Nurse Clinician - Center for Blood Cancers

Why Join Us? We are looking for talented and highly-motivated individuals who demonstrate a natural desire to support the meaningful work of community oncologists and the patients we serve.

The Center for Blood Cancers Nurse Clinician (NC) operates under a clinical case management model to provide and coordinate care to patients during all phases of the treatment in the Center for Blood Cancers Program. In collaboration with physicians, advance practice providers, patients and families, the Nurse Clinician (NC) gathers data and uses his/her knowledge of complex health problems to provide and facilitate the delivery of quality, evidenced-based care, while promoting efficient and effective patient outcomes in both the inpatient and outpatient setting. This position provides education and support to physicians, staff, patients, caregivers and families regarding innovations/evidence for quality outcomes. In collaboration with physicians, staff, patient and families, the NC facilitates implementation of the plan of care during all phases of treatment and facilitates communication among patients/caregiver/family and all care providers. The NC is cognizant of the psychosocial and financial impact that disease and hospitalization has on the patient and family and acts as an advocate to identify and obtain needed resources and support. Nurse clinicians have expertise in nursing practice and ensure continuing expertise through clinical experience and continuing education. The complexity of the role requires a high level of autonomy.

Essential Functions:
•    Facilitates patient and family-centered visits and interactions, promoting collaboration, and communication between the patient, family, and all health care providers in the outpatient setting. Plans and manages care collaboratively with the interdisciplinary team, patient and family.
•    Performs daily acute health assessments, including pertinent history, review of systems and physical assessment; collects and reviews all pertinent clinical and diagnostic data to assist physicians and team members to thoroughly assess and evaluate each patient encounter. 
•    Performs direct care of patient as needed 
o    Vital sign measurements
o    Lab draws/specimen collection
o    Assists with provider performed procedures including, but not limited to, bone marrow biopsies
o    Starts peripheral IVs, manages central venous access devices including accessing and de-accessing implanted ports and PICCs
o    Prepares & administers chemotherapy and other standard of care or research drugs according to Tennessee Oncology (TO) standards after training and competency validation 
o    Manages prescription/refill extensions per TO policy, procedure, standards
o    Triages calls/communications from outpatients and their caregivers, hospital staff, home care agencies, etc. Utilizes critical assessment skills to assess and evaluate patient concerns/needs, using approved symptom management algorithms
•    Collects and synthesizes pertinent data, assists with interpreting findings, communicates the need or issue to the physician and team, and implements plan, following all policies, procedures, or physician-directed protocols. Documents relevant information in medical record. Shares findings with patient and family in a meaningful manner. 
•    Collaborates with physicians, nursing staff, patient/family, and other disciplines to define plan of care with measurable clinical outcomes. Takes primary responsibility for coordinating the plan of care across the continuum of treatment (from the time the patient enters the Center for Blood Cancers Program until they return to the care of the referring physician.)
•    Maintains up to date knowledge of Heme-Malignancy/Center for Blood Cancer drug regimens, therapeutic interventions, supportive care and symptoms management interventions and/or other therapies
•    Maintains patient outcome as central focus. (Outcomes include excellent clinical management, appropriate patient and family education, follow-up care, and patient’s perception of satisfaction with services and care provided). Identifies actual and potential problematic situations and actively intervenes to achieve a satisfactory resolution.
•    Monitors patient’s response to treatment and works with all health care providers, patient, and family to adjust plan of care as needed.
•    Acts as a liaison between patients and providers to ensure that all essential medical communications are clear and accurately conveyed.
•    Assists patient and family in navigating healthcare system for clinical needs. In collaboration with physician and patient/family, assesses need for referrals to other healthcare resources and assists with contacts. 
•    Collaborates with patient and family, nursing personnel, and care coordination staff/patient advocates/financial counselors/social services to assure needs are clearly understood and met (including psychosocial, financial, prescriptions, transportation or other factors that could negatively impact care). Works collaboratively with external agencies and Tennessee Oncology centralized teams such as Telephone Triage/Care Coordinators to avoid duplication of efforts
•    Serves as a resource for the patient and family by providing comprehensive education at all phases of care that is adjusted to the learning needs/level of the patient and family. Provides relevant educational materials.
•    Provides additional emotional support for the patient and family throughout the treatment process, with attention to the special problems of the complex heme-malignancy patient.
•    Acts as a liaison between inpatient and outpatient nursing, assisting with coordination of care pre and post discharge from the hospital or emergency/urgent care setting
•    Assists with completion of required paperwork such as FMLA, short & long-term disability, etc.
•    Assists with surgery scheduling, prior authorizations, and other related duties as needed
•    Follows all policies, procedures, standards related to use of drug cabinet including drug verification, drug administration, documentation, and billing
•    Documents charges for services performed and medications administered.
•    Assists with stocking & management of clinic inventory and supplies.
•    Generates and reviews daily clinical reports for completion and accuracy.
•    Serves as resource person to contribute to the training and education of other physicians and staff.
•    Works collaboratively research teams regarding patients who are potentially eligible for research studies or are enrolled on study; disseminates protocol information and assists in protocol compliance.
•    Participates in leadership activities, such as participating in interdisciplinary patient care meetings, assigned committees, QOPI or other accreditation preparation, and quality improvement activities as assigned.
•    Demonstrates continued professional growth by actively seeking opportunities for continued learning, maintaining relevant professional organizations memberships and obtaining/ maintaining specialty certification. 
•    Performs other duties, within realm of competency, as assigned.
•    Travels to other TN Oncology clinics and or care settings as needed

Qualifications

EDUCATION & TRAINING:
•    Graduation from an accredited/approved school of nursing. BSN strongly preferred. 
•    Licensed to practice professional nursing in the State of Tennessee or holds compact state license.
EXPERIENCE:
•    Three years nursing experience required. One year of Oncology or Heme-malignancy/Stem Cell Transplant nursing experience preferred. 
•    Experience in an outpatient facility preferred
CERTIFICATION:
•    Current AHA or ARC certification in Basic Life Support (BLS) or required within 3 months of hire
•    OCN or BMTCN certification required within 2 years of hire. 
•    ONS Fundamental Chemotherapy/Immunotherapy card required within 6 months of hire. 

Physical Requirements:

OSHA Risk Category: 1

Physical Activity Required    Amount of time
    None    Less than 1/3
(Occasionally)    1/3 to 2/3
(Frequently)    More than 2/3
(Regularly)
Standing                 X
Walking                 X
Sitting         X        
Fingering or manual dexterity                 X
Repetitive finger motion                 X
Lifting or exerting force         X        
Up to 50 pounds             X    
Reaching or stretching         X        
Climbing or balancing    X             
Crouching or stooping    X             
Speaking                 X
Hearing                 X
Seeing (with correction)                 X