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Job Summary
Part Time - 32 hours per week - Rotating, Variable
Staff Nurse AMB - MNA
Heart Transplant | Center for Advanced Heart Disease | BWH Main Campus
GENERAL SUMMARY/ OVERVIEW STATEMENT:
The Post Heart Transplant Nurse Coordinator is a professional registered nurse licensed in the state of Massachusetts with cardiac surgery experience who is responsible for all aspects of ambulatory and in-hospital care of the pre-transplant and post-transplant patient. This position will work closely with all members of the transplant team, inpatient staff, and others as necessary to ensure efficacious care during the transition between pre-, peri-, and post-transplant phases in ambulatory and hospital settings.
Additional responsibilities will include collecting and entering data into EPIC and heart transplant databases as required by the hospital and by local, regional, and national agencies.
Transplant patients are an extremely complex group of patients and, as such, the transplant coordinator must possess a strong clinical background. This nurse must be organized; they must pay attention to detail, demonstrate the ability to coordinate and follow through on all aspects of the patient’s care and effectively communicate with all members of the transplant team, the patient/family and transplant unit.
The transplant coordinator will need to demonstrate the ability to effectively manage patients by assuming full responsibility for assessment, planning, implementation, and evaluation of patient care. The RN is directly responsible to a designated nurse manager or nurse director.
The transplant coordinator will work on site at the BWH Main campus, and at any off-site locations in Massachusetts and surrounding states, as needed and directed by leadership. Therefore, this candidate may need to obtain necessary nurse licensure in other states.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
• Facilitates interactions of the multidisciplinary team members, including physicians, social work, transplant pharmacist, nutritionist, and outside consultants.
• Acts as a liaison between members of the inpatient care team and outpatient management team, including heart transplant nurse practitioners.
• Communicates with referring physician team to keep them up-to-date regarding patients' clinical status.
• Telephone contact with patients to assess clinical status, monitor response to therapy, adjust medications in consultation with clinical providers, and organize outpatient or inpatient follow-up as needed.
• Assists in urgent patient triage, including emergency room visits and transfer from outside institutions, and documents the care provided.
• Provides education to transplant patients and family members regarding important aspects of care, including but not limited to: activity, diet, medication adherence, and healthcare follow-up. Helps to maintain current supply of patient/family education materials.
• Sets up consults with specialty providers, follows up on consult recommendations, and communicates results to patients and other providers.
• Assists with communication and correspondence to/from patients, employers, pharmacies, and insurance providers with regard to medication prescriptions, cardiac rehabilitation, disability, family medical leave, and payment coverage. May also communicate and correspond with other providers (e.g., utility company, telephone company) as dictated by patient needs. These duties may require telephone calls, faxes, mail, and/or e-mail.
• Meets regularly with medical program director and nurse practitioners to facilitate quality and process improvement initiatives. As requested, implements and assesses initiatives and summarizes results for the team.
• Attends weekly clinical meetings and heart transplant clinics as needed.
• Collaborates with financial counselor and social work to assist patients/families in need of financial support, insurance coverage, medications, housing and/or utilities.
• Ability to work on-campus wearing appropriate PPE when caring for patients requiring all levels of precautions.
• Ability to triage and manage high patient volumes with complex needs in a crisp and pithy manner.
• Other duties as assigned.
Data Activities:
• Collects demographic and clinical data from hospital computer system, administrative sources, charts, and weekly conferences and enters data into heart transplant databases as needed, including the United Network for Organ Sharing (UNOS) system.
• Provides research nurses with clinical data on subjects enrolled in research studies.
• May be asked to assist in writing summaries for administrative or clinical purposes as requested by the Nurse Manager, Nurse Director, or Medical Director of the Heart Transplant Program.
Participates with all assigned QAPI processes as directed.
PROFESSIONAL ATTRIBUTES:
• Establishes effective professional relationships with other members of the healthcare team.
• Serves as a role model and resource for other staff, providing assistance with the care coordination process, clinical skills, and patient teaching.
• Maintains communication with other transplant programs to keep abreast of current information.
• Maintains professional relationships with appropriate professional organizations.
• Regularly incorporates new scientific findings in specific areas of expertise into clinical practice.
• Maintains awareness of new developments in the specialized area and participates in research activities.
PARTICIPATORY MANAGEMENT:
• Utilizes time and materials effectively.
• Participates in the orientation of new staff members, students, and others as appropriate.
• Provides input into the evaluation of other staff as appropriate.
• Adheres to hospital and departmental policies. Recommends changes in policies and procedures through appropriate channels.
• Participates in determining and implementing goals and objectives for the transplant program, and in the periodic review of the program.
QUALIFICATIONS:
1. Graduate of an approved school of nursing with current registration in Massachusetts. Newly licensed nurses BSN required.
2. Five years or more of Intensive Care Cardiac Surgery experience required; must have within the past 2 years.
3. Transplant Patient care experience required.
4. Ambulatory experience with telephone triage strongly preferred; within the last 12 months.
5. Knowledge of community resources and post/non-acute care providers preferred.
6. Familiarity with discharge and resource planning preferred.
7. CCTC or ABTC obtained within 2 years of employment.
SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:
Ability to work independently while collaborating with others in the care of complex patients with advanced heart disease, multiple co-morbidities, and eventual heart transplantation.
Excellent written and oral communication skills to work with individuals from various fields of expertise, including physicians, nurses, hospital administrators, and outside clinical and administrative providers. Flexibility, excellent judgment, and the ability to work independently and as part of a team are essential.
Excellent organizational abilities to formulate and meet rigorous clinical timetables.
Must display interpersonal skills and ability to work as part of a multidisciplinary team.
Maintains communication with other transplant programs to keep abreast of current information.
Utilizes time and materials effectively.
WORKING CONDITIONS:
Administrative office, outpatient, and inpatient settings. Working conditions may include busy and sometimes stressful patient care encounters, and environments where there may be exposure to communicable diseases and hazardous materials.
Work is performed across administrative, outpatient, and inpatient healthcare settings. The role requires managing a fast-paced and frequently changing environment, including periods of high operational demand and stressful patient care situations. Working conditions may include exposure to communicable diseases, hazardous materials, and other clinical risks consistent with the healthcare environment. The position requires frequent collaboration with patients, staff, providers, and leadership across multiple settings.
SUPERVISORY RESPONSBILTIES:
HOSPITAL WIDE RESPONSIBILITIES:
Works within legal, regulatory, accreditation and ethical practice standards relevant to the position and as established by BWH/Partners; follows safe practices required for the position; complies with appropriate BWH and Partners policies and procedures; fulfills any tra