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Registered Nurse (Tele-ICU/CCU), San Diego, CA, US ID#17007

When your mission depends on quality health care, rely on a team who can deliver results. From cutting-edge analysis to optimized health programs, Cherokee Nation Healthcare Services (CNHS) can manage any size federal project. Federal clients who partner with CNHS improve their access to care, medical readiness and program efficiency. Wherever the mission takes you, CNHS delivers world-class solutions, on time and on budget. 
SUMMARY
Candidates for this position will work in a virtual Tele-Critical Care Unit/ Critical Care Unit Remote Monitoring Platform (Tele­ ICU/CCU RMP) to be used by Hospital Staff at the Virtual Medical Center in San Diego, CA.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Provides comprehensive virtual nursing care, monitoring and consultation to on-site medical staff caring for acute and/or chronically ill adult to geriatric patient populations with complex and critical medical-surgical conditions while meeting established standards of care, and delivering care within the principles of the Nursing Process.

  • Collects, documents, analyzes, and interprets physiological, hemodynamic, and laboratory results important to patient treatment regimens and ongoing assessments. Reports any abnormal or pertinent findings to on-site medical providers, charge nurses and supervisors as appropriate. Virtually, contributes to medical examinations of patients by observing, recognizing, recording and reporting changes in patient conditions, symptoms, reactions to medications, and responses to treatment modalities to on-site care personnel.
  • Virtually performs all nursing care procedures consistent with the command's nursing procedure manual and unit specific policies.
  • Collects and analyzes patient and family data for the purpose of assessment, diagnosis, and collaboration of case management between medical providers, the patient, and their family.
  • Efficiently assembles a focused assessment of physiological, psychological, and medical record data.
  • Uses critical thinking skills in diagnosing clinical problems and consults with on-site care providers on potential interventions. Assists on-site care providers in re­evaluating prior diagnoses and care plans at appropriate intervals in accordance with the individual patient’s expected outcomes.
  • Prioritizes and reports clinical observations accurately and in a timely manner.
  • Uses clinical decision support tools in determining evidence-based practices for clinical problems.
  • Develops potential resolutions to routine, urgent, and emergent patient problems appropriately by demonstrating effective decision-making. Works closely with on-site care personnel to ensure resolution. Advocates needs and wishes of patients and family with regard to health care.
  • Formulates and presents succinct and comprehensive assessments of real or potential problems to the on duty intensivist.
  • Provides consultation on clinical patient problems in a timely manner; communicates unresolved issues to the on duty intensivist.
  • Provides consultation on emerging clinical problems by direct observation via teleconferencing
  • Proactive surveillance of adverse physiological trends
  • Assurance of appropriate prophylactic strategies based on intensivist’s orders
  • Patient chart review
  • Appropriate reaction and follow through to medical and biotelemetry alerts and alarms
  • Remain proficient in personal ICU knowledge of pathophysiology, pharmacology, hemodynamics, bedside technology and nursing care.
  • Remain proficient in basic and advanced features of the "electronic critical care CAO (eCC), the Early Warning Dashboard (EWD), the Medical Early Warning System (MEWS) and all associated programs within the organization to enhance efficiency in assessment and documentation.
  • Consults with members of the internal and external Tele-ICU team and bedside ICU interdisciplinary teams to ensure safe and error-free care during routine care and emergent conditions.
  • Complies with best practices and other care directives that the hospital has endorsed in response to Performance Improvement initiatives.
  • Reports clinical, administrative or technical problems that results in medical errors, near misses, unsafe care or suboptimal communication between the Tele-ICU staff and ICU staff through the Patient Safety Report system and Chain of Command in accordance with pertinent policies and procedures.
  • Maintains patient confidentiality.
  • Virtually assists on-site care personnel in the administration of all medications, immunizations, blood and blood products, as prescribed by a Licensed Independent Practitioner (LIP) and in compliance with NMCSD guidelines, policies and instructions.
  • Ensures the accurate handling of medications and controlled substances to include their proper labeling, storage, administration and wasting, as well as the proper documentation of all actions in accordance with NMCSD guidelines, policies and instructions.
  • Utilizes knowledge of pharmacology and intravenous therapy to closely monitor expected responses and potential side-effects, documents all actions, and reports observations directly to the on-site care personnel.
  • Virtually consults with on-site care personnel on the administration of potent vasoactive medications, IV push medications, arterial blood gas sampling, central line maintenance, and care of respiratory compromised and critically ill patients with complex health impairments.
  • Identifies life threatening conditions and consults with the on-site care personnel on potential treatment plans utilizing current appropriate algorithms and other approved protocols.  During patient care emergencies, provides appropriate virtual support to ancillary personnel upon request. 
  • Virtually performs nursing care specific to the unique needs of families suffering a bereavement loss.
  • Consult with bedside staff in the evaluation for the presence of pain.
  • Identifies patient/family/significant other need for health teaching and notifies the bedside nurse as needed.
  • Assesses educational needs of patients and families and provides instructions on procedures and treatments as needed.
  • Consults with the multidisciplinary team to ensure proper coordination of patient care and education.
  • Consults on all patient readiness for transfer or discharge and assists in the preparation of all required documentation, and provides follow-up information to the patient and/or family when requested.
  • Identifies and attempts to defuse escalating patient situations to minimize the use of physical restraints in accordance with NMCSD guidelines, policies and instructions by providing recommendations for alternative plans of care.
  • Virtually ensures the safe and effective operation of patient care equipment. This includes the safe practice of nursing care, proper handling of hazardous materials, and maintenance of physical security.
  • Monitors, operates and troubleshoots highly specialized equipment to include, but not limited to, electronic arterial pressure sensors, cardiac/respiratory monitoring systems, infusion pumps, patient controlled analgesia pumps, and various types of mechanical ventilators, end tidal 02/C02 devices, and central venous and arterial catheters.  Collaborates with other ancillary support departments when troubleshooting problems with specialty equipment.
  • Maintains nursing practice by reviewing literature and/or attending seminars, programs, or workshops for continuing education.
  • Upon Government request, provide basic and advanced level classes on the unit and participates in command education and training programs.  Applies computer skills in the provision of care, physiological monitoring and documentation.
  • Participates in Continuous Improvement initiatives by identifying problems, collecting data, developing a plan of action, assessing results, and providing recommendations. Participates in evidence based projects and research that impact nursing practice and collects relevant data to support activities.
  • Responsible for reading and responding to all pertinent email routinely on scheduled shift worked.
  • Participates in staff meetings.
  • Submits scheduled and worked hours accurately according to NMCSD, VMC-IP/TCCU guidelines, policies and instructions.
  • Completes and adheres to all required unit and command training prior to expiration date. Articulate the role and functions of the tele-ICU clearly and professionally to visiting guests.
  • Assists in the maintenance of the care environment.

SUPERVISORY/MANAGEMENT AUTHORITY
No supervisory/management authority.
KNOWLEDGE, SKILLS AND ABILITIES

  • Knowledge of advanced nursing specialty concepts including principles and practices to independently perform nursing assignments that require expanded training and experience.
  • Knowledge of the pharmacological indications, dosages, delivery modes, desired actions, side effects and incompatibilities of therapeutic agents associated with the inpatient population served.
  • Skill to observe and note changes in patient conditions using specialized monitoring devices and diagnostic  test results,  while maintaining  awareness  of expected  responses to prescribed therapies.
  • Knowledge to develop individualized, comprehensive nursing plans of care to meet the specialized needs of the inpatient population with consideration of physical, emotional, social and cultural factors.
  • Knowledge to act decisively and appropriately during clinical emergencies and establish priorities in routine and stressful situations. Evidence of ability to cope well with change. Provide basic technological support and escalates unresolved issues in a timely manner per unit standard.
  • Skill to communicate effectively both verbally, in writing and via Video Tele-Conference.
  • Skill to develop and maintain good interpersonal, interdepartmental, and inter-facility relations.
  • Skill to act as a patient advocate and customer service representative.
  • Knowledge of patient's rights and Advanced Directives.
  • Knowledge of and skill to counsel patients and families regarding changes in lifestyle and assistance available from community agencies.
  • Knowledge of the command's Mission and Vision and how the position effectively contributes to their support.
  • Knowledge of infection control guidelines and proper procedures for handling, storage and disposal of infectious waste.
  • Knowledge of the information management systems utilized for clinical documentation and data retrieval.  

Special Requirements

  • In accordance with BUMEDINST 6220.9B, all personnel, including direct and indirect care providers, administrators, ancillary services, volunteers, students, and others who may come in contact with patients, must receive and maintain appropriate vaccination against seasonal influenza. The incumbent must, as a condition of employment, be immunized on an annual basis against influenza. Refer to local command influenza instruction.
  • In accordance with BUMEDINS 6230.15, susceptible or occupationally exposed health care employees who have direct contact with patients will receive appropriate immunization against communicable diseases unless a current immunization, a protective titer, or a medical exemption is documented. This policy applies to all health care settings, regardless of age or sex of the health care employee. Employees who have contact with or potential exposure to human blood or blood products (whether from patient care, laboratory, or other health care settings) are provided hepatitis B virus vaccine in accordance with the local blood borne pathogen exposure control plan.
  • Incumbent must have active, current registration as a professional nurse in a State, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.  Incumbent must be in good standing, and under no restrictions, with the state licensure board in any state in which a license is held.
  • This position is a Department of Navy Civilian Drug Testing Designated Position (TOP) subject to applicant testing and random employee drug testing.
  • In accordance with BUMEDINST 1500.ISC employees assigned to or subject to being assigned to duties providing direct patient care, either diagnostic or therapeutic must possess and maintain: Basic Life Support (BLS) certification.
  • Must be able to attain and maintain a SECRET security clearance. A favorable Access National Agency Check and Inquiries (ANACI) background investigation is required for a non-critical position with access to a network system.  A favorable Tier 3 background investigation is required for all NCS positions with access to network systems and PII.
  • The incumbent will work rotating shifts to include weekends and holidays. Shift lengths may be 8, 10 or 12 hours.
  • Coverage is required 24/7/365.  The Contractor shall be responsible for administering the leave for individuals filling coverage positions.  The contractor shall provide replacement coverage by an e-ICU/Virtual Critical Care Registered Nurse SME who meets the minimum contract qualifications and is approved for work (i.e., has been credentialed and privileged, as appropriate, has satisfactorily completed orientation, and has originating site access).  The Contractor shall prepare the schedule of workers for all positions for which replacement coverage is required.
  • A current TNCC Certification is required and must be maintained.
  • A current CCRN Certification or CCRN-E Certification is required and must be maintained.
  • Applicants and incumbents have a minimum of five (5) years of recent experience as a staff nurse in high-acuity adult critical care or adult Tele-Critical Care.

WORK ENVIRONMENT
This position is primarily performed in a climate controlled.

About Cherokee Federal
Cherokee Federal – a division of Cherokee Nation Businesses – is a team of tribally owned federal contracting companies focused on building solutions, solving complex challenges, and serving the nation’s mission around the globe for more than 60 federal clients. Our team of companies manages nearly 1,000 projects of all sizes across the construction, consulting, engineering and manufacturing, health, and technology portfolios.
Since 2012, the Cherokee Federal team of companies has won more than $5 billion in government contracts. Our 3,000+ employees work in 26 countries, 50 states and 2 U.S. territories.
Why choose Cherokee Federal? Visit our website and learn about the great reasons to join our team.  cherokee-federal.com
Compliance
Applicants selected will be subject to a U.S. Government security investigation and must meet eligibility requirements for access to classified information.
We are an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected Veteran status, gender identity and sexual orientation. If you’d like more information about your EEO rights as an applicant under the law, please copy and paste the links to the following two sites: EEO Statement | EEO Poster; https://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf   and  https://www.dol.gov/ofccp/regs/compliance/posters/pdf/ofccp_eeo_supplement_final_jrf_qa_508c.pdf
If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may e-mail CNB.Compliance@cn-bus.com for assistance. This email address is for accommodation requests only and cannot be used to inquire about the application process or status.
For Pay Transparency Non Discrimination provision, please copy and paste the following link: Pay Transparency Nondiscrimination Provision; https://www.dol.gov/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf 
We maintain an Affirmative Action Plan for proactively seeking employment and advancement for qualified protected veterans and individuals with disabilities. Upon request, we will schedule time to make our Affirmative Action Plan accessible. If you are interested, please submit a written request with the email subject line: 2020 Request to View Affirmative Action Plan to the Compliance Administrator at “CNB.Compliance@cn-bus.com” This email box is not for resumes or follow up on job applications.


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