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General Summary
This role is aimed for the nurse who is a clinical and professional leader at the practice setting level. This position advances evidence based practices, leads practice setting governance initiatives, and mentors others to achieve and grow in the role of the professional nurse. This position also takes a leadership role in overall design and implementation of a patient centered care delivery system that facilitates achievement of patient outcomes, supports continuity of care and patient flow between care delivery sites, and enhances patient and care giver satisfaction.  Monitors the quality and cost effectiveness of nursing practice and governance systems at the practice setting level.  Is accountable patients and families for the processes and outcomes of care during an episode of care.  Is accountable to peers for the advancement of group practice on the practice setting, and to the nurse manager for the totality of work performance. 

Principal Responsibilities and Tasks

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification.  They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

Clinical Practice/Care Delivery

1. Serves as a clinical expert and professional resource for the practice setting nurses; mentors and coaches other nurses to advance their development
2. Advances clinical practice on the practice setting; consistently integrates evidence into practice and uses this as a firm foundation for practice setting practice; coaches staff
3. Utilizes clinical expertise to teach other nurses informally on the practice setting in a structured role or through formal teaching in classes
4. Role models patient-Centered Care and mentors others in their growth
5. Participates in some or all elements of research
6. Independently provides, directs and coordinates clinical care within the critical care transport environment. Is accountable for the processes and outcomes of care delivered to patients.
   1. Conducts comprehensive patient assessment, integrating multiple data sources, which forms the basis for identification of patient/family needs and problems.
   2. Facilitates effective transition of patients between referring and receiving institutions. 
   3. Works effectively with the multidisciplinary team to plan patient care.
   4. Under orders from the base station attending physician or established medical guidelines, initiates immediate life support therapies including but not limited to parenteral administration of approved medications; intravenous/intraosseous therapies; EKG monitoring; arrhythmia interpretation; CPR; defibrillation; external cardiac pacing airway management; endotracheal intubation; cricothyrotomy; ventilator operation; chest decompression; management of patients with altered neurological status; including cervical spine immobilization; application of splints and devices needed for transport.
   5. Utilizes available resources within and outside the institution for the purpose of providing comprehensive care to patients and families.
   6. Evaluates and revises individualized plan of care appropriately reflecting current and changing status of the patient and/or family.
   7. Assesses patient progress and offers additional or alternate plans of care as needed.
7. Provides bedside patient care in an intensive care unit during low transport volume times in order to maintain bedside clinical skills.
8. Maintains transport unit in a state of readiness; maintains a safe transport environment by insuring that all equipment is secured and that the ambulance systems are operationally safe.

Practice Focus Areas:

1. 1. Leads practice setting based Clinical Practice governance
2. 1. Leads practice setting based efforts for developing/evaluating RBC

1. 1. Oversees practice setting based patient education processes

1. 1. Develops clinical practice protocols and standards for practice setting

Professional Development

1. Takes a leadership role in the design, implementation, coordination and evaluation of an effective model for program professional practice and governance.
2. Actively engages in advancing own practice; role model for others
3. Mentors and coaches others to achieve/maintain competency required for the patient population served
4. Serves as an expert preceptor and mentors others in the preceptor role; plans clinical experiences for orientation
5. Mentors and coaches practice setting leaders or those assuming leadership roles on councils or governance initiatives
6. Keeps self current with regard to the following trainings and/or certifications: Basic Cardiac Life Support (BCLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), Critical Care Nurse Certification (CCRN), and annual Infection Control, Fire Safety, and TB training.
7. Serves as expert resource in the delivery of clinical care to patients and integrates knowledge and skills in delivering patient care.

Practice Focus Areas:

1. 1. Leads practice setting based Professional Development governance activities; participates actively in divisional and organizational efforts
   2. Coordinates practice setting level education appropriate for patient population
2. 1. Oversees practice setting based competency validation processes
3. 1. Oversees  practice setting orientation program
4. 1. Provides health-related contributions through community services, such as health fairs, and participates in public relation activities

1. 1. Supports an effective peer review process to monitor quality and effectiveness of care.​​​​​​​

Service Quality/Safety

1. Models customer service behaviors and service recovery skills
2. Leads efforts to address Nursing sensitive quality Indicators (NSQI) improvement opportunities; develops/implements and evaluates action plans
3. Monitors patient and practice setting safety standards; actively contributes to development and implementation of improvement plans
4. Mentors CN Is and CN IIs on PI and/or evidence-based practice
5. Participates in some or all elements of research
6. Is accountable for the outcomes, cost effectiveness, and quality of care for patients within MEC:
7. Takes a leadership role in the development and/or revision of a practice setting based quality management program.
8. Assures the quality and outcomes of program systems and committees

Practice Focus Areas:

1. Leads practice setting based Process Improvement governance activities.
2. Leads efforts for patient/family satisfaction and Service Recovery at practice setting level; develops and implements action plans to address initiatives; serves as a customer service liaison or representative.
3. Trends quality data on a consistent basis and leads efforts to address deficiencies.
4. Oversees Joint Commission and other regulatory site visits (mock and actual); helps prepare practice setting and staff on an ongoing basis​​​​​​​

Unit Operations

1. In collaboration with MEC Management, participates in day-to-day practice setting management, including staffing, scheduling, incorporation of professional practice activities, multidisciplinary collaboration, quality monitoring, and staff development.

• Assists with keeping MEC Management abreast of staffing, committee activities, and group participation in program development.
• Takes a leadership role in interviewing and recommending selection for new staff.
• Takes a leadership role in designing, managing, and evaluating the program's system for reviewing promotions.
• Takes a leadership role in the orientation of nursing staff.  Monitors and/or evaluates effectiveness of overall practice setting preceptorship program.  Tracks staff competency and assure that required activities to demonstrate competency are completed.
• Demonstrates awareness of practice setting financial performance.  Assists in cost reduction and improved efficiency.
• Performs charge role as scheduled; mentors new charge nurses
• Orients nurses to governance structure and councils
• Leads practice setting governance activities at some level and actively participates at divisional or organizational level
• Serves as service steward such as liaison for lab, nutrition, pharmacy, etc.  Incorporates feedback from team members into improvements in practice setting operations, which support patient care.
• Assume active role in regulatory activities such as tracers, disease specific certification visits, etc.
• Roles models and holds peers accountable for maintaining AACN guidelines for Healthy Work Environment (communication, collaboration, effective decision making, recognition, leadership, staffing).

Practice Focus Areas:

• Leads practice setting governance initiatives
• Leads practice setting based efforts addressing elements of Healthy Work Environment
• Leads practice setting Reward and Recognition activities
• Leads efforts that support practice setting operations such as equipment maintenance, scheduling, supply utilization monitoring etc.
• Leads practice setting based peer review processes

Education and Experience

• Graduation from an accredited school of nursing.
• Current licensure in the State of Maryland as a Registered Nurse.
• Current Advanced Cardiac Life Support (ACLS) training or Pediatric Advanced Life Support (PALS), if applying for as a pediatric nurse. Critical Care Nurse Certification (CCRN); and annual Infection Control, Fire Safety, and TB training.
• Maintenance of 20 contact hours of education/year.
• Member of a professional organization.
• Critical Care Nurse Certification (CCRN) is required or must be obtained within one year of employment. Management may grant a six-month extension for special circumstances.
• Bachelors degree is preferred
• Minimum three  years of relevant clinical work experience within intensive care settings.  Per regulations associated with transport nurses, experience must be within the past five years.

Knowledge, Skills and Abilities

• Demonstrated ability to act in a clinical leadership role.
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• Demonstrates competency in the following skills, annually: endotracheal intubation, cricothyrotomy, chest decompression, intraosseous infusion, arterial and central line maintenance, and program specific skills (equipment, etc.).
• Demonstrated ability to promote professionalism through acts such as involvement in professional organizations, teaching, research, publishing, and/or certification in area of specialty.
• Demonstrated/documented interpersonal skills and highly effective communication skills.
• Demonstrated evidence of professional growth and development through enrollment in degree program, specialty certification, teaching in formal hospital programs or outside of hospital, board member of professional association, etc.
• Demonstrated ability to assume a clinical leadership role.  Demonstrated effectiveness as a multidisciplinary team member.
• Ability to learn and use computer systems in order to manage patient information.
• Ability to demonstrate knowledge and skills necessary to provide care appropriate to the patient population(s) served.  Ability to demonstrate knowledge of the principles of growth and development over the life span and ability to assess data reflective of the patient's requirements relative to his or her population-specific and age specific needs.    

Patient Safety

• Takes action to correct observed risks to patient safety.
• Reports adverse events and near misses to appropriate management authority.
• Identifies possible risks in processes, procedures, devices and communicates the same to those in charge.

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