Registered Nurse - Radiation Oncology

Job Description

Under the supervision of the Administrative Nurse (AN) or Charge Nurse, the Registered Nurse (RN) is responsible for providing skilled and comprehensive nursing care to radiation oncology patients with a wide variety of oncological and/or disease-related problems seen for consultation, treatment, and follow-up. Through application of the nursing process, provides direct care and implements plans for continuity and coordination of patient care with other members of the patient’s health care team.In collaboration with the AN, provides appropriate guidance and supervision for ancillary nursing personnel and participates in orientation of new medical and/or technical personnel.

This nurse will support our patients across the department. The position will be communicating with patients/family on behalf of the entire care team. The nurse will coordinate changes to treatment plans as delegated by the provider. The RN will serve as the point of contact for the patient/family and ensure that care is timely and efficient. Through application of the nursing process, provides direct care and implements plans for continuity and coordination of patient care with other members of the patient’s health care team.In collaboration with the AN, the nurse provides appropriate guidance and supervision for ancillary nursing personnel and participates in orientation of new medical and/or technical personnel.

Specific daily responsibilities include direct ambulatory triaging of patient calls and lab results, coordinating studies and specialty referrals, notifying Providers of any upcoming orders needed, and providing initial and ongoing patient education.Directing the coordination of care for the patient across disciplines and the care continuum as needed. The RN will focus on new patient referrals, coordinating their care through multimodality treatments and ensuring they move efficiently and safely through their care journey. The RN will work closely with one or more physicians who will direct and delegate care as appropriate across numerous disease lines. The RN helps manage side effects, symptoms, care, and coordination of complex interdisciplinary services.

This position will additionally assist with the non-Operating Room anesthesia cases within Radiation Oncology by cross-training to provide direct patient care. This includes assisting the Anesthesia provider with induction/recovery of pediatric and adult patients in a procedural setting. This includes but is not limited to, pre-procedure screening/assessments; working closely with an anesthesiologist; assisting anesthesia with induction; transporting patients under anesthesia to/from radiology scans; transporting to/from Treatment Room, PACU, PICU, all inpatient units, Emergency Department, and Radiation Oncology; as well as all routine cares and assessments. The RN will also recover the patient post- anesthesia for discharge home, admission, transfer to outside facility, or return to their inpatient room.

While the Pediatric age patient population are the primary recipients of non-OR anesthesia, Adults may also require this option and care to be provided.

Nurses with pediatric, adult procedural areas and oncology backgrounds looking for a variety of work from patient teaching, helping patients navigate complex care, and possibility of some procedural work may find a variety of interesting work in this position.

Responsibilities include compliance with Medical Center and departmental Policies and Procedures, Environmental Safety, House and Telephone Standards, compliance with all regulatory agency requirements.

The position will involve travel between all UCSF Radiation Oncology sites. This role will be primarily based at Mission Bay and/or Parnassus, but the RN must be available to also work at ANY of our other Rad Onc locations and may occasionally include our procedural areas.

The hours are daytime M-F, generally from about 6:30AM to 6PM, but may vary with start times from 6:00 AM to 11:00 AM and end times may vary from 3:00 PM to 8:00 PM.

The RN helps manage side effects, symptoms, care, and coordination of complex interdisciplinary services. The nurse will work closely with one or more physicians who will be directing and delegating care as appropriate.

Responsibilities

Responsible for maintaining the knowledge and abilities essential to the performance of stated behaviors. Carries out legal responsibilities within the scope of the Nurse Practice Act. Accountable to the AMB NURSE MGR for overall work performance.

%

of time

Essential Function (Yes/No )

Key Responsibilities

(To be completed by Supervisor)

20

Assessment

• Identifies patients’ physiological and psychosocial status in order to implement plans of care.
• Seeks and utilizes available diagnostic tests, lab values, reports and medical record information to increase awareness of current or potential problems.
• Responds to or refers inquiries appropriately. Recognizes and reports specific physical and emotional conditions/needs/concerns of the patient to the appropriate members of the healthcare team. Alerts physician to unusual conditions of the patient to facilitate immediate attention.
• Obtains vital signs (including blood pressure, heart rate, temperature, respiratory rate, and oxygen saturation) and weights on patients being seen for consult, for follow-up, and for weekly treatment visits. Reports abnormal findings to MD.
• Anticipates patient’s response to treatment and/or disease progression and assesses appropriately per the patients clinical condition.
  
  

20

Planning

• Develops holistic health care plans based upon the patient’s medical condition, treatment goals, and psychosocial status.
• Anticipates potential physical and psychosocial problems in order guide patient teaching, support, coordination of, and timely provision of necessary care.
• Incorporates the patient’s family into the plan of care as appropriate.
• Coordinates planning with other members of the Cancer Center, SFGH, VA, and other facilities as relevant.
• Mentors, trains, assists, and is a resource for staff to improve coordination of patient’s care.
  
  

30

Implementation

• Demonstrates and applies specialized knowledge of oncology and radiation therapy nursing in providing direct care, education and support to patients/families.
• Exhibit independence, self-direction and accountability to the patient, family and Oncology team.
• Provides appropriate nursing care according to UCSF standards outlined in the Nursing Procedures Manual. This includes, but may not be limited to, care of patients requiring intravenous therapy, oxygen therapy, contrast injection, pain management and sedation. It also includes monitoring of various systems (e.g. tubes, drains, catheters) and management of surgical revisions (e.g. ostomies and wounds), skin care, and nutrition teaching.
• Assists with intra-procedural support with anesthesia service with pediatric and adult patients and recovery. Documents appropriately in EMR including Universal Protocol, pre/post VS, and other relevant assessments.
• Responsible for care of gamma knife patients from admission through discharge including counseling and evaluating patients prior to the procedure, assisting the neurosurgeon with frame placement, scan preparation, coordination, discharge teaching, and all other duties related to the nursing care of the gamma knife patient. Makes follow-up calls to gamma knife patients after discharge to determine status post-procedure status of the patient.
• Provides appropriate nursing care according to UCSF standards outlined in the Nursing Procedures Manual. This includes, but may not be limited to, care of patients requiring intravenous therapy, oxygen therapy, contrast injection, pain management and sedation. It also includes monitoring of various systems (e.g. tubes, drains, catheters) and management of surgical revisions (e.g. ostomies and wounds), skin care, and nutrition teaching.
• Reports concerns about patient status and/or abnormal changes in patients’ conditions to appropriate health care team members.
• Assists physician and patient during diagnostic procedures (e.g. pelvic exams, needle biopsies and aspirations), nasopharyngeal scoping, spinal tap, sedation, and brachytherapy appliance insertion and removal, and other unit-based therapy procedures.
• Complies with all UCSF/ MTZ Comprehensive Cancer Center and unit-based policies and procedures including infection control, safety and administrative and clinical practices.
• Understands and implements the procedures for medical emergencies, Code Blue and other emergency/disaster situations.
• Evaluates and documents response of patient to treatment plan and nursing interventions.
• Directs and delegates appropriate tasks to Medical Assistants and Administrative Staff and ensures adequate follow-through.
• Acts as Charge Nurse in the absence of the Administrative Nurse as assigned.
• May work at any UCSF Health Radiation Oncology Site as determined by the needs of the department. This may include traveling to another UCSF location during the course of a shift.
• Ability to work flexible hours as determine by the needs of the department.Start times generally vary from about 6:00 AM to 11:00 AM and end times may vary from about 3:00 PM to 8:00 PM, and may occasionally require overtime. Other start and end times may occur as needed for example to cover partial shifts of 4 hours.
• Assists the patient to navigate complex health care system between various clinics, specialty practices, treatments and other medical services.
• Assists the physicians in managing and coordinating care between various other specialty practices and medical services as needed.
• Assists in upholding the quality of care, and is a responsible steward of resources avoiding waste and mindful of efforts to control cost.
  
  

10

Advocacy/Patient Education

• Assesses patient’s and family’s understanding of illness and knowledge of Radiation Therapy; educates and documents accordingly.
• Utilizes clinical knowledge and communication skills to serve as an initial and continued resource for patients/family.
• Informs patients/family about services available at UCSF/MTZ Comprehensive Cancer Center and in the community.
• Promotes the patient’s participation in planning for and understanding of their care.
• Evaluates the effectiveness of health teaching by obtaining feedback from patients and/or families, observations of outcomes and progress, and contributes to revision of care plan accordingly.
• Assess patient’s current understanding and readiness to learn of the proposed treatment plan.
• Provide ongoing patient education for the patient and family.
  
  

10

Coordination/Communication

• Coordinates resources and communicates to minimize fragmentation of care within the department, patient care units, other clinics and departments, or other facilities.
• Serve as multidisciplinary contact point for all patient, studies, and other needs.
• On behalf of the patient, serve as primary point of contact for phone calls, requests, inquiries by patient, family members, and outside care providers.
• Facilitate completion of labs, and evaluation studies for the patient.Obtain the results of studies done at other centers. Notify provider of results as appropriate.
• Provide clinical documentation to the financial counselors to obtain insurance authorization for the treatment plan as needed.
• Initiate referrals to ancillary services for the patient as requested by provider.
• Assess subjective and objective data and escalate appropriately.
• Review patient records and medication profiles to confirm compliance to treatment regimen and protocols as established by patients’ providers.
• Communicate lab results and medication changes to patients by telephone under the direction of the provider as appropriate to scope.
• Document clearly and thoroughly. Documentation includes but is not limited to patient records, requisitions, and referrals.Utilize electronic medical record for documentation.
• Communicates directly with appropriate nurses verbally and in writing (when appropriate) regarding specific needs or concerns of the patient.
• Assists in the supervision of timely and appropriate transportation of patients to and from other units/facilities.This includes obtaining report and giving report as needed from outside units/facilities to safely provide/manage patient care.
• Facilitates appropriate community health and social service referrals (i.e. VNA, Hospice, housing, transportation, etc.).
• Documents nursing assessments and interventions in patient chart appropriately.
• Coordinates the efforts for patient teaching, directions and planning for diagnostic tests, other appointments and hospital admissions.
• Evaluates the effectiveness of health care teaching by obtaining feedback form patient and caregivers and observation of procedures and outcomes.
• Uses the Principles of AIDET and Living Pride initiatives of the Medical Center in communication with patients and others.
• Upholds the Medical Center Telephone Communication Standards.
• Uses APEX MyChart effectively and responds to patient messages within the required time.
• Uses email, internet and other electronic communications within Medical Center and departmental policies.
• Maintains HIPAA privacy standards per Medical Center Policies.
  
  

10

Professionalism

• Assumes responsibility for keeping informed of changes in policies and procedures related to his/her role in the job setting.
• Demonstrates knowledge of radiation safety standards and practices and observes all required precautions. Timely returns radiation safety badges.
• Treats all patients, visitors, and co-workers with courtesy, sensitivity, and respect always in accordance with Medical Center standards.
• Maintains flexibility in shift and work assignments (i.e. overtime, shifts, assignment, site, and holidays).
• Maintains confidentiality in matters related to patients and/or staff.
• Timely complies with all UCSF nursing service requirements and state licensure requirements.
• Complies with all activities mandated by regulatory agencies such as CMS, JCAHO and/or Title 22.
• Assists with data collection for various research projects, QA/QI initiatives such as hand-hygiene data, chart audits, etc.
• Participates in the orientation of nursing, medical and technical personnel with regard to the patient care functions and standards in the Department of Radiation Oncology.
• Create and deliver patient education materials for the department.
• Create standardized protocols for use by nurses to enhance and efficiently continue care and present those for approval through UCSF committees.
• Assist with creation of disease-based standards that all providers follow within the department in collaboration with Physicians and department Chair.
• Uses conflict resolution skills.
• Is engaged or participates in Department, Nursing, Medical Center Committees such as Magnet as applicable or recommended
• Participates in special projects for the department such as work groups for the department IAP goal, or delegated tasks from Administrative Nurse
  
  

10 0%

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Qualifications

Required Qualifications:

• Three years of RN clinical experience in acute care/TCU/or critical care within the last five years
• One year Oncology experience within the last five years
• Radiation Oncology experience
• Active Registered Nurse (RN) licensure in the State of California
• Active American Heart Association CPR Certification
• PALS Certification
• ACLS Certification within 6 months of hire
• PACU or Circulator/ Scrub experience in a procedural area
• Proficient in pediatric and adult recovery
• Proficiency in clinical telephone triage
• Excellent proficiency with starting IVs
• Experience accessing and caring directly for central access devices
• Proficiency in placing and maintaining pediatric peripheral intravenous access
• Proven organizational skills with the ability to accept full responsibility for a defined and delegated area and patient caseload
• Proven ability to work effectively with physicians and other support staff
• Ability to deal with issues related to death and dying
• Excellent communication skills (written & verbal) and professional conduct
• Basic computer skills including, use of email, internet, navigating windows, and ability to learn various computer systems such as EPIC, Aria and other clinical tools
• Excellent organizational skills, proficiency in meeting deadlines, ability to work independently, and prioritize workload
• Demonstrated clinical competence, including effective leadership, teaching, and communication skills, or an equivalent combination of education and experience
• This position requires flexibility to orient and work at all UCSF Health locations
  
  

Preferred Qualifications

• BSN
• Combination of experience working with cancer patients in hospital, procedural, and ambulatory care settings
• Accessing ports
• MS in Nursing with a focus in nursing practice or leadership
• CPHON certification
• Aria or Mosaiq experience
• Care Coordination experience
  
  

License/Certifications

• Active Registered Nurse (RN) licensure in the State of California
• Active American Heart Association CPR Certification
• PALS Certification
• ACLS Certification within 6 months of hire