Respiratory Care Practitioner III

About the role

Assesses, plans, implements and evaluates respiratory therapy care and life support to patients in all areas of the medical center, including neonatal intensive care who have deficiencies and abnormalities of the cardiopulmonary system under the supervision of physician and prescription. Performs other patient comfort duties necessary to maintain the flow of patient care in the unit.

Responsibilities

• Upholds Kaiser Permanente’s Policies and Procedures, Principles of Responsibilities and applicable state, federal and local laws.
• Applies philosophy and demonstrates knowledge of the Patient Bill of Rights; treats members, coworkers, and individual employees with respect and dignity.
• Maintains the privacy and confidentiality of both members and employees with regard to medical records and communication regarding disease, conditions, and status.
• Greets members promptly and courteously, addresses adult members by their proper title (i.e., Mr., Mrs., Ms.) and last name except when otherwise mutually agreed upon by the provider and patient.
• Adheres to regional and department guidelines for telephone courtesy and consideration; documents caller name, phone number, reason and urgency, date/time, and staff taking the call.
• Provides immediate notification to the provider or designee for emergency or urgent messages.

Respiratory Care Duties

• Demonstrates knowledge, application, competency, and assessment skills for neonatal, pediatric, and adult patient groups.
• Provides direct and indirect care and service to neonatal, pediatric, and adult patients; participates in patient care rounds as an active member of the critical care team.
• Knows admitting diagnosis and pulmonary pathophysiology for assigned patients; performs patient assessment and provides appropriate therapy.
• Evaluates and states data obtained from respiratory monitoring devices; evaluates patient response to all respiratory care and documents required information per department policy.
• Determines appropriateness and provides recommendations for respiratory care services, considering age, cognitive ability, and developmental status.
• Initiates new routine orders within the time specified in department policies and procedures.
• Measures and adjusts airway cuff pressures; recommends changes in diagnostic and therapeutic procedures to physicians, nursing, and/or coworkers.
• Modifies treatments/procedure techniques that do not require a change in physician orders to optimize care, considering patient age and development status; reports modifications to appropriate team members.
• Utilizes the appropriate chain-of-command when consulting on patients not responding to standard therapeutic procedures.
• Performs respiratory diagnostic and therapeutic procedures; verbalizes mechanisms of action, dosage, contraindications, and adverse reactions for all medications upon request.
• Obtains approval prior to administering any medications not included on the approved medication list; stores unused doses in the department medication cabinet or refrigerator as indicated.
• Provides ventilatory support during patient inter- and intra-hospital transfers; may be part of a high-functioning pediatric and neonatal transport team.
• Performs procedures for disinfecting and sterilization; adheres to infection control policies and procedures.
• Washes hands before and after patient contact and after using the restroom; adheres to isolation procedures as indicated; practices Universal Precautions at all times.
• Performs and evaluates blood gas analysis, including quality control procedures per laboratory policy; obtains arterial blood samples; ensures required information on samples and requisition slips.
• Handles and disposes of blood samples per policy; performs analyzer maintenance and quality controls; ensures cleanliness of the blood gas laboratory.
• Performs cardiopulmonary and neonatal resuscitation (CPR/NR) and responds to emergencies in all areas; auscultates lungs to assure proper endotracheal tube placement.
• Identifies primary affected lobes and positions patient to optimize treatment while ensuring safety prior to initiating chest physiotherapy; identifies contraindications and provides recommendations to the physician.
• Performs oral, nasal, and tracheal suctioning to ensure airway patency; collaborates with physician and nursing on appropriate suctioning frequency.
• Provides reasonable solutions upon identification of problems; participates in group action problem-solving processes.
• Complies with patient safety practices/policies; takes appropriate safety measures considering patient age and developmental status.
• Provides timely, accurate, legible record keeping and data entries per departmental policy; enters required information into the Respiratory Care department system for procedures, workload, and staffing.
• Assumes responsibility for all required Respiratory Care documentation on assigned patients.
• Effectively utilizes equipment and supplies; sets up, operates, troubleshoots, and performs corrective action per department policy and manufacturer recommendations.
• Utilizes appropriate procedures in reporting malfunctioning or suspect equipment and supplies; determines whether equipment malfunction is life-threatening versus non-life-threatening and responds appropriately.
• Assumes responsibility and ensures patient safety during any equipment failure; maintains inventory level of respiratory care equipment and supplies as assigned.
• Maintains department productivity standards; reports inability to complete procedures and seeks assistance if patient care is compromised.
• Demonstrates flexibility and adaptability by accepting new ideas and supporting changes in the department and hospital/clinic; functions independently with minimum direction.
• Utilizes effective listening, verbal, nonverbal, and writing skills formally and informally; utilizes the chain-of-command in difficult situations or decisions.
• Immediately reports critical values to appropriate team members; interacts professionally when discussing patient care plans/recommendations with healthcare team members.
• Participates in training and orientation of new employees; provides patient education within the department and medical center; attends department continuing education and meetings as required.

RCP II Responsibilities

• Functions at the independent level in adult critical care areas.
• Assesses for implementation or discontinuance of mechanical ventilation.
• Implements all modalities of ventilation approved for use in the medical center.
• Adjusts ventilator parameters in response to changes in acid-base balance and oxygenation.
• Effectively weans patients from mechanical ventilator per medical center protocols.
• Implements all respiratory modalities of care specific to adult critical care.

RCP III Responsibilities

• Functions at the independent level in neonatal critical care areas.
• Assesses for implementation or discontinuance of mechanical ventilation.
• Implements all modalities of ventilation approved for use in the medical center.
• Adjusts ventilator parameters in response to changes in acid-base balance and oxygenation per protocol or physician order.
• Effectively weans patients from mechanical ventilator per medical center protocols.
• Implements all respiratory modalities of care specific to neonatal critical care.
• Documents therapy and intervention in the medical record per medical center policy and procedure.

Requirements

• One (1) year of recent NICU experience within the past 12 months.
• Graduate of an approved 2-year Respiratory Care program accredited by the Respiratory Care Accrediting Board (RCAB) or Commission on Accreditation for Respiratory Care (CoARC).
• Respiratory Care Practitioner License (California) from the National Board of Respiratory Care.
• Neonatal Resuscitation Program certification.
• Registered Respiratory Therapist Certificate.
• Basic Life Support certification.

Preferred Qualifications

• Certified Pulmonary Function Technologist (CPFT) or Registered Pulmonary Function Technologist (RPFT) from the National Board of Respiratory Care (NBRC) for any Respiratory Care Practitioner working in the Pulmonary Function Laboratory.
• Pediatric Advanced Life Support Certification (PALS) and S.T.A.B.L.E. Certification.
• Two (2) years recent experience in the Neonatal Intensive Care Unit within the past 24 months.