of acute care nursing experience, IV competent,

Oncology/Chemotherapy administration experience preferred, basic computer literacy required.

Experience/Specialized Skills

Preference will be given to candidates who have prior experience in the oncology setting, and current ONS chemotherapy and Biotherapy Administration Certification. Prior vascular access experience is required, experience in the use and maintenance of central venous access devices including PICC, Implanted Ports and Tunneled catheters.

Required Education/Course(s)/Training

Current Registered Nurse Licensure in New Hampshire.

BLS certification is required at the time of hire, ACLS certification is required within 1 year of hire to department.

ONS Chemotherapy and Biotherapy Administration Certification is required within one year of hire.

Preferred Certification/Registration: ONCC certification is preferred.

PHYSICAL DEMANDS

The Oncology Nurse must be in good health as demonstrated by a pre-placement health screening. Work requires the use of Universal Blood and Body Fluid Precautions, and Infection Control Guideline, kneels, bends, walks and stands 80% of the time. Speaking and hearing essential in instruction and supervising nursing personnel, in receiving physician orders and patient requests, and in instruction patients and their families. Excellent communication skills and rapport with people necessary; good telephone skills required. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. The employee must regularly lift and/or move up to 10 pounds and occasionally lift and/or move up to 50 pounds.