Respiratory Therapist-RRT Neonatal/Pediatric Specialist (RRT-NPS)

Job Summary:

The Registered Respiratory Therapist-Neonatal/Pediatric Respiratory Care Specialist (RRT-NPS) is titled such because they have successfully passed a National Board of Respiratory Care (NBRC) specialized advanced examination. They perform under the direct supervision of the Respiratory Therapy Supervisor, and is delegated an assignment by the supervisor and department director to achieve quality patient care and expected productivity during a routine workflow experience. They are ultimately accountable to the respiratory supervisor and department director, and NICU administration.

The RRT-NPS therapist demonstrates knowledge, skill and ability to:

• Provision of appropriate age/growth/cognitive development during care:
  • vital signs - Dysfunction signs and symptoms,
  • selection and application of appropriate therapy intervention and
  • size selection for supply/equipment and alarm parameter/alarm adjustments and
  • patient education, including family or significant other, when needed to facilitate the understanding required for patient cooperation of procedure and assessments of patient.
• Sensitivity to cultural and religious beliefs of patients, visitors, and staff.
• Adherence to all policy for infection prevention, surveillance, and control and consistent use of proper hand hygiene/standard precaution practice and cleaning/storage of supplies/equipment compliant with guidelines, including, safe use of PPE/eyewash, cold disinfection process.
• Adherence to all safe work practices, such as use of environmental controls (door codes/negative flow treatment room/panic button), operation of hospital beds, and all respiratory medical equipment, office equipment and pneumatic tube system.
• Follow policy and work independently with minimal supervision in making clinical and operational competent decisions in the completion of all daily tasks in an orderly and functional fashion in a challenging environment.
• Compliance in HIPPA/EPIC during care of patient and with your personal health information.
• Preceptorship of students and completion of their daily evaluations.
• Adherence to all work policies and demonstrate the ability to work independently with minimal supervision in the completion of routine assigned tasks and department overall daily/shift objectives.
• Understanding of personal behavior's effect on departmental PPI goals/outcomes.
• Intuitive practice of established guidelines for:
  • patient identification/ staff identification,
  • use of electronic work lists, other EMR features, for the documentation/archival/retrieval/billing of services provided,
  • inclusion of patients’ cautions, allergies, and co-morbidities for provision of safe patient care,
  • report using SBAR at receipt or hand off of patient.
• The indication/implementation/application/cautions and contraindications for respiratory scope of practice procedures (non-invasive and invasive) in a systematic manner to include assessment and planning, intervention and monitoring/evaluation in collaboration with the dept. supervisor and multidisciplinary care team as evidenced by documentation in the EMR, direct observation by the supervisor/preceptor and patient evaluation of care. Services provided to include, but not limited to:
  • Expansion Therapy
  • Inhaled medication administration/Sputum Induction and Specimen Collection
  • Airway Management:
  • pulmonary hygiene therapy: CPT (manual and device) and naso-tracheal suction,
  • artificial airway management/suction/extubation/tracheal decannulation,
  • physician requested assistance for crycothyrotomy and tube exchange.
  • Invasive and Non-invasive Mechanical Ventilation: Initiation/Monitoring/Titration-Weaning and Transport (in house and external) of all ventilatory modes and all currently available brands of equipment and age-specific platforms
  • Medical Gas Administration - Delivery device/Monitoring for desired/adverse effects
  • Oxygen and Oxygen/Helium mixture/Cylinder Use/Handling /MRI/Storage
  • Air/ oxygen piping system use/shut-off
  • Blood Gas/Co-Oximetry: Specimen Collection and Analysis/Results Reporting
  • Pulse Oximetry/SpO2 Trend Study/ Home O2 Evaluation
  • EKG: Lead placement/Test Acquisition/safe equipment operation/use.
• Other duties as assigned.

Performance Expectations:

The RRT-NPS therapist must:

• Demonstrate quality health care through cross-training in areas as their experience supports the knowledge and skills for areas listed:
  • Neonatal Intensive Care (NICU)
  • NICU Transport Team
  • Emergency Department
• Demonstrate practice of all established patient safety and infection control intervention.
• Demonstrate intuitive ability to evaluate patient clinical and educational needs, establish and adjust plan of care as appropriate for best outcome and discharge readiness each encounter using evidence-based algorithms, physician orders, and approved practice guidelines/protocol.
• Communicate with physician/mid-level provider for the implementation or discontinuation of care as appropriate.
• Demonstrate intuitive skills and performance ability to complete Respiratory Care Consult Initiation/ High Risk Evaluation.
• Demonstrate ability to focus on discharge readiness/planning through oxygen/ventilator titration/weaning and multi-disciplinary communications.
• Systematic use and operation of software systems and recognize, resolve or report variances from normal expected workflow and ability to follow computer downtime policy to ensure patient safety and completion of scheduled work.
• Accepts adjustments to scheduled times/shifts/rotations in order to meet patient care needs and departmental daily objectives and to maintain a safe working environment.
• Must be accessible through telephone number provided and follow staffing guidelines for staffing during internal and external disasters.
• Actively participate in department PI goals and demonstrate personal improvement after remediation.
• Participation in department meetings and education/training, and meet the established deadlines for completion.
• Acquire and maintain skill/competency and required credentials for position including cross trained specialty areas.
• Maintain BLS, NPR and PALS certification, NBRC RRT and NPS credentials and State RCP licensure in active status.
• Demonstrate/maintain required skills competency for Neonatal Transport Team participation (may be called to assist with pediatric emergency while on duty, also),
• Coordinate the RT staff component of the NICU Transport Call Schedule and take a minimum of three 24-hour transport call shifts per 14-day schedule (unless on leave/PTO the entire schedule),
• Complete Forrest General Hospital (FGH) Preceptor training and demonstrate effective preceptor skills for staff/students,
• Train/perform as superuser for upgrades of EMR systems as assigned,
• Be trained, per director or neonatologist request and facility need, for American Heart Assn. NRP or PALS Instructor or a Certified-National Asthma Educator (NAECB) and provide instruction per facility/community request, or a STABLE support instructor,
• Obtain =/> 50% of require MS RCP License renewal CEUs are AARC approved education,
• Participate in research and clinical inquiry to foster evidence-based practice and develop new procedures for new practice, equipment or processes,
• Annual review of the NICU/pediatric age-specific respiratory policies and practices,
• Provide a daily report of NI ventilator supply status to dept. supervisor and dept. director,
• Verify supply inventory is adequate for census and medical equipment clean and functional,
• Accept additional assignments by director of committee, PI audits of care/practice/policy and billing compliance to promote patient, staff, and health care team satisfaction as assigned,
• Exhibit leadership through conflict/problem/process related issue resolution.

Since this job role has defined specific extra job duties related to education and PI the current limitation is 8 Full Time positions with absolute balance to 4 regular assigned FT, NICU RRT-NPS to respective shifts and 4 routinely NICU assigned RRT-NPS to respective shifts.

Qualifications:

Education/Skills:

Graduate of an accredited Respiratory Care Practitioner Program is required. Graduate of an Associate of Applied Science Degree Program is preferred. FGH NICU Transport and FGH Preceptor Training are required to be completed within 1 year of position acceptance and maintained from there on out.

Work Experience:

Respiratory Therapy work experience in an NICU and NICU Transport care setting is required.

Certification/Licensure-DUE UPON HIRE:

• Licensed with MS Department of Health (MSRT)
• Registered by NBRC
• RRT—Neonatal/Pediatric Specialty Credentials (can be obtained within six months of accepting the position with a min. of 2 years working in a NICU)

Additional Certification/Licensure — Obtained based on the required timeframe below:

• Basic Life Support

Within 30 Days of Employment

Required

• Advanced Cardiac Life Support

Within 90 Days of Employment

Preferred

• Neonatal Resuscitation

Within 90 Days of Employment

Required

• Pediatric Advance Life Support

Within 90 Days of Employment

Preferred

**Additionally, NRP or PALS Instructor and/or National Asthma Educator per director request to meet FGH needs.

Mental Demands:

Ability to perform repetitive tasks and to exercise good judgment and initiative to set priorities appropriately for patient care, and ones’ own required staff training and education. Ability to follow directions precisely with accuracy and the realization error in judgment or performance may have serious consequence to patients. Have "sincere interest" in the quality of respiratory services provided and being capable, dependable, flexible, and reliable and thoughtful and responsive at all levels of engagement with health team and patient customers. Exhibits leadership qualities and acts as preceptor to students and less experienced therapists and those cross-training for NICU for the succession planning of the NICU RTs. Has an intuitive willingness to accept more responsibility and self-initiative to attend, research, develop and present continuing education programs for potential and current respiratory services provided.