I. General Summary - This is not a remote position

The Neonatal Escalation Safety Telemetry (NEST) program is a 24/7 remote operation that is staffed with experienced labor & delivery RNs and provides remote monitoring of fetal tracings for obstetric patients across all UMMS hospitals. Under the direction of the Assistant Nurse Manager, the RN will work in conjunction with the bedside team at all UMMS L&D units to provide additional observation of fetal tracings and early identification and escalation of concerning tracings. He/she advances evidence-based practices, and mentors others to achieve and grow in the role of the professional nurse. As a member of the NEST team, he/she serves as a leader, change agent, and coordinator of patient care services within the obstetric service line. 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 safety and caregiver satisfaction. Is accountable to 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, and to the Assistant Nurse Manager for the totality of work performance.

II. 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. These are not to be construed as an exhaustive list of all job duties performed by personnel so classified.
 
Clinical Practice/Care Delivery

1. Monitors tracing for fetal physiological parameter abnormalities. Assesses individual fetal monitoring tracings and documentation of interventions done by the care team when abnormalities are identified by the NEST nurses.

2. Notifies the primary registered nurse or charge nurse of concerning electronic fetal heart rate and uterine activity tracing findings, poor-quality signal, etc. Follows the established chain of command for escalation of concerning fetal tracings.

4. Utilizes Electronic Medical Records to validate findings from remote fetal monitoring station.

5. Serves as a clinical expert and professional resource for L&D nurses; mentors and coaches other nurses to advance their development. Communicate in an efficient and effective manner with all members of the care team

6. Advances clinical practice within the NEST; consistently integrates evidence into practice and uses this as a firm foundation for the NEST.

7. Utilizes clinical expertise to teach other nurses. Role models Patient-Centered Care and mentors others in their growth.

Practice Focus Areas:
Focus on use of National Institute of Child Health and Human Development (NICHD) fetal monitoring terminology in the interpretation and communication of fetal heart tracing in a timely manner.
 
Professional Development
1. Actively engages in advancing own practice; role model for others. Mentors and coaches others to achieve/maintain competency required for the patient population served.

2. Serves as an expert preceptor and mentors others in the preceptor role; plans clinical experiences for orientation. Mentors and coaches unit leaders or those assuming leadership roles on councils or major governance initiatives.

3. Leads unit processes for development of ancillary personnel’s skills and development.

Practice Focus Areas:

A. Leads unit based Professional Development governance activities; participates actively in divisional and organizational efforts.

B. Coordinates unit level education appropriate for patient population.

C. Oversees program-based competency validation processes.

D. Oversees unit orientation program.

E. Provides health-related contributions through community services, such as health fairs.

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. Leads performance improvement initiatives by designing, implementing, evaluating, and disseminating results.

4. Monitors patient safety standards; actively contributes to development and implementation of improvement plans.

5. Participates in some or all elements of research.

Practice Focus Areas:
A. Identifies and integrates “Best practices” for communication.

B. Trends quality data on a consistent basis and leads efforts to address deficiencies.

C. Oversees Joint Commission and other regulatory site visits (mock and actual); helps prepare unit and staff on an ongoing basis.

Unit Operations

1. Performs charge role as scheduled; mentors new charge nurses. Assists with orientation of newly hired RNs and supporting those newly off orientation.

2. Serves as a NEST steward such as liaison for L&D units.

3. 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:

A. Leads NEST governance initiatives.

B. Leads NEST based efforts addressing elements of Healthy Work Environment.

C. Leads NEST Reward and Recognition activities.

D. Leads NEST operations efforts, such as equipment maintenance, scheduling, supply utilization monitoring etc.

E. Leads NEST based peer review processes.

The University of Maryland Medical System is a 14-hospital system with academic, community and specialty medical services reaching every part of Maryland and beyond. UMMS is a national and regional referral center for trauma, cancer care, Neurocare, cardiac care, women’s and children’s health and physical rehabilitation. UMMS is the fourth largest private employer in the Baltimore metropolitan area and one of the top 20 employers in the state of Maryland. No organization will give you the clinical variety, the support, or the opportunities for professional growth that you’ll enjoy as a member of our team. 

Education & Experience

1. BSN Required
2. Licensure as a Registered Nurse in the state of Maryland, or eligible to practice due to Compact state agreements outlined through the MD Board of Nursing is required.
3. Electronic Fetal Monitoring Certification is required.
4. Minimum of 5 years labor and delivery experience is required.
5. Demonstrated evidence of professional growth and development through at least one of the following:

• Current and active specialty certification 
• Current matriculation or completion of a degree or certificate program (Post Baccalaureate or higher, 12 credits or greater) within past 24 months
• Formal teaching within past 24 months (portfolios including “Formal Teaching” require a signed “Approval for Formal Teaching” document)
• Member of a professional association board or committee within past 24 months (not a hospital committee),
• Actively participates as a peer reviewer for a professional journal (minimum of 2/year, portfolios including “Peer Reviewer” require a signed “Peer Reviewer Validation Form”)

6. Maintenance of 20 continuing education hours /24 months.

**Calculated in hours such as 30 minutes = 0.5 hour. Proof of attendance required

Knowledge, Skills & Abilities

1. Demonstrated ability to assume a clinical leadership role. Demonstrated effectiveness as a multidisciplinary team member.
2. Demonstrated ability to use computer systems in order to manage patient information.
3. Demonstrated 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 sage-specifics.
4. Demonstrated/documented highly effective interpersonal, written and verbal communication skills.

This is not a remote position.

CPR certification from American Heart Association

• Working Conditions

  1. Weekend, shift work, holiday, on-call, and overtime may be required.
  2. Work requires constantly sitting or standing at a workstation and repetitive work with both hands.

• Patient Safety

  Ensures patient safety in the performance of job functions and through participation in hospital, department or unit patient safety initiatives.