The RN Clinical Instructor directs, oversees, and maintains responsibility for clinical orientation for nursing clinical fellows. Serves as a "hands-on" direct care giving and teaching role with patients, families and nursing clinical fellows. Directly supervises activities of nursing clinical fellows.

The Neonatal Intensive Care Unit is a 70 bed Level IV NICU. Care is delivered to infants and families transported from approximately 40 regional community hospitals in three states. The patient ages typically range from 23 weeks gestation to 37 weeks gestation, term infants and older children with multiple disease processes. Comprehensive services include medical-surgical care for infants with conditions including but not limited to pre-maturity, genetic disorders, pulmonary disorders and cardiac disorders. The unit also provides for the inter-hospital transportation of infants as well as ECMO services.

The NICU is ranked nationally every year by in neonatology, and we are the only top 10 ranked program in the Washington D.C. metropolitan area. We treat more than 800 babies every year. Our success is rooted in our dedication to providing family centered care in a collaborative and respectful interdisciplinary environment.

Children's National NICU is a regional referral center for neonatal patients requiring ECMO therapy for respiratory failure, and for neonatal patients requiring whole body cooling for treatment of birth asphyxia/hypoxic ischemic encephalopathy.

As a Level IV NICU, we offer the highest level of care for premature and ill newborns, as designated by The American Academy of Pediatrics. This means we can:

• Offer the full range of pediatric medical subspecialists, pediatric surgical subspecialists, and pediatric anesthesiologists on site.
• Perform complex surgical procedures to repair complex congenital or acquired conditions.
• Coordinate all aspects of care for conditions and associated complications including: coagulation defects, congenital heart defects, Extracorporeal membrane oxygenation (ECMO) gastrointestinal disorders, genetic and/or metabolic disorders, prematurity, respiratory distress and failure, pulmonary hypertension, renal disorders and sepsis and septic shock.

The department utilizes a multi-disciplinary approach to care utilizing the services of physicians, nurses, respiratory therapists, unit specific pharmacist and dietitians, and other support services necessary to provide quality care. A full-time Neonatal Transport Team consisting of specialty trained neonatal transport nursing personnel, neonatal Respiratory Therapists, and for complex cases, a Neonatology fellow or attending physician conducts transport. The team can transport via ambulance, helicopter, or fixed wing air transport as needed.

Children's National Hospital, based in Washington, DC, celebrates 150 years of pediatric care, research and commitment to community. Volunteers opened the hospital in 1870 with 12 beds for children displaced after the Civil War. Today, it is among the nation's top 10 children's hospitals. Children's National is transforming pediatric medicine for all children. Children's National has been designated a Magnet hospital, demonstrating the highest standards of nursing and patient care delivery. Our pediatric academic health system offers expert care through a convenient, community-based primary care network and specialty outpatient centers in the D.C., metropolitan area, including the Maryland and Northern Virginia suburbs. Children's National is home to the and , and a top NIH-funded children's hospital. It is recognized for its expertise and innovation in pediatric care, and as a strong voice for children through advocacy at the local, regional and national levels.

All nursing practice is based on the legal scope of practice, national and specialty nursing standards, CNMC 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. CNMC supports the development of RN relationships within the community; specifically those relationships associated with the health and well being of the community at large.

Minimum Education
BSN (Required)
Minimum Work Experience
5 years NICU Nursing experience required; experience in care of children preferred. (Required)
Functional Accountabilities
Professional Practice/Research

• Discuss with each orientee the role expectations of orientee, Clinical Instructor, Advanced Practice Specialist and Staff Development

• Specialist related to orientation and ongoing education.

• Review individual orientee learning needs and develop an individualized education plan for orientee; Communicate orientation outcomes to

• all involved.

• Use teaching methods that facilitate education using adult learning principles.

• Participate in competency training for Unit.

• Identify patient and family educational needs with orientees.

Education

• Discuss with each orientee the role expectations of orientee, Clinical Instructor, Advanced Practice Specialist and Staff Development

• Specialist related to orientation and ongoing education.

• Review individual orientee learning needs and develop an individualized education plan for orientee; Communicate orientation outcomes to all involved.

• Use teaching methods that facilitate education using adult learning principles.

• Participate in competency training for Unit.

• Identify patient and family educational needs with orientees.

Clinical Instruction

• Provide direct patient care in area of specialty independently or in the role of a preceptor.

• Identify weekly clinical experience goals with each orientee in conjunction with Manager, Coordinator, Advanced Practice Specialist, and/or Staff Development Specialist; plan appropriate assignments and learning experiences according to didactic sequence and needs of each orientee.

• Plan patient care assignments - select experiences a day ahead and be flexible with changes; communicate w/ manager and charge nurse.

• Use individual & dual assignments. Individual - assign orientee to one or more clients-the orientee may be responsible for only certain aspects of care or total care. Dual -the orientee work along w/a staff member or CI to care for one or more clients; define role expectations of the orientee & specific objectives for the assignment (a very directed experience); dual assignments may also be two orientees assigned to one patient (important for clear communication re: aspects of care each will do).

• Develop follow-up activities with orientee after patient care experience.

• Arrange for "other" clinical experience - i.e. clinics, ORs, cath lab, etc., as appropriate for fellows and direct these experiences.

Patient Care Instruction

• Participate in planning patient and family education, in collaboration with orientee and nursing staff; select teaching/learning methods appropriate to content and families learning preference.

• Participate in planning patient and family discharge needs, in collaboration with orientee, case manager, nursing staff, and physicians.

• Allow orientee to prepare for the patient care assignment by reviewing the patient's diagnosis, status of the patient, current management plan (meds and nursing care). Prior to patient care the orientee should be able to describe pathophysiology and explain nursing care; develop med cards; describe med action, desired effect, dosage range, side effects; major nursing implications and explain related diagnostic tests (if any had been done).

• Help orientee organize their patient care priorities; role play possible scenarios and provide support to the orientee by asking questions to encourage critical thinking.

• Post Clinical Conference - Facilitate patient care discussions at a post conference; have orientee record experiences related to the case history of the patient in their clinical log, care given, personal response to clinical encounters, and questions for follow-up; document achievement of competencies of each orientee.

• Participate in teaching content in the didactic and lab setting; facilitate socialization of the orientee to the work place; serve as a role model to the orientee in terms of patient care provider, teacher, and leader.

• Participate in providing direct patient care through: assignment with orientee; teaching patients and families utilizing selected teaching/learning methods; implement discharge activities as appropriate to patients and families; what must be done on schedule; what must be done sometime during the shift.

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

Organizational Accountabilities
Organizational 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