Advanced Practice Nursing
From the outpatient departments to the intensive care units to the operating rooms, Cleveland Clinic advanced practice nurses work to provide quality patient care across the hospital system. This group of some 960 certified registered nurse practitioners, clinical nurse specialists, certified nurse midwives and certified registered nurse anesthetists work independently and in collaboration with physicians performing physicals, ordering and interpreting tests and procedures, prescribing medications, coordinating care, and performing patient education.
Seventeen family health centers and ambulatory surgery centers offer ample opportunities for nurses to practice general and subspecialty care in an outpatient environment.
Nurses in behavior health provide world-class care in a psychiatry unit with a medical component. Different areas within behavior health include adults, pediatrics, geriatrics and chemical dependency. Behavior health nurses take a team approach to nursing and rely on different definitions of success and cure than other nurses. By intervening early, educating patients about the appropriate uses of seclusion and restraint, and through nonviolent physical crisis intervention training, nurses on the units have been able to reduce the use of seclusion and restraint and improve patient outcomes. Behavior health units are run by a certified psychiatrist, with nurses putting a heavy emphasis on withholding judgment and having a deep respect for all individuals no matter their behavior condition.
Experienced registered nurses with a broad background and good understanding of the continuum of care may function as case managers. These nurses perform a valuable service by guiding patients with complex needs and multiple physicians through their Cleveland Clinic experience.
Cleveland Clinic Staffing Resources
Through Cleveland Clinic Staffing Resources, a systemwide flexible staffing pool, Cleveland Clinic RNs, LPNs, and dialysis and surgical technicians take assignments throughout the health system for one shift or days and months at a time. Nurses who value flexibility and variety enjoy this way of practicing nursing.
Critical Care Nursing
Collaborative efforts of the physicians and nurses accommodate this sicker patient population that often involves multiple co-morbidities. In addition to traditional ICUs, Cleveland Clinic also makes use of specialized ICU’s in areas such as neurology, heart and vascular and neonatal. The diversity of the patients, the highest acuity of care and the fast-paced nature of work in ICUs offer nurses daily opportunities for professional growth, satisfaction, and challenge.
Heart & VascularNursing
As the nation’s No. 1 heart center, Cleveland Clinic offers nurses unique opportunities in every facet of cardiac care. In an environment where the extraordinary is commonplace, nurses collaborate as equal partners with physicians in developing strategies and interventions to improve patient care and outcomes, as well as in evaluating new products and medications.
Cleveland Clinic medical/surgical nurses care for a wide variety of patients and provide a broad scope of care working on multidisciplinary teams. Many medical/surgical opportunities are also specialized in areas including colorectal, orthopaedics, post-bariatric, metabolic, urologic, palliative care, cancer and gynecology.
Nurse educators help improve patient outcomes by influencing evidence-based nursing practice as educators. They help nurses enhance their clinical competence, knowledge and understanding via classroom instruction, simulation laboratory experiences, hands-on clinical support, ongoing in-services and competency assessments.
We accomplish our mission by providing essential services in the following key areas:
- RN orientation
- Critical care classes
- Continuing educational opportunities
- ACLS, PALS and NRP certification
- Unit-specific inservices
- Technology updates
- Chemotherapy classes
- Leadership development course work
- Pediatric Critical Care Classes
- Specialty Curriculums
- Preceptor Development Classes
- New graduate support opportunities
We provide service that is high quality, timely, and directed at meeting or exceeding the needs of the customer. We maximize our impact by effectively using the diverse resources of our department and by viewing one another as internal customers. We promote open communication, high professional standards, and a spirit of inquiry.
The Office of Nursing Informatics plays an essential role in defining and implementing the strategy for innovative technological systems and processes to support the delivery of quality patient care and to enhance nursing practice. The Office of Nursing Informatics’ mission is to support evidence-based nursing practice and improved patient outcomes with technology solutions that enhance nursing communication, documentation and efficiency.
What is Nursing Informatics?
Nursing Informatics is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice. Nursing informatics facilitates the integration of data, information and knowledge to support patients, nurses and other providers in their decision-making in all roles and settings. This support is accomplished through the use of information structures, information processes, and information technology.” (ANA Scope and Standards of Nursing Informatics Practice, 2001, pg vii) The ANCC Nurse Informatics Certification was established in 1994. There are currently more than 680 (ANCC, 2007) certified nurse informaticists in the United States.
The Nursing Informatics specialty at Cleveland Clinic offers a wealth of benefits for experienced nurses who like
- Professional and personal growth
- Flexibility and creativity
- A supportive team environment
- Reward and recognition
- Educational support.
- A professional informatics career ladder
- An informatics development program
What is the promise for the future?
The future holds rapid and ongoing paradigm shifts for clinical caregivers, especially in the areas of electronic documentation, physician order entry and the collaborative transformation of clinical practice.
Technology holds the promise to eliminate redundancy, aggregate relevant information in easy to access and read formats and improve caregiver efficiency, as it enhances nursing practice and drives improvements in patient quality outcomes.
For Cleveland Clinic nurses, the future promises an explosion of new information technology that includes, among others- implementation of RFID technology and personalized electronic scheduling and automated patient acuity classification. These technological advances and others yet to be defined are focused toward keeping Cleveland Clinic nurses at the forefront of quality care delivery and the Destination for Nursing Practice.
How and where do I start to become a nursing informatics specialist?
A variety of leadership positions are available for nurses with skills, education and ambition. These positions range from executive leadership to assistant nurse managers, education and informatics. Many of our leaders are groomed from within.
The staff of the Office of Nursing Quality and Practice strives to improve patient care by communicating evidence-based standards and by monitoring and reporting the progress of key nursing quality indicators. Staff in Nursing Quality regularly recommend and participate in research related to nursing interventions, patient safety initiatives, shared governance, and promoting the forces of magnetism.
Nursing Research and Innovation
The Department of Nursing Research and Innovation encourages any nurse who has a research question, an idea for a research study, or an innovative process or device to come forward and pursue their ideas. Oftentimes, the most important ideas for research are those generated by clinicians who provide direct patient care. Mentorship is available by senior nurse researchers who are PhD-prepared nurses with experience in nursing research and providing guidance and support to facilitate the conduct, translation and dissemination of research and evidence-based nursing practices.
Who are the Nurse Researchers that mentor, coach, and educate individuals and teams in nursing research?
In the Department of Nursing Research and Innovation, nurse researchers are PhD prepared nurses who have experience in nursing research and provide guidance and support in many ways to facilitate evidence based nursing practices. Each nurse researcher has specific Institutes that they provide research mentorship and consulting services to, based on their clinical backgrounds and/or research interests (see bios for each RN team member). In addition, each nurse researcher has their own focused program of research.
Who are the nurse investigators that conduct nursing research?
We encourage any nurse who has research questions, an idea for a research study, or an innovative process or device to come forward and pursue their ideas. Staff nurses, nursing management, clinical specialists, nurse educators or practitioners and ancillary team members can all be involved. Oftentimes, the most important ideas for research are those generated by clinicians who provide direct patient care. We encourage collaborative research practices and utilize our wide array of clinical experts within our system to aid us in the process of gaining and generating new knowledge.
How do nurses get “time” to conduct nursing research?
Stepping away from bedside practice to conduct research (no matter what stage of research the project is in) involves nursing time that may need to be covered by another caregiver. The Nursing Research Fund (NURF) Award provides small grant funding to aid in research processes. Nurses can apply for funding two times per year and proposals are reviewed and scored by a review team.
Award funds can be allocated to personnel expenses and used to facilitate data collection and other processes that require office time or allow time for one-on-one education with their nurse researcher mentor.
The Department of Nursing Research Intranet site has templates, guidelines, checklists, algorithms and useful links to information you can download from the Internet. These and other resources are available to support nurses and aid in making research happen. Additionally, graduate students often complete clinical research practicum's with our team. Students may be temporarily assigned to your research project, as desired, to help you create a study database, retrieve review literature from our electronic library services, enroll subjects in clinical research and/or enter data into an electronic system. In this way, nurses can focus on aspects of research that cannot be completed by others.
Nurse researcher mentors can provide guidance in every aspect of the research process, including determining feasibility of a proposed project, reviewing the literature, developing research questions, assisting with multidisciplinary collaboration, providing editorial (proposals, abstracts, posters and manuscripts) and grant writing support, completing Institutional Review Board application and associated forms, designing/developing an instrument, understanding statistical analysis reports, and educating on multiple research related topics (one-on-one or in a group). Mentorship not only enriches the project by providing different viewpoints, discussion may enhance the scientific merit of the project or simplify processes; it may prevent time spent on frivolous or unnecessary activities and minimize redundant work.
Providing invaluable help to new mothers and their families, OB nurses are a critical part of the obstetrics team. These nurses have positive attitude and excel at dealing with the challenges that come with serving a diverse population group and entire families. Passionate about educating new mothers, OB nurses continue Cleveland Clinic's legacy of exemplary care as they help bring the tiniest patients into the world. These nurses work in conjunction with our Pediatric Nursing partners in our three hospitals with Level III NICUs and over 80 NICU beds throughout our health system.
Cleveland Clinic Oncology Nurses care for a wide variety of patients with cancer and provide a broad scope of care working in multidisciplinary teams. Many oncology opportunities are available in specialized areas such as Bone Marrow Transplant, Leukemia, Solid Tumor Oncology, Palliative Medicine, Research, Radiation Oncology and specialized disease teams. As the top cancer center in Ohio and nationally recognized by U.S. News & World Report, Cleveland Clinic Oncology Nurses work with the latest innovative treatment plans as well as clinical trials.
Pediatric nurses are trained to care for children with the most severe problems and to assist our young patients and families as they navigate the numerous challenges they may face. Cleveland Clinic Children’s Hospital maintains an extraordinary record of positive outcomes including one of the lowest mortality rates of any pediatric ICU in the country. Our nurses also care for our tiniest patients in three different Level III NICUs and over 80 NICU beds throughout the health system.
The satisfaction of meeting these daily challenges provides a stimulating atmosphere for the all-RN nursing staff, as evidenced by low turnover and a vacancy rate of less than 5 percent. Pediatric nurses work in collaboration with physicians and other professionals with opportunities to specialize, conduct research and participate in decisions concerning policy and practice that define their day-to-day work.
With more than 200 inpatient and ambulatory operating rooms, Cleveland Clinic uses nurses in hundreds of surgical procedures every day. An OR residency program provides nurses interested in perioperative nursing with ideal training on how to circulate and scrub.
As radiologic procedures continue to advance, patients undergoing procedures require the need for a patient-centered approach provided by registered nurses. These patients require assessment, intervention and discharge planning from qualified nursing caregivers. Radiology nurses work independently to provide specialized nursing treatments and care to a diverse population of acute, critical and non-acute patients in a specialty patient care setting that requires unique skills and versatility. A thorough knowledge of patient assessment is required as the patient population spans every age and a wide variety of diseases on any given day. Radiology nurses utilize skills employed in many other nursing specialties and incorporate them into the radiology setting.
Other Specialty Nursing Areas
With its wealth of institutes and areas which attract patients with the highest acuity, Cleveland Clinic is looking for exceptional nurses in all of its fields. Some other notable specialty areas include:
To ensure nurses have the competencies and skills to properly care for patients with diabetes, the department of Nursing Education & Professional Practice Development promotes a broad array of opportunities for education and professional growth. Nurses are trained in inpatient diabetes treatment techniques such as meal planning and insulin management.
Nurse on Call
For more than 17 years, Cleveland Clinic’s award-winning Nurse On Call program has successfully managed more than 12 million total calls and triaged over 5 million clinical calls. Our caring, compassionate staff of registered nurses have years of specialized training and experience in internal medicine, family medicine, and pediatrics, among others.
Nurses in pain management are dedicated to serving the rehabilitation and intervention needs of people with acute or chronic long-term pain. The goal of these nurses is to help patients manage their pain so they can resume normal, productive lives. To exemplify Cleveland Clinic values of compassion and teamwork, pain management nurses work tirelessly in interdisciplinary teams to help patients move beyond their perceived limitations while encouraging healthy living.
Nurses in rehabilitation serve patients with impairments and disabilities in the areas of mobility, self-care, communications, swallowing and cognition; the impairments may result from accidents, illnesses or natural causes. In order to help create a unique plan of care for each patient, rehabilitation nurses work as part of a multidisciplinary team. Working together with their team and family members, our nurses seek to help the patient return to his or her community, while maintaining as much physical mobility and independence as possible.
As part of Cleveland Clinic’s devotion to world-class patient care, we have a team of Skin Care Nurse Coordinators dedicated to prevent patient skin issues such as hospital acquired pressure ulcers. Before beginning skin care facilitation, Skin Care Nurse Coordinators must have the equivalent experience with a concentration in wound and skin care and complete the training program at Cleveland Clinic's R.B. Turnbull Jr., MD, School of Enterostomal Therapy Nursing.