The Cardiovascular Operating Room Nurse provides specialized patient care in a surgical setting in accordance with applicable scope and standards of practice with the policies, values, and mission of the organization. The CVOR nurse monitors and manages the patient and operative environment during surgery to maintain a safe environment, optimize outcomes and maximize available resources. All nursing practice is based on the legal scope of practice, national and specialty nursing standards, Children's National Policies and Procedures, and in accordance with all applicable laws and regulations. The Professional Model of Care requires registered professional nurses to be responsible and accountable for their own practice. Children's National supports the development of RN relationships within the community; specifically those relationships associated with the health and well-being of the community at large. A RN is an independent practitioner who functions as an identified resource to staff in a patient care area. H/She will provide comprehensive patient care to a variety of patients. Incorporate all members of the health care team in the planning and delivery of patient care. Will deal successfully with complex clinical problems. Conduct quick assessment of patients and handle emergency situations appropriately. Demonstrate evidence based practice through participation in unit projects and activities.Minimum Education Bachelor's Degree BSN (Required) Minimum Work Experience 3 years Experience as an Operating room RN (Required) 2 years Experience in Cardiothoracic or Cardiovascular surgery. Internal applicants may acquire their experience at CNH. (Required) 1 year Pediatric experience preferred (Preferred) Required Skills/Knowledge Successfully complete the hospital orientation at Children's National. Excel in organizational skills, adjust for changes and be able to complete assignments on time. Care will incorporate best practices based on benchmarks and evidence within the literature Maintain proficiency in Cardiovascular/Cardiothoracic surgery and serve as a resource for new information or changes to Cardiovascular/Cardiothoracic care. Knowledge of basic computer skill and ability to learn and apply new technology and skills Adaptability: Maintaining effectiveness when experiencing major changes in work responsibilities or environment; adjusting effectively to change by exploring the benefits of trying new approaches, and collaborating with others to make the change successful Building Partnerships: Developing and leveraging relationships within and across work groups to achieve results Collaboration: Working cooperatively with others to help a team or work group achieve its goals Diversity and Inclusion: Being sensitive to cultural diversity, race, gender, and other differences in the workforce; recognize the value of diverse perspectives and experiences and fosters a work environment reflective of the community Decision Making: Identifies and understands problems and opportunities through gathering, analysis and interpretation of information; chooses the best course of action and evaluates alternatives, and makes timely decisions; takes the action that is consistent with available facts and constraints and optimizes outcomes; demonstrates critical thinking skills by problem solving patient care. Managing Relationships: Meeting the personal needs of individuals to build trust, encourage two-way communication and strengthen relationships Managing Work: Effectively manages one time and resource to ensure work in completed efficiently Required Licenses and Certifications Registered Nurse in District of Columbia Upon Hire (Required)Basic Life Support for Healthcare Provider (BLS) Upon Hire (Required) Certified Nurse OR (CNOR) (Preferred) Functional AccountabilitiesFunctions as a Cardiovascular/Cardiothoracic OR Nurse

• Maintain proficiency in Cardiovascular/Cardiothoracic surgery and serve as a resource for new information or changes to Cardiovascular/Cardiothoracic care.

• Consults and coordinates with healthcare team members to assess, plan, implement and evaluate intraoperative patient care plan

• Consider assessment data gathered during handoff and from the patient and family to ensure completion of plan of care

• Prepares the CV operating room for the patient and surgical procedure. Assembles equipment, supplies and implants, and ensures equipment is function, supplies and implants are available. Demonstrates proficiency in both open and closed heart procedures.

• Understands the purpose of positioning devices and uses them correctly, following policy, to protect the patient from injury and to promote optimal exposure of the surgical site.

• Actively participates in Universal Protocol and timeout, including the fire risk assessment with the surgical team prior to the start of the surgical procedure according to hospital guidelines. Completes the post procedure pause at the conclusion of the case.

• Delivers perioperative patient and family centered care incorporating the nursing process while providing developmentally appropriate, culturally sensitive, evidenced based care.

• Working knowledge of cardiopulmonary bypass and ECMO to assist team in rapid deployment

• Follows established policy and procedures for instrument counts; initiates corrective action when instrument counts are incorrect.

• Verifies medications, concentrations, expiration dates of all medication received on the sterile field in concert with surgical tech, surgeon, and anesthesia provider

• Utilizes outcome data at the patient level to make care decision in preparation for and during the surgical procedure

• Serves as the communication liaison to patients, families, and members of the operating room

• Participates in the quality improvement activities and uses quality measures to understand individual and unit performance

• Provides direct guidance and oversight of the orientee in all patient care and clinical activities and ensures those behaviors adhere to documentation standards, standards of care, and policies and procefures

• Participates in unit shared governance initiatives to improve patient care, throughput as determined by leadership

• Works within the scope of practice and delegates according to Nurse Practice Act

Demonstrates the knowledge of risk and safety issues and uses measures to ensure optimal outcomes

• Communicates observations or concerns related to unsafe situations that pose risk to patients, families or the healthcare team

• Stop in the face of uncertainty and take time to resolve the situation

• Continuously validate and verify information needed for decision making

• Demonstrate accurate, clear, and timely verbal and written communication

• Actively promote safety for patients, families, visitors and co-workers

• Pay attention to detail, practice STAR - Stop, Think, Act, Review

• Assist the surgical team in emergency situations

Demonstrates actions that shows accountability and professional judgment

• Arrives to the unit on time

• Handles difficult situations appropriately

• Utilizes downtime constructively

• Complies with departmental policies and procedures

• Consistently participates in staff meeting and in-services to improve skills

• Completes, documents, and reports all mandatory education and training

New Knowledge, Innovations, and Improvements

• Initiate ways to improve operations through quality improvement and implement related solutions

• Care incorporates best practices based on benchmarks and evidence within the literature

Transformational Leadership

• Contribute to Magnet re-designation as evidenced by independent involvement or leadership in: committees, task forces, and/or community outreach

• Role model critical thinking skills by problem-solving patient care and unit/system issues.

• Communication reflects development of plan of care and ability to advocate to meet patients' needs; makes suggestions for resolution of system issues

• Role model procedures for escalation of issues; Utilizes chain of command

• Demonstrate a collegial and respectful relationship with peers, physicians and other departments

• Demonstrate proper use of identified hand off process; Follow up on inconsistent practice related to handoff

• Take the lead in implementing change and support management decisions

• Role model behavior that reflects empathy, concern, and a desire to help others

Structural Empowerment

• Independently maintain regulatory requirements e.g. license, BLS

• Initiate professional activites to enhance nursing practice

• Engage in active review of peers giving constructive feedback through timely participation in evaluation

• Role model adherence to national safety standards and service excellences standards; Champion advancement of education and certification

• Orchestrate involvement of the healthcare team and role model professional behavior and teamwork with co-workers

• Serve as a resource as needed and know when to escalate to next level

Exemplary Professional Practice

• Analyze assessment data gathered from patient and family to ensure completion of plan of care

• Role model excellent clinical skills with complex patients; Care reflects analysis of patient status and appropriate interventions

• Direct prioritization and organization for complex patient with rapidly changing needs

• Documentation exemplified adherence to the highest standards of practice

• Anticipate and proactively plan for educational needs; Verify with patient and family through the hospital /outpatient stay and prior to discharge

• Excel in organizational skills, adjust for changes and be able to complete assignment on time

• Role model caring in all encounters with patient and family as evidenced by feedback from parents and an increase in patient satisfaction scores

Organizational AccountabilitiesOrganizational Accountabilities (Staff) Organizational Commitment/Identification

• Anticipate and responds to customer needs; follows up until needs are met

Teamwork/Communication

• Demonstrate collaborative and respectful behavior

• Partner with all team members to achieve goals

• Receptive to others’ ideas and opinions

Performance Improvement/Problem-solving

• Contribute to a positive work environment

• Demonstrate flexibility and willingness to change

• Identify opportunities to improve clinical and administrative processes

• Make appropriate decisions, using sound judgment

Cost Management/Financial Responsibility

• Use resources efficiently

• Search for less costly ways of doing things

Safety

• Speak up when team members appear to exhibit unsafe behavior or performance

• Continuously validate and verify information needed for decision making or documentation

• Stop in the face of uncertainty and takes time to resolve the situation

• Demonstrate accurate, clear and timely verbal and written communication

• Actively promote safety for patients, families, visitors and co-workers

• Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance