Tallahassee Memorial Healthcare (TMH) is a private, nonprofit community-based healthcare system that provides care to a 22-county region in North Florida and South Georgia. We are a career destination with over 6,000 colleagues who reflect the diversity of our community. 

TMH is the region's healthcare leader and top provider of advanced care with a 772-bed acute care hospital and the region's only:

• Level II Trauma Center 
• Primary Stroke Center 
• Level III Neonatal Intensive Care 
• Pediatric Intensive Care 
• The most advanced cancer, heart and vascular, orthopedic & surgery programs in the Panhandle. 

Our system also includes a psychiatric hospital, multiple specialty care centers, six residency programs and more than 50 affiliated physician practices. 

The Cardiac Stress Lab Registered Nurse provides specialized nursing care to patients undergoing cardiac diagnostic testing in the outpatient cardiology setting. The RN works collaboratively with cardiologists, advanced practice providers, nuclear medicine technologists, echocardiography staff, and other members of the clinical team to safely and efficiently perform cardiac stress testing.

The RN assists with nuclear myocardial perfusion stress testing, exercise stress testing, pharmacologic nuclear stress testing, and stress echocardiography, as applicable to clinic operations and approved protocols. The nurse is responsible for patient assessment, preparation, vascular access, medication administration, cardiac monitoring, recognition of changes in patient condition, emergency response, patient education, and clinical documentation.

Essential Duties and Responsibilities

Cardiac Stress Testing

• Prepare and assess patients before cardiac stress testing, including review of the patient's medical history, current medications, allergies, symptoms, and relevant clinical information.
• Verify the ordered stress-test procedure and confirm appropriate patient preparation according to approved protocols.
• Assist with exercise and pharmacologic nuclear stress testing and exercise or pharmacologic stress echocardiography.
• Obtain baseline and interval vital signs and assess the patient's condition throughout testing.
• Apply electrodes and obtain/monitor 12-lead ECGs and cardiac rhythm throughout testing.
• Establish and maintain peripheral IV access as needed for testing.
• Administer medications used during stress testing according to provider orders, approved protocols, applicable nursing scope of practice, and organizational policy.
• Closely monitor patients for symptoms, ECG changes, hemodynamic changes, medication reactions, and other signs of intolerance during and following testing.
• Promptly communicate abnormal findings or changes in patient condition to the supervising provider.
• Assist the provider and testing team during termination of testing or management of adverse patient responses.
• Monitor patients during the post-test/recovery period and ensure appropriate clinical stability prior to discharge from the testing area.

Patient Safety and Emergency Response

• Recognize cardiac arrhythmias, ischemic ECG changes, abnormal blood pressure responses, and signs or symptoms of patient deterioration.
• Initiate appropriate nursing interventions within scope of practice and established emergency protocols.
• Maintain proficiency in emergency response procedures and the use of emergency equipment.
• Assist with emergency interventions, including activation of the appropriate emergency response process when necessary.
• Ensure emergency supplies and equipment within the stress-testing area are available and ready for use.

This fits particularly well with the identified need for stress-testing staff to actively respond when patients experience adverse reactions during testing. 

Patient Education

• Explain testing procedures and expectations to patients before testing.
• Reinforce pre-test instructions, medication instructions, and activity restrictions according to the ordered test and established protocols.
• Educate patients regarding symptoms that should be reported immediately during testing.
• Provide appropriate post-test instructions and answer patient questions within the RN's scope of practice.

Clinical Documentation

• Accurately document patient assessments, vital signs, IV access, medications administered, symptoms, ECG/rhythm observations, nursing interventions, patient responses, and recovery status in the electronic medical record.
• Ensure required components of the stress-test encounter are completed before concluding the patient's visit.
• Communicate significant findings and patient-care concerns to the supervising provider and appropriate members of the care team.

Collaboration and Lab Operations

• Work closely with Nuclear Medicine and Echocardiography staff to maintain safe and efficient patient flow.
• Coordinate with cardiologists and APPs regarding patient readiness, abnormal findings, medication administration, and concerns identified during testing.
• Assist with maintaining appropriate clinical supplies and emergency equipment within the testing area.
• Participate in quality-improvement, safety, competency, and workflow-standardization initiatives related to the Cardiac Stress Lab.
• Provide coverage and assistance across stress-testing modalities based on patient volume and operational needs.
• Maintain a clean, organized, patient-ready clinical environment.

The Registered Clinical Nurse (RN) is fundamental in achieving recognized world-class health care. Assumes direct and indirect responsibility for the patient's care environment. The primary responsibility is providing care through collaboration with health care team members and the autonomous application of the nursing process. Also provides leadership, mentoring and role modeling for other members of the health care team. Responsibilities include, but are not limited to, coordination and delegation of care in a safe, secure and clean environment.

Behavioral Criteria: Adaptable, using evidenced based practice and information technologies while maintaining focus on providing comfort, relieving pain and alleviating anxiety. Practices within the scope and conditions of the Florida Nurse Practice Act. Follows all policies, procedures, and requirements of TMH, and actively supports a commitment to the mission and vision of TMH, consistently displaying behaviors in harmony with the ICARE values.

Reports:

Practice Manager/Medical Director

Supervises:

None

Required Education: Associate's Degree in Nursing

Preferred: Bachelor's Degree in Nursing

Required Experience:

Minimum: No previous experience required; Preferred: 2 or more years’ experience.

Required Certification/License/Registry:

Current license to practice as an RN in Florida

Minimum Qualifications

• Current Registered Nurse (RN) license in the State of Florida or appropriate multistate/compact privilege.
• Current Basic Life Support (BLS) certification.
• Advanced Cardiovascular Life Support (ACLS) certification required or obtained within the organization's established onboarding timeframe.
• Demonstrated competency in cardiac rhythm recognition and ECG interpretation.
• Demonstrated competency in peripheral IV insertion and medication administration.
• Ability to recognize and respond appropriately to changes in cardiovascular status and medical emergencies.

Preferred Qualifications

• Previous cardiology, cardiac diagnostic testing, emergency department, critical care, telemetry, cath lab, or other cardiovascular nursing experience.
• Previous experience with exercise and pharmacologic cardiac stress testing.
• Experience caring for patients receiving pharmacologic stress agents such as regadenoson (Lexiscan).
• Experience working collaboratively with Nuclear Medicine and Echocardiography teams.
• Experience with Epic or another electronic medical record system.

Knowledge, Skills, and Abilities

• Strong cardiac assessment and rhythm-recognition skills.
• Knowledge of cardiovascular medications and stress-testing principles.
• Ability to recognize subtle changes in patient condition and respond rapidly and appropriately.
• Strong critical-thinking and clinical judgment skills.
• Excellent patient communication and education skills.
• Ability to work effectively in a fast-paced procedural environment.
• Strong interdisciplinary communication and teamwork.
• Ability to manage multiple patients and testing workflows while maintaining attention to patient safety.

Working Conditions

• Outpatient cardiology/diagnostic testing environment.
• Frequent standing and walking throughout the workday.
• Requires ability to assist patients with positioning and mobility.
• Routine exposure to patients with cardiovascular disease and the potential for acute changes in patient condition.
• Work may involve proximity to Nuclear Medicine testing areas and radiopharmaceutical procedures; the RN follows applicable radiation-safety requirements but does not independently perform Nuclear Medicine technologist functions.

If you are interested in becoming a part of TMH’s legacy of quality & compassionate healthcare, we want to know you.

Please submit your application & resume TODAY!  We look forward to speaking with you.

Tallahassee Memorial HealthCare is an equal opportunity employer and drug-free workplace. All employment is contingent upon successful completion of a drug screen, background check, reference verification, health assessment, and credential/license verification.

Tallahassee Memorial HealthCare is an equal opportunity employer and drug-free workplace. All employment is contingent upon successful completion of a drug screen, background check, reference verification, health assessment, and credential/license verification.