Clinical Nurse Specialist

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Job Summary

The Clinical Nurse Specialist maintains standards of the practice for nursing as defined by the American Nurses Association Code of Ethics, Nursing Scope and Standards of Practice and Nursing's Social Policy Statement.
The Clinical Nurse Specialist actualizes the vision, mission, values, balanced scorecard performance measures for Montefiore medical Center.
The Clinical Nurse Specialist participates in performance improvement/research activities; maintains professional practice standards and clinical expertise; and demonstrates leadership skills. The Clinical Nurse Specialist demonstrates core and unit specific competencies based on the patient population served.
The Clinical Nurse Specialist is a registered nurse who is a clinical expert in the delivery of evidence- based nursing interventions within a designated population (e.g. geriatrics); type of problem (e.g. wound management); setting (e.g. critical care); type of care (e.g. palliative care) or disease/pathology/medical specialty (e.g. diabetes, oncology). The Clinical Nurse Specialist possesses advanced knowledge of the science of nursing with a specialty focus and applies that knowledge to nursing assessments, diagnoses, interventions and in the design of innovations and assists the interdisciplinary team in the assessment, planning, implementation and evaluation of the care of a select group of patients. The Clinical Nurse Specialist also functions independently to provide theory and evidence-based care to patients and families in their attainment of health goals.
The Clinical Nurse Specialist makes recommendations to establish standards of practice and participates in educational activities, clinical research studies and technological developments as pertinent to the advancement of quality in the clinical specialty. The Clinical Nurse Specialist works with nurses to advance their nursing practices and improve outcomes and provides clinical expertise to interdisciplinary team members to effect system-wide changes to improve programs of care throughout Montefiore Medical Center.

Essential Functions

• Patient/Family Clinical Practice - Demonstrates clinical expertise in the provision of high quality, age appropriate care within the designated clinical specialty.
  * Conducts comprehensive wellness and illness assessments utilizing known or innovative evidence based tools, techniques/methods.
  * Identifies the need for new or modified assessment methods or instruments within the specialty area.
  * Describes problems, e.g. variations in normal and abnormal symptoms, functional status or risk behaviors inherent in disease, illness or developmental processes, which have etiologies amenable to nursing interventions.
  * Provides direct and indirect evidence based interventions for complex patient-family illness/risk behaviors within the specialty.
  * Provides consultation recommendations to the interdisciplinary team for specific specialty patient- family care issues.
  * Collaborates with interdisciplinary team members to integrate specific nursing interventions for a comprehensive plan of care or its revision to enhance patient-family outcomes.
  * Recommends referrals to interdisciplinary team members for specific patient-family needs within the specialty.
  * Provides/coordinates complex discharge planning/ direct and indirect education/support groups, incorporating relevant cultural diversity and age appropriate content/techniques, as clinically indicated, for specific specialty patient-family health goals.
  * Evaluates the effectiveness and outcomes of interventions individually and in collaboration with the interdisciplinary team.
  * Intervenes in emergent clinical situations to provide appropriate solutions and limit recurrences.
• Nurses and Nursing Practice - Directs the provision of quality, age appropriate, cost effective patient-family nursing care delivery within the specialty.
  * Utilizes/designs methods/tools to assess patterns of outcomes related to nursing practice within the specialty.
  * Collaborates with nursing personnel to implement evidence based and innovative, cost effective interventions to improve specialty patient-family outcomes.
  * Utilizes/designs methods/tools to assess knowledge, skills and practice competencies of nursing personnel to advance the practice of nursing within the specialty.
  * Implements educational programs incorporating age specific information and targeting the competency needs of nursing personnel in order to improve nursing practice and specialty patient-family outcomes.
  * Serves as a role model through directly providing, guiding, coaching, mentoring, supporting/evaluating nursing care activities.
  * Identifies collaboratively the need for technological changes or clinical products incorporating evidence, clinical outcomes and cost effectiveness.
  * Provides recommendations to nursing leadership regarding developments in the respective clinical specialty.
  * Identifies nursing practice issues for evaluation/ research studies.
  * Disseminates evidence based research outcomes for application to patient care and specialty patient-family needs.
  * Presents/publishes regarding individual advanced practice clinical specialty.
  * Precepts graduate clinical nurse specialist students and others/acts as a resource to faculty and students from affiliating institutions on clinical and educational matters.
• Organization/System - Demonstrates leadership skills within the context of the medical center and division/care center structure, mission, culture, policies, resources and goals.
  * Develops/revises/implements evidence based policies/ procedures/guidelines/protocols/ best practices/ standards to improve specialty clinical practice.
  * Designs/utilizes system level assessment methods/tools to identify and evaluate organization structures, facilitators, barriers, functions and timeliness of interventions impacting nursing practice and nurse sensitive, specialty patient-family outcomes.
  * Utilizes interpersonal, organizational, communication networks and role relationships to problem solve and influence clinical decision making to improve patient care.
  * Incorporates fiscal accountability and innovative strategies into planning for clinical projects and educational programs.
  * Leads and collaborates with nursing and interdisciplinary team members in implementing cost effective, innovative patient care programs, solutions and change strategies which can be generalized across differing units, populations or specialty patient-family care issues/needs across the continuum of care.
  * Participates in medical center quality improvement activities pertinent to the clinical specialty.
  * Serves as a clinical resource in the identification, investigation and resolution of actual/potential risk management, quality of care or ethical issues.
  * Implements processes to sustain evidence based changes in nursing practice, programs of care and clinical innovations.
  * Implements strategies to reduce patient length of stay and resource consumption.
  * Provides education to interdisciplinary team members pertinent to specialty patient-family health needs/goals as clinically indicated.
  * Documents the outcomes of the impact of respective clinical nurse specialist practice on the organization/system.
• Demonstrates knowledge and skills necessary to provide age appropriate patient-family care within the designated specialty
  * Assesses and interprets data relative to the age status of the patient-family.
  * Differentiates between normal age related parameters and abnormal parameters.
  * Participates with the interdisciplinary team to develop a plan of care cognizant of sensory deficits, psychomotor deficits and/or maturational age of the patient-family.
  * Implements plan of care consistent with the patient's age, sensory/psychomotor deficits and/or maturational age.
  * Modifies plan of care according to patient's age, biopsychosocial and physiological needs.
• Integrates the standards of excellence into daily clinical practice.
  * Consistently demonstrates:
  * Respect: Honors and values each person.
  * Effective Communication: Effectively listens, conveys, and receives ideas, information, and direction.
  * Sensitivity: Demonstrates willingness and ability to listen and understand others' feelings, needs and circumstances.
  * Professionalism: Demonstrates confidence, competence and pride in work and appearance.
  * Exceeding Expectations: Assists others without being asked.
  * Courtesy: Treats everyone with kindness and care.
  * Teamwork: Builds cooperative, constructive working relationships.
• Non-Clinical/Technical competencies
  * Consistently demonstrates:
  * Customer Focus/Service Orientation: Meets patient/ customer needs in timely, positive, and professional manner.
  * Quality of Work: Work performed is consistently accurate and thorough and at the expected level.
  * Problem Solving: Identifies and carefully assesses situation/information/data before taking action within scope of practice and/or licensure/certification.
  * Time Management: Uses his or her time effectively and efficiently. Work is accomplished at the expected volume/level.
  * Initiative: Takes timely and appropriate action in accordance with defined job responsibilities and operating within scope of practice and/or licensure/ certification.
  * Dependability: Associate requires minimum supervision, carries through effectively on all work assignments; is reliable; usually present and on time.

Qualifications

• Licensed as a registered Clinical Nurse Specialist in New York State Required.
• Current New York State Registration as a Registered Nurse Required.
• Masters or doctoral degree in nursing as a clinical nurse specialist Required.
• Minimum of five years clinical practice experience, three of which must be in the specialty or a combination of education and specialty experience approved by the director of the division or department Required.
• Certification in the specialty and/or subspecialty Required.