Senior Clinical Nurse - Transitions of Care Center - Full Time - Days

Job Description

Strength Through Diversity

Ground breaking science. Advancing medicine. Healing made personal.

Registered Nurse - 2554106


Roles & Responsibilities: 

Under the oversight of the Transitions of Care Center Clinical Nurse Manager, the Senior Clinical Nurse is a Registered Professional Nurse with broad knowledge and clinical and telehealth nursing skills who participates in performance improvement, professional development and training, departmental patient education coordination, facilitates strategies to improve the patient experience and patient education, and serves as a resource for nursing staff in the delivery of quality care based upon nursing theory, research, and approved Department of Nursing and institutional standards.

Departmental Duties and Areas of Responsibility:
I. Performance Improvement
a. Quality Assurance and Performance Improvement (QAPI): Participates in the Registered Nurse Team QAPI process by conducting review of colleagues’ telephonic intervention, clinical work, and documentation in collaboration with CNM and Program Coordinator 
b. Productivity: Collaborates with CNM and Program Coordinator in order to review and support staff in keeping expected departmental telephonic productivity rate. 
II. Professional Development & Training
a. Orientation: Collaborates with CNM in order to refine schedule and content of onboarding orientation; tailors program based on staffs training needs
b. Preceptorship: Precepts RNs and nurses transitioning to Charge RN competency during orientation and training period 
c. Charge Nurse Role Oversight: Serves as team members’ resource, training leader and daily operational and clinical and support
III. Patient Education 
a. Service Line/Diagnosis Materials: Reviews and coordinates cross-campus post-discharge patient educational information from patient AVS/Discharge; coordinates with unit-specific teams to standardize materials into departmental educational portfolio/curriculum for staff use. 
b. Departmental Patient Education Tools: Develops evidence based patient education material in order to standardize patient education throughout department calls.
c. Site Liaison: Serve as liaison between Transitional Care Department and clinical units for expansion, education and ad hoc patient and staff educational needs
IV. Clinical/Operational Oversight
a. Daily Clinical and Operational Troubleshooting: Serves as support to staff members by fielding clinical and workflow related questions. Escalates to CNM as needed.
b. Standard of Practice/Policy Needs: Reviews TOCC’s SOP with CNM and Program Coordinator and presents evidence based ideas which would make the TOCC staff’s work more efficient and beneficial to the TOCC’s assigned patients. Collaborate within Nursing Department policy and procedure framework to bring new policy/procedure needs to finalization.
MSHS Role-Specific Duties and Responsibilities:

Patient Care: 
1. Acts as a clinical leader to support the daily functioning of the unit on a shift basis.
2. Delivers patient care by incorporating the tenets of the professional practice model of Relationship Centered Care and through the application of the nursing process based upon theory, research, evidence-based practice, and approved organizational nursing standards.
3. Assesses and evaluates patient care needs and applies critical thinking skills in patient care management.
4. Integrates relevant assessment and intervention skills for the delivery of nursing care.
5. Collaborates with the interdisciplinary healthcare team in the development, implementation, and evaluation of the plan of care.
6. Coordinates and prioritizes all aspects of patient care including teaching, rounding, coaching, and planning “after hospital care” and delegating to others as appropriate.
7. Educates patients and caregivers, while anticipating needs and readiness to learn, about their plan of care, transition of care, promotion of health, and prevention of disease.
8. Communicates effectively and professionally with patient, family and all members of the Interdisciplinary Patient Care Team.
9. Manages assignments within the Care Delivery Model of Modified Primary Nursing and demonstrates allocation of material resources effectively.
10. Oversees role of charge RN and assignment of this in daily workflow
Patient Experience:
1. Role models the tenets of Mount Sinai Relationship Centered Care (MSHRCC) through facilitation of the following actions including, but not limited to, Admission Welcome, Bedside shift Report, HELP, AM/PM Care, 5 Minute Sit Down, Purposeful Hourly Rounding, Medication Review, Discharge Wrap Up, and MD/RN Unit Collaboration.
2. Considers the patient’s values, preferences, cultural diversity, expressed needs and knowledge in all aspects of care.
3. Establishes and maintains a therapeutic relationship with the patient and family.
4. Uses evidence-based practices to increase understanding of patients’ perceptions of care.
5. Initiates service recovery for patients and family members who have concerns and escalates to Clinical Nurse Manager/Assistant Nurse Manager/Nursing Shift Manager or Patient Relations as needed.
6. Demonstrates caring, respect, compassion, empathy and active listening through dialogue, body language and actions.
7. Supports staff use of evidence-based practices to increase understanding of patients’ perceptions of care.
8. Encourages staff to speak of the inpatient Purposeful Hourly Rounding (PHR) on assigned patients addressing the 4 Ps in telephonic work.
9. Collaborates w/CNM to improve Patient Experience tracking and processes/protocol

Quality and Safety: 
1. Practices safe and efficient patient-centered care, identifying and escalating barriers and opportunities for improvement.
2. Demonstrates clinical skills and knowledge crucial to quality and safety in the patient population served.
3. Implements process improvement strategies based on institutional, evidence-based ensure and procedures.
4. Engages in formal and informal peer and institutional review processes, including but not limited to QAPI call review
5. Collaborates with interdisciplinary teams to create and implement quality improvement projects, evidence-based practice activities and nursing research studies.
6. Contributes to quality and safety practices and required compliance measures.
7. Implements principles of high reliability to identify and avoid high risk behaviors to provide a safe environment for patients.
8. Escalates potential safety hazards or gaps from best practice following institutional chain of command protocol.
9. Utilizes institutional information technology by documenting nursing practice to support quality and performance improvement initiatives.

1. Coordinates nursing care on a shift basis within a specific unit using the Care Delivery Model of Modified Primary Nursing. 
2. Assigns staff for the oncoming shift and recommends need for additional staff as necessary.
3. Coordinates with Clinical Nurse Manager/Assistant Nurse Manager/Nursing Shift Manager to ensure that supplies are appropriately utilized and inventory is sufficient for patient care.
4. Recommends the progression of new employees within their unit based orientation. – Orientation specific ownership/preceptorship
5. Provides feedback to members of the nursing staff regarding adherence to job obligations, ensure and regulatory requirements in consultation with the Clinical Nurse Manager/Assistant Nurse Manager/Nursing Shift Manager or designee.
6. Assists in preparing time and staffing schedules in accordance with unit needs, patient care and contractual obligations.

Professional Development:
1. Develops/participates in leadership of orientation new nurses charge role and patient education 
2. Contributes to the environment of care to support clinical colleagues, patients and their families and members of the healthcare team.
3. Advances clinical competence in nursing practice to progress from competent to expert
4. Projects a professional image to colleagues and communicates with styles and methods that demonstrate caring, respect, compassion and empathy.
5. Incorporates ethical principles into decision making for patient and family.
6. Encourages and demonstrates a spirit of scholarship, inquiry, life-long learning and innovation for self and others.
7. Acquires knowledge and skills relative to the role, patient population, clinical specialty and local or global health community needs.
8. Participates in shared decision making through specialty practice councils, nursing department committees, and unit initiatives.
9. Serves as a professional role model and preceptor for new staff and students.
10. Advances as a clinical leader by developing staff in the charge role and assigning accordingly
11. Articulates the values of research and evidenced based practice and its application to the environment of care.
12. Contributes to the profession of nursing through participation in professional organizations.

General Skills and Competencies: 
1. Must have relevant clinical competence in area of nursing practice assigned 
2. Evidence of ability to maintain interpersonal relationships, communicate appropriately to others, and work effectively and efficiently to solve problems
3. Demonstrates the ability to work in a team displaying effective communication and critical thinking
4. Ability to read, write, understand and speak English in a clear and concise manner
5. Visual, physical, auditory and cognitive ability to assess patient status
6. Physical and mental health necessary to care for acutely ill patients with a broad variety of diagnoses and behaviors on a daily basis
8. Manual dexterity to perform a variety of clinical procedures relevant to practice area 
9.Proficiency in Microsoft Office Suite; basic data coordination and analysis, retrieval systems and necessary electronic medical record documentation systems in a proficient manner





Bachelor of Science with a major in nursing required; Masters preferred.
Licensed as a registered nurse with current registration in New York State

Relevant clinical competence in area of nursing practice assigned

1. RN




Strength Through Diversity


The Mount Sinai Health System believes that diversity is a driver for excellence. We share a common devotion to delivering exceptional patient care. Yet we’re as diverse as the city we call home- culturally, ethically, in outlook and lifestyle. When you join us, you become a part of Mount Sinai’s unrivaled record of achievement, education and advancement as we revolutionize medicine together.


We work hard to acquire and retain the best people, and to create a welcoming, nurturing work environment where you can develop professionally. We share the belief that all employees, regardless of job title or expertise, can make an impact on quality patient care. 


Explore more about this opportunity and how you can help us write a new chapter in our story! 


Who We Are


Over 38,000 employees strong, the mission of the Mount Sinai Health System is to provide compassionate patient care with seamless coordination and to advance medicine through unrivaled education, research, and outreach in the many diverse communities we serve.


Formed in September 2013, The Mount Sinai Health System combines the excellence of the Icahn School of Medicine at Mount Sinai with seven premier hospital campuses, including Mount Sinai Beth Israel, Mount Sinai Beth Israel Brooklyn, The Mount Sinai Hospital, Mount Sinai Queens, Mount Sinai West (formerly Mount Sinai Roosevelt), Mount Sinai St. Luke’s, and New York Eye and Ear Infirmary of Mount Sinai.


The Mount Sinai Health System is an equal opportunity employer. We promote recognition and respect for individual and cultural differences, and we work to make our employees feel valued and appreciated, whatever their race, gender, background, or sexual orientation. 


EOE Minorities/Women/Disabled/Veterans

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