Nurse Clinician- Sickle Cell Program

Patient Care Coordination

Serve as a primary clinical point of contact for sickle cell patients across the continuum of care, from routine disease management to acute pain episodes and complications.
Coordinate care activities among hematologists, advanced practice providers, social workers, pharmacists, pain management specialists, and other members of the multi-disciplinary team.
Facilitate timely scheduling of laboratory monitoring, diagnostic testing, specialty consultations, and follow-up appointments.
Monitor patient status and proactively identify and address barriers to care, including social determinants of health that disproportionately affect the sickle cell population.

Care Planning

Develop individualized, evidence-based care plans in collaboration with the multi-disciplinary team for each patient in the sickle cell program.
Ensure care plans address medical, psychosocial, functional, and educational needs — including pain management, hydroxyurea therapy, disease-modifying treatments, and transition planning for adolescent patients.
Review and update care plans as patient conditions change throughout the course of care.

Patient and Family Education

Provide clear, compassionate education to patients and families regarding sickle cell disease, treatment options, pain crisis management, medication adherence, and follow-up care expectations.
Assess health literacy and tailor educational approaches to meet diverse patient needs.
Connect patients and caregivers with appropriate community resources, disease-specific support groups, and financial assistance programs.

Clinical Practice

Perform comprehensive nursing assessments and triage of patient concerns, including acute pain episodes, fever, and other sickle cell-related complications.
Manage symptom-related calls and patient portal messages, escalating to the appropriate provider when indicated.
Administer or coordinate treatments and medications per established protocols and physician orders, including infusion therapies and hydroxyurea monitoring.
Document all clinical activity accurately and in a timely manner within the electronic health record (EHR).

Quality and Program Development

Participate in quality improvement initiatives specific to the sickle cell population.
Contribute to the development and refinement of clinical pathways, protocols, and patient education materials.
Support efforts to reduce emergency department utilization and hospitalizations through proactive outreach and care management.
Engage in departmental meetings, case conferences, and multi-disciplinary care team huddles.