Registered Nurse-Practice-Ambulatory Care Nemours Children's Hospital, Delaware

1. Clinical Judgment: 

• Independently develops, implements, evaluates, and modifies clinical practice to meet individual patient and family needs
• Collects and interprets complex patient data.        Focuses on key elements of situation while sorting out extraneous detail and exercises clinical judgment based on an immediate grasp of the whole picture for the patient population of the assigned clinical area
• Serves as a coach to new graduates and clinical students
• Cares for patients in the office as well as through telephone triage utilizing pediatric protocols and clinical advice from the clinical provider. 
• Safely administers medications as prescribed by the provider

1. Clinical Inquiry:

• Identifies clinical questions. Seeks advice, resources or information to improve patient care.
• Utilizes and contributes to evidence-based practice.
• Participates in unit based shared governance and/or committees to improve clinical practice.

1. Caring Practices:

• Determines and prioritizes the patients nursing care needs and maintains responsibility for directing aspects of care which are delegated to patient care team members.
• Initiates, implements and evaluates standards of care based on identified patient needs.
• Consistently shows empathy, sensitivity and insight and is able to intervene in stressful situations.
• Individualizes both emotional and physical pain management and comfort measures specific to patient and family.
• Further develops therapeutic relationships with patients and families and maintains appropriate boundaries.
• Contributes to a nurturing environment that is supportive of colleagues in less than optimal situations.
• Anticipates and integrates cultural differences into patient and family care.

1. Response to Diversity:

• Fosters a non-discriminatory climate, recognizing, supporting and including cultural diversity in organizational and nursing policy development.
• Recognizes unique differences of patients and families.  Incorporates these into patient plan of care.
• Provides for alternative means of communication as required to meet patient and family needs.
• Tailors nursing care to meet the age specific and developmentally appropriate needs of patient and family.
• Preserves and protects the confidentiality, autonomy, dignity and rights of patient and families.

1. Advocacy/ Moral Agency:

• Advocates on behalf of patients/ families and personnel, promoting adherence to the ANA Code of Ethics for Nurses.
• Acts as resource for patients and families working towards resolution of ethical issues.  Initiate’s ethics consult when appropriate. 
• Effectively communicates and negotiates needed changes in a patient’s plan of care.  Seeks opportunities to learn and be mentored.

1. Collaboration:

• Works as a team member to ensure optimal patient outcomes.  Supports colleagues by maintaining an attitude of respect and interdependency.
• Develops problem-solving strategies based upon the unique needs and strengths of the patient and family. 

1. Systems Thinking:

• Participates in departmental and hospital programs for Quality Assessment and Improvement, identifying opportunities to improve services, making recommendations and implementing actions as appropriate and consistent with the goals of the Nemours Foundation. 
• Demonstrates leadership ability in responding to situations and efficiently uses existing resources.
• Provides care that meets professional standards of practice and meets regulatory requirements. 
• Contributes toward the budget process. Engaged in unit-based fiscal accountability. 
• Individualizes patient and family teaching.        Utilize available electronic resource.

1. Facilitation of Learning:

• Identifies areas of educational needs of others.
• Reviews patient teaching plans to ensure they are evidence based.  Contributes to revision of standards of care policies.
• Helps evaluate effectiveness of patient and family education.
• Seeks out a mentor to facilitate individual growth.
• Participates in unit/departmental/ hospital educational programs.

Requirements

• Associate (2 years of training beyond high school; e.g., Diploma, Associate’s degree) (BSN within 3 (ADN) or 4 (Diploma) years of date of hire).  If not already obtained, a Bachelor of Science in Nursing (BSN) must be achieved within 3 (ADN) or 4 (Diploma) years of date of hire. 
• Current AHA Healthcare Provider (HCP) Certification required.

• Certified Pediatric Nurse (CPN); Additional certification (i.e.PALS) may be required based on practice designation

• 1-3 years relevant experience