Clinical Nurse Specialist

The Clinical Nurse at Tufts Medical Center possesses and applies the skills and knowledge necessary for the delivery and management of patient care from admission through discharge. The Clinical Nurse is knowledgeable of current trends in healthcare, including advances in technology, pharmacology, treatment care modalities, quality, and patient safety. The Clinical Nurse serves as a patient and family advocate while facilitating a cooperative and collaborative environment among all healthcare providers.

1. Assesses and collaborates with patient, family/significant others, and other disciplines to identify expected outcomes based on synthesis of data and diagnosis, and to identify cultural needs to develop a care plan that enhances the health care experience.
2. Plans and develops individualized outcomes-based care plans incorporating the patient and family's readiness and barrier to learning, orchestrates and validates a plan of care for each shift, initiates interdisciplinary patient/family meetings to facilitate communication regarding the plan of care, communicates and coordinates the patient's discharge plan utilizing unit-based and community resources to ensure a seamless transition for the patient and their family, and ensures the plan of care utilizes principles and concepts of project, organizational, or systems management.
3. Implements the plan in a safe and timely manner, documents the implementation and any modifications, including changes or omissions, of the identified plan, collaborates with nursing colleagues and others to implement the plan, utilizes evidence-based interventions and treatments specific to the diagnosis or problem, provides and coordinates health teaching which is required by individuals, families, and groups to maintain an optimal level of health, and documents per hospital and regulatory requirements/policies, all aspects of care, including but not limited to, treatments/procedures performed and patient response.
4. Evaluates the effectiveness of the planned strategies in relation to patient responses and the attainment of expected outcomes and knowledge, uses the evaluation process to update the plan of care as dictated by the patient response and/or if desired outcomes have not been achieved.
5. Demonstrates and applies the skill and judgment necessary to implement the nursing plan of care, nursing interventions, and procedures necessary for the care of the patient and family based upon critical thinking skills and a spirit of inquiry, and the plan of care is evidence-based and utilizes research when appropriate, incorporates new knowledge and strategies to initiate change in nursing care practices, and demonstrates the knowledge and skills necessary to provide age-appropriate, culturally, and ethnically sensitive care to all patients and families.
6. Performs procedures and treatments using nursing knowledge and judgment, according to established unit/practice area guidelines and professional standards.
7. Safely administers and assesses the patient response to medication utilizing essential knowledge of pharmacology and Hospital and Department Standards of Care.
8. Maintains clinical competency with respect to technology and utilizes equipment in a safe manner.
9. Performs as an advocate and as an educator for patients and families.
10. Provides high-quality care in an efficient and safe manner, utilizing data trends to support and improve clinical practice.
11. Participates in hospital and/or unit-based patient safety and quality activities and uses principles to support and improve patient outcomes (unit-based, hospital-wide, The Joint Commission, NPSGs, NDNQI, Patient First, and other local, state, and federal patient safety initiatives).
12. Participates in performance improvement activities through data collection, analysis, and evaluation.
13. Champions quality, safety, regulatory, and patient-family satisfaction.
14. Facilitates cooperative and collaborative relationships among the various disciplines and departments to ensure effective quality patient care delivery and to create a positive and professional work environment.
15. Delegates responsibilities to others with an understanding of their roles, knowledge, and capabilities.
16. Influences others to achieve Service Excellence by establishing a climate for optimal patient care, mutually supportive collegial relationships, and professional development, treating both internal and external customers with courtesy, respect, and caring behavior, promoting a safe, clean, therapeutic environment for patients, families, and staff, acknowledging cultural differences that exist among staff and patients, identifying customer service needs on the unit, presenting self in a professional and calm manner, and providing responsible and efficient use of resources.
17. Participates in professional development and lifelong learning activities that assist in developing and maintaining their continuing competence, enhance their professional practice, and support achievement of their career goals, including maintaining current licensure and adhering to the Massachusetts Nurse Practice Act, assuming responsibility for participating in educational opportunities to support and meet clinical competency requirements, seeking out educational and professional resources, developing professionally as a self-directed, motivated learner, seeking out advanced certification opportunities and ongoing education opportunities, precepting and mentoring newly hired staff and nursing students, investigating available technology and resources to apply evidence-based practice and research into daily professional activities, promoting leadership at the bedside as a delegator, collaborator, facilitator, and communicator, and promoting unit and organizational growth through a shared governance model.
18. May assume charge nurse functions in collaboration with unit leadership.
19. Facilitates communication by seeking and sharing job-related information that supports a culture of respect and responsibility, assuming responsibility and ownership for professional conduct, accepting responsibility for positive and productive communication skills, attending and actively participating in staff meetings (when unable to attend, accepts responsibility for reading staff meeting minutes), and accepting responsibility for reading emails to keep current with unit and hospital-based information.

The Clinical Nurse at Tufts Medical Center must possess and apply the skills and knowledge necessary for the delivery and management of patient care from admission through discharge. The Clinical Nurse must be knowledgeable of current trends in healthcare, including advances in technology, pharmacology, treatment care modalities, quality, and patient safety. The Clinical Nurse must serve as a patient and family advocate while facilitating a cooperative and collaborative environment among all healthcare providers.

The Clinical Nurse must have the skills and knowledge to provide care to patients throughout the life span, with consideration of aging processes, human development stages, and cultural patterns in each step of the care process. The Clinical Nurse must be able to provide care for a designated group of patients according to unit guidelines and hospital policies, procedures, and protocols.

The Clinical Nurse must have the skills and knowledge to provide care to the age groups of the population served, including knowledge of growth and development, ability to interpret age-specific data and response to care, and provide age-appropriate communication.

The Clinical Nurse must be able to perform procedures and treatments using nursing knowledge and judgment, according to established unit/practice area guidelines and professional standards. The Clinical Nurse must safely administer and assess the patient response to medication utilizing essential knowledge of pharmacology and Hospital and Department Standards of Care.

The Clinical Nurse must maintain clinical competency with respect to technology and utilize equipment in a safe manner. The Clinical Nurse must perform as an advocate and as an educator for patients and families. The Clinical Nurse must provide high-quality care in an efficient and safe manner, utilizing data trends to support and improve clinical practice.

The Clinical Nurse must participate in hospital and/or unit-based patient safety and quality activities and use principles to support and improve patient outcomes (unit-based, hospital-wide, The Joint Commission, NPSGs, NDNQI, Patient First, and other local, state, and federal patient safety initiatives). The Clinical Nurse must participate in performance improvement activities through data collection, analysis, and evaluation.

The Clinical Nurse must champion quality, safety, regulatory, and patient-family satisfaction. The Clinical Nurse must facilitate cooperative and collaborative relationships among the various disciplines and departments to ensure effective quality patient care delivery and to create a positive and professional work environment.

The Clinical Nurse must delegate responsibilities to others with an understanding of their roles, knowledge, and capabilities. The Clinical Nurse must influence others to achieve Service Excellence by establishing a climate for optimal patient care, mutually supportive collegial relationships, and professional development, treating both internal and external customers with courtesy, respect, and caring behavior, promoting a safe, clean, therapeutic environment for patients, families, and staff, acknowledging cultural differences that exist among staff and patients, identifying customer service needs on the unit, presenting self in a professional and calm manner, and providing responsible and efficient use of resources.

The Clinical Nurse must participate in professional development and lifelong learning activities that assist in developing and maintaining their continuing competence, enhance their professional practice, and support achievement of their career goals, including maintaining current licensure and adhering to the Massachusetts Nurse Practice Act, assuming responsibility for participating in educational opportunities to support and meet clinical competency requirements, seeking out educational and professional resources, developing professionally as a self-directed, motivated learner, seeking out advanced certification opportunities and ongoing education opportunities, precepting and mentoring newly hired staff and nursing students, investigating available technology and resources to apply evidence-based practice and research into daily professional activities, promoting leadership at the bedside as a delegator, collaborator, facilitator, and communicator, and promoting unit and organizational growth through a shared governance model.

The Clinical Nurse must may assume charge nurse functions in collaboration with unit leadership. The Clinical Nurse must facilitate communication by seeking and sharing job-related information that supports a culture of respect and responsibility, assuming responsibility and ownership for professional conduct, accepting responsibility for positive and productive communication skills, attending and actively participating in staff meetings (when unable to attend, accepts responsibility for reading staff meeting minutes), and accepting responsibility for reading emails to keep current with unit and hospital-based information.