ECMO Specialist PRN-Local

About the Role

Job Title: ECMO Specialist

Location: Kettering, Ohio (On-Site; Must be local and within driving distance)

Employment Status: PRN position

Scheduling Requirements: 

The PRN Specialist must be willing to provide a minimum of 5 days of availability throughout each month

Job Summary:

The ECMO Specialist provides bedside critical care assistance to patients receiving ECMO therapy within IH customer facilities. The ECMO Specialist I have a functional understanding of extracorporeal life support (ECLS), mechanical circulatory support (MCS), and will participate in required IH training for continuing education and experience. This position regularly reports to the clinical operations manager, however at specific accounts an alternate IEC designee/coordinator may serve as an initial contact person in the chain of command. 

Compensation and Benefits:

• Competitive compensation is offered, with pay rates ranging from $750 to $900 per shift.
• Holiday bonus and crisis pay opportunities.
• Employees may elect to participate in the employer's Guideline 401(k) retirement plan. Participants may make pre-tax or Roth contributions to a retirement account. Integration Health matches contributions at 100% of the first 1% of the employee's deferrals and 50% of deferrals between 1% and 6% of the employee's salary.
• Exemplary training program.

Job Responsibilities: 

•  Skills and Knowledge:
• • Excellent communication skills necessary to work with all hospital employees, physicians, patients, family members and community professionals.
  •  Has completed ECLS education modules and can demonstrate a cursory understanding of extracorporeal technology and treatments.
•  Clinical Duties:
• •  Provide continuous monitoring of the ECLS patient and circuit (up to a 1:3 ratio, Specialist: patients). 
  •  Monitor and adjust the ECLS blood flow and sweep gas flow per established guidelines or physician/advanced practice provider orders. 
  • Recommend appropriate changes to patient management based on relevant patient data and/or changing patient status. 
  • Review all laboratory and radiographic reports related to the ECLS patient and report any irregularity immediately to ECLS physician/advanced practice provider. 
  •  Collaborate with the ECLS physician/advanced practice provider, ECLS Specialists and other health care professionals to coordinate all tests and evaluations. 
•  Monitor Activated Clotting Times (ACT) and other coagulation tests and adjust or recommends the adjustment of anticoagulant drugs per hospital guidelines or physician/advanced practice provider orders.
• Monitor patient Intake and Output (I's & O's) per customer guidelines or physician/advanced practice provider orders and make appropriate recommendations.
• Verify ECLS circuits and bedside carts are stocked and in the correct location. 
• Coordinate interventions and/or procedures with the bedside staff to provide best practice care for the patient in accordance with customer guidelines.
•  May assist the ECLS physician with initiation of support and decannulation in conjunction with the surgical team only as directed. 
• Perform other duties as assigned, in accordance with training and competency level, by the ECLS physician/advanced practice provider, the clinical operations manager, director of education, coordinators of Integration Health, co-coordinators of Integration Health, or designee. 
• Documentation:
• •  Responsibly use ADP and Concur apps/websites to log hours worked, location, and work-related expenses. Efficiently employ technology to independently schedule flights, hotels, car rentals, etc.
  • Document appropriately in the patient chart in accordance with hospital guidelines.
• Communication:
• •  Integration Health has a robust administrative team promoting an expanding business model pursuant of multiple avenues of patient support opportunities. An ECLS Specialist I will communicate professionally and in a timely manner with an administrative team that includes Scheduling & Logistics, Credentialing, as well as Leadership personnel.
  • Promote IH culture and professional standards in a positive manner.
  • Will have professional dialogue about ECLS and medical management with the ECLS physician/advanced practice provider but should not undermine their decisions or communicate negative opposition to the patient, the patient's family or designee, or other medical staff in that facility.
• Training:
• • Develop skills and knowledge related to extracorporeal life support through completion of ECLS education modules, Wet Labs, and Hands-on circuit training.
  • Introduction to multiple ECLS systems including: Cardiohelp, CentriMag, Spectrum, & Rotaflow.
  • Bedside orientation with tenured ECLS Specialists.
  • Introduction to diverse patient demographics, treatment modalities and strategies, including cross-training to all patient age groups.
  •  Demonstrate competency during training and assessments with all ECLS equipment and ancillary tools.
  • New Specialists will demonstrate safe and conscientious practices with a preceptor and complete basic ECLS competency prior to solo staffing.
  • ECLS knowledge assessments will be performed to aid recognition of individual strengths and weaknesses to foster personalized education & training.
• Competencies:
• • Complete competencies on one ECLS pump system prior to first solo deployment.
  • Complete competencies on Cardiohelp and at least one variety of a component system pump within the first 3 months of employment.
  • Verbalize an understanding of the differences in VA and VV ECMO and different cannulation strategies for each.
  • Verbalize the effects that changes in native cardiac output has on VV and VA ECMO.
  • Demonstrate a complete circuit check and verbalize the significance of the findings and potential concerns.
  • Make appropriate adjustments to blood flow as directed and anticipate the changes in pressure and flow variables being monitored.
  • Verbalize the significance of monitoring SvO2.
  •  Interpret ABGs and make appropriate sweep changes based on standard sweep calculation as directed.
  •  Recognize changes in venous, pre-oxygenator, post-oxygenator and delta pressures and verbalize the significance, possible concerns or complications and potential causes.
  • Activate and set appropriate alarms on any pump to which they've been oriented.
  •  Properly identify alarms and respond appropriately.
  •  Identify the effects and potential causes of changes in preload and afterload.
  • Verbalize two situations when it is appropriate to hand crank.
  • Demonstrate how to use a hand crank properly or switch to a backup pump (Centrimag) on any piece of equipment to which they've been oriented.
  • Recognize venous air and respond appropriately.
  • Demonstrate safe removal of arterial air.
  • Recognize two types of oxygenator failure and make appropriate recommendations.
  • Demonstrate the ability to zero transducers and flush pigtails as needed.
  • Demonstrate how to change a cracked pigtail and/or stopcock safely and efficiently.
  • Demonstrate how to make temperature changes on any heater/cooler system.
  • Recognize and troubleshoot heater failure and take appropriate actions.
  •  Verbalize and demonstrate the appropriate actions for an accidental decannulation of an arterial, venous and dual lumen cannula.
  •  Verbalize a basic understanding of native blood flow through an adult heart, lungs and aorta, including the 3 common aortic branches.
  • Verbalize a basic understanding of the coagulation process, anti-coagulation drugs and the associated laboratory tests used.
  • Verbalize a basic knowledge of ventilator modes, strategies and the relationship to the ECLS system.
  •  Verbalize a basic understanding of the benefits and risks of sedation, neuromuscular blockers and cooling.

Minimum Requirements:

• Bachelor's degree preferred. Associate degree with 2-3 years of related Critical Care &/or ECLS experience will be considered in lieu of Bachelor's degree.
• Maintain unencumbered professional license (RN, RRT, CCP).
• • For RNs, a Nurse Compact license, if applicable, will be maintained for travelers; additionally, individual state licenses may be necessary.
  • For RRTs, requested individual state licenses will be maintained for travelers.
  • For CCPs, requested state licenses will be maintained for travelers.
• Maintain advanced credentials as applicable to each profession. 
• Maintain AHA credentials in BLS 

Physical Requirements: 

• Must be able to effectively communicate and perform in stressful situations. 
• Must be able to stand, walk, see, hear, read, speak, and write for prolonged periods without accommodations. 
• Must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 50 pounds. 
• Must be able to move or reposition patients of any weight or size with assistance.