Start Date: 10/09/2022

End Date: 01/07/2023

Status: Open

Total Positions: 1

Skill: RN NICU

Duration: 13 - Weeks

Location: NY - St. Peter's Hospital

Shift Start Time: 07:00:00

Shift End Time: 19:30:00

Description:
Types of Patients Served

The patient population in the NICU consists of a variety of neonates with various medical
problems. Medical care is provided by Board Certified neonatologists and a Neonatal Nurse Practitioner. At least one Board Certified neonatologist is on site 24 hours a day. The approach to care is family centered and delivered by a multidisciplinary team including Spiritual Care, Respiratory Therapy, Nursing and Rehabilitation Therapists.

This includes:
A. All neonates born at SPH
B. All neonates transported into SPH
C. All neonates admitted directly from private pediatrician’s office if admission criteria are met

II. Ages of Patients Served

A. Neonatal ICU: 24 weeks to 3 months

III. Current Services for Patients and Patients’ Families:

Frequent Procedures, Processes, Services

1. Comprehensive level III neonatal intensive care services
a) Antenatal consultation
b) Attendance at all high risk deliveries
c) Evaluation and management of unexpected ill neonate in delivery room

2. Comprehensive level III NICU care includes:
a) Respiratory management:
(1) Dedicated respiratory therapist
(2) Oxygen therapy via, nasal cannula, RAM cannula or nasal CPAP
(3) Conventional mechanical ventilation
(4) High frequency ventilation
(5) Oscillator ventilation
(6) Nitric oxide
(7) Surfactant administration
(8) Continuous pulse oximetry
b) Vascular access
(1) Peripheral access
(2) Umbilical lines
(3) Percutaneous venous catheter
c) Retinal exams
d) Neurology
(1) Lumbar puncture
(2) Neuroimaging including cranial ultrasound, CT scans and MRI
(3) EEG
e) Developmental Care
(1) NIDCAP environment
(2) Developmental follow-up
f) Nutritional support
(1) Total parenteral nutrition
(2) Early enteral feedings
(3) Lactation specialist-full term and premature specialists
(4) Breast feeding initiatives for mothers of premature infants
(5) Human Donor Milk
g) Social services and Hospice
(1) Full time social service worker
(2) Pediatric hospice services
h) Case management
(1) Clinical Care Coordinator services
(2) Universal hearing screen
(3) Parent education including infant CPR and monitoring training
(4) RSV prophylaxis program with MedImmune 360 Access
(5) Developmental follow-up
(6) Primary care nursing
(7) Family education & counseling
i) Cardiac services
(1) Pediatric cardiology on site availability 24 hours a day
(2) Invasive cardiac monitoring
(3) EKG services
(4) Cardiac echocardiography
(5) Invasive arterial monitoring
j) Infection control and prevention
(1) Infectious disease consultants
(2) Infection control department
(3) Quality improvement monitoring of hospital-acquired infections
k) Laboratory
l) Medical Imaging



Scope and Complexity of Patient’s Care Needs

Patient care in the NICU is delivered by a system of primary nursing for total patient care within the context of an interdisciplinary team. Clinical Care Coordinators (C3s) support primary nurses in the complex discharge planning and utilization management needs of select neonates using the nursing process as the framework for individual case management. The primary nurse is accountable for developing a plan of care from admission to discharge.

Respiratory Therapists (RTs) are integrated members of the care delivery team. RTs provide direct patient care, including ventilator management and pulmonary interventions (i.e., nebulized medications, intubations, suctioning, surfactant administration, arterial blood sampling). .
1. Resuscitation and treatment of neonates >23 weeks gestation born at SPH or transported
into SPH
2. Major diagnoses:
- Extreme Prematurity (23-28 weeks)
- Prematurity (29-37 weeks)
- Prematurity (29-37 weeks)
- Small for gestational age
- Large for gestational age/macrosomia
- Respiratory Distress Syndrome
- Chronic lung disease
- Sepsis
- Patent Ductus Arteriosus
- Persistent pulmonary hypertension of the newborn
- Perinatal birth asphyxia
- Hyperbilirubinemia
- Trisomy syndromes
- Congenital anomalies
- Intrauterine growth retardation
- Infant of diabetic mother
- Hypoglycemia
- Bowel obstruction
- Imperforate anus
- Necrotizing enterocolitis
- Intestinal volvulus, perforated intestine
- Feeding intolerance
- Apnea and/or bradycardia
- Maternal substance abuse/withdrawal syndrome
- Neonatal seizures
- Cerebral vascular infarct or hemorrhage
- Interventricular hemorrhage/periventricular leukomalacia
- Cardiac arrhythmia’s
- Retinopathy of prematurity
- Hydrocephalus
3. Comprehensive care of all sick newborns with the exception of the following:
a) Neonates requiring ECMO
b) Neonates requiring surgery
c) Neonates requiring peritoneal dialysis
d) Neonates with major endocrine disorders