Registered Nurse, Paediatric Intensive Care Unit - Female

Professional Connections (Profco)

Saudi Arabia

Ref: RP057-199

Job description / Role

Employment: Full Time

Description
- Pediatric Intensive Care Unit (PICU)
- Number of Beds: 18
- Nurse Patient Ratio: 1:1-2

Scope of Service:

The Pediatric Intensive Care Unit (PICU) provides 24 hour intensive nursing care for patients aged neonate through adolescence.

The primary conditions and diagnoses treated are:
- Congenital heart disease, pre and post-operative cardiac surgery
- Hematology/Oncology, Immunocompromized patients
- Metabolic disorders
- Pediatric General Surgery, Neurosurgery
- Vascular Surgery, ENT, Endocrinology
- All sick medical patients requiring intensive care

Frequent Procedures/Services/Functions:
- The PICU utilizes numerous nursing diagnostic and therapeutic modalities to facilitate patient care, including the following:
- Use of nursing process, assessment, pl anning, interventions, and evaluation
- IV Therapy
- Thermo-regulation
- Hemodynamic monitoring
- Cardiac and neurologic monitoring
- Ventilatory support, Invasive and non invasive.
- High frequency ventilation and nitric oxide therapy.
- Psychosocial care
- Patient and family education
- Medication administration
- Trauma care
- Continuous renal replacement therapy (CRRT)
- Pain management

Hours of Operation:
24 hours a day, 7 days a week

STAFFING PLAN

Number and Mix of Staff:
- Staffing is provided by registered nurses functioning in a total care nursing system. There is a charge nurse assigned for each shift. This person is respon sible for monitoring of quality of care delivered by nursing personnel during the shift. Shift assignments are made by the charge nurse and based on the following criteria:
- Complexity of patient's condition and required nursing care.
- Dynamics of patient's status, including the frequency with which the needs for specific nursing care activities change.
- Type of technology employed in providing nursing care.
- Degree of supervision required by each nursing staff member based on her/his previously assessed level of competence.
- Availability of supervision appropriate to the assessed and current competence of nursing staff member.
- Relevant infection control and safety issues.

Method of Adjusting to Staffing Variances:
- The charge nurse reassesses all patients for level of care required and determines if patients may be transferred to a less intensive level of care. Charge nurse may use temporarily reassigned nurses from other units or overtime is utilized to staff for variances in patient volume and acuity.

HOW ARE INSERVICES/CONTINUING EDUCATION PROGRAMS PROVIDED TO MAINTAIN

STAFF COMPETENCY
- Continuing education is offered through Nursing Development & Saudization (ND&S) and at the Unit level coordinated by the Head Nurse and Clinical Instructor. Education needs are identified through needs assessment tools, treatment protocols, performance improvement activities, regulatory agencies, new technology, new equipment, new products and individual input and surveys. Topics other than those which are based upon mandates and updated protocols, are also arranged. These may be issues of interest raised by the Unit staff, topics selected fr om the departments' needs assessment or information of interest or relevance from other departments.

Annual review of education includes:
- Age Specific Care competency
- Performance Improvement
- Fire and Electrical Safety
- Infection Control and prevention online modules
- Skin Care and Pressure Ulcer Prevention online module
- Wound Care Online module
- Point of Care Testing (POCT)
- Medication Safety Online module

METHOD OF COMMUNICATION WITH OTHER DEPARTMENTS:
- Internal and External Methods of Communication:
- Internally and externally, communication is accomp lished via direct verbal communication, telephone, fax, and intranet and written memos. Staff meetings are held on a monthly basis, or more frequently if required.
- Collaborative practice meetings are scheduled on a quarterly basis or as required.
- Other meetings are scheduled as required.

Describe Collaborative Relationships With Other Departments:
- The Head Nurse and staff participate on many multidisciplinary committees, as well as on Hospital wide performance improvement groups and committees. Re presentatives from other departments are invited to attend staff meetings when new programs are introd uced or if complicated issues arise, to facilitate a mutually desirable resolution.

GOALS OF DEPARTMENT
- Ensure optimal flow of pediatric patients through the unit.
- To continue to function as the tertiary referral center for critically ill children in Saudi Arabia.
- Deliver high quality culturally sensitive care in a cost-effective manner
- Continue to develop quality improvement programs within the unit
- Improve quality care by reviewing and implementing evidence based practice
- To establish a family centered healing environment

CRITERIA FOR ADMISSION TO SERVICE
- The PICU provides care to patients from newborn to 14 years. PICU patients may be admitted from the Emergency Department, other nursing units, surgery areas, OR, or from outlying hospitals via air and ground transport. These patients are critically ill and have at least one of the following requirements:
- For evaluation and treatment of life threatening illnesses or acute organ failure
- For evaluation and treatment of illnesses that are amenable to treatment and that require intensive monitoring
- For (evidence-based) concern of (pending) imminent physiological deterioration
- When the patient requires frequent (re)evaluation (including laboratory tests)
- When the patient requires intensive nursing care beyond the capabilities of regular in patient nursing unit.

All admissions should be approved by the PICU intensivist OR designee. The criteria listed below provide algorithms for decision-making.

Cardiovascular System Assessment:
- Life-threatening arrhythmia
- Continuous infusion of anti-arrhythmic agent(s)
- Continuous infusion of vasoactive agent(s)
- Pericardial effusion with tamponade.
- Patients in cardiogenic shock

Respiratory System Assessment:
- Respiratory rate > 40 or unstable ventilatory pattern (e.g., Cheyne-Stokes respirations)
- PaO2 - FiO2 > 0.50 or increasing FiO2 requirement over 4-8 hours
- PaCO2 > 6.0 Kpa and pH - Concern that endotracheal intubation may be required within 4-8 hours
- Requires (aggressive) pulmonary toilet every 2 hours or more often
- Ventilation or oxygenation dependent on mechanical ventilator
- Acute airway obstruction or acutely impaired airway protective reflexes

Gastrointestinal System Assessment:
- Acute upper or lower GI tract hemorrhage causing orthostatic hypotension. Suspected (or
- documented)> 2 units of acute PRBC blood loss.
- Hepatic dysfunction causing acute encephalopathy
- Clinical evidence of peritonitis
- Tense abdomen with concern that intr a-abdominal hypertension is present

Renal System Assessment:
- Newly diagnosed renal failure with fluid overload leading to cardio-pulmonary compromise
- Urine output hemodynamic stability) not resolved by fluid challenges.
- Require new institution of Continuous Renal Replacement Therapy (CRRT).
- Acute hypertensive crisis
- Hypertensive encephalopathy.

Central Nervous System Assessment
- Acute deterioration of Glasgow Coma Score - New onset stupor or a decrease of 2 or more in the GCS within the last 12 hours
- Uncontrolled or poorly controlled seizures
- Progressive muscle weakness involving respiratory muscles
- Acute meningitis with neurological abnormalities
- Acute cerebral infarct status post thrombolytic administration and/or mechanical thrombolysis or requiring frequent nursing neurologic assessments and with fairly high probability for needed decompressive crainectomy
- Acute spinal cord injury for frequent hemodynamic monitoring
- Any condition that requires crainiotomy or ventriculostomy with risk of vasospasm
- Any condition associated with increased intracranial pressure associated with progressive neurological defects
- Impending or Actual Sepsis
- Evidence of Systemic Inflammatory Response Sy ndrome (SIRS) with a decrease in systolic blood pressure by 20% from the patient's baseline.
- Lactic acidosis (lactate > 4.0 mmol/L)
- Cryptic (unexplained) shock with or without hypotension
- Other Conditions
- Acute drug intoxications with obtundation, compromised airway protective reflexes, hemodynamic instability, incipient cardiac arrhythmias.
- Acute drug intoxications requiring continuous infusion medications or frequent administration of intravenous medications
- Acute drug intoxications requiring dialysis Other metabolic conditions (e.g., severe rhabdomyolysis) requiring frequent monitoring or medical interventions

Nursing Workload Requirements
- Requirements that I and O measured hourly for more than 8 hours
- Requirements that respiratory rate and quality measured every hour, the use of therapeutic inhalers, oxygen therapy, CPAP or BiPAP with nursing assessment at least every hour, intermittent suction
- required hourly, or hourly arterial blood gas determinations
- Requirements that debridement/irrigations/tubing, extensive application of ointments/preparations, extensive wound vac changes, multiple dressing changes, requirement for multiple staff in order to complete a dressing change
- Requires frequent (hourly) assessment and in tervention related to cognition because of, altered consciousness, or who requires repeated medical therapy for cognitive support

DISCHARGE CRITERIA
- Patients are discharged from PICU when
- Their acute illness is treated
- Their medical condition has stabilized
- They do not require frequent eval uation (including laboratory tests) and /or intensive nursing care
- It has been determined by the patient/family and physician that aggressive treatment such as is
- provided in an ICU setting is no longer appropriate.

All discharges should be approved by the PICU intensivist OR designee. The criteria listed below provide algorithms for decision-making.

- Cardiovascular System
- Absence of life-threatening arrhythmia for 24 hours or at the discretion of the intensivist.
- No continuous infusion of vasoactive agent(s)
- No continuous anti-arrhythmic infusion
- Pericardial tamponade resolved of >24 hours or at the discretion of the intensivist.

Respiratory System
- Respiratory rate between 12 -40 breaths/minute
- No significant retractions or accessory muscle use
- PaO2 > 8.0 KPa with FiO2 - PaCO2 7.32, (non chronic lung disease patient)
- Requires pulmonary toilet less often than every four hours
- Extubated for at least 12 hours, if intubated for respiratory distress or failure
- Gastrointestinal System Assessment
- Stable or improving hepatic encephalopathy, if present during current PICU admission
- Resolved active GI bleeding
- Clinical evidence of peritonitis resolved (treated)

Renal System Assessment
- Urine output > 0.5 ml/kg/hr, or dialysis program established for patients with chronic renal failure
- Off dialysis or conversion to intermittent hemodialysis
- Central Nervous System
- Glasgow coma score > 8 and stable and improving by requiring less frequent monitoring
- Seizures controlled on stable medical regimen for >24 hours
- Stable or improving respiratory muscle strength with Maximum Negative Inspiratory Force > 30 cm
- H2O
- Assessment for (Impending or Actual) Sepsis
- Stable Systolic blood pressure (Age in years X2 + 70mmHg) with resolving Systemic
- Inflammatory Response Syndrome
- Resolved Lactic acidosis (lactate > 4.0 mmol/L)
- Resolved Cryptic (unexplained) shock with or without hypotension

Other Conditions
- Stable or improving consciousness and airway prot ection with resolving acute poisoning, without
- need for further monitoring
- Assessment of Nursing Workload Requirements
- Resolved Requirements that I and O need hourly measurement.
- Resolved Requirements that respiratory rate and qu ality need hourly measurement, as well as the use
- of therapeutic inhalers, oxygen therapy, CPAP or BiPAP with nursing assessment and intermittent
- suction, and arterial blood gas .
- Resolved Requirements that debridement/irrigations/tubing, extensive application of
- ointments/preparations, extensive wound vac changes, multiple dressing changes, requirement for
- multiple staff in order to complete a dressing change.
- Resolved Requirements of frequent (hourly) assessment and intervention.

Benefits
- The Hospitals generous benefits package is beyond comparison to packages you can receive in your home country. Take a moment to consider the attractive, potentially tax-free salary, generous leave time, free Hospital housing, free medical & dental care, in addition to airline tickets, recreational facilities, relocation allowance, severance bonus, and remarkable service bonuses.
- Our client hospital allows you to gain experience with some of the world's foremost Medical professionals.
- Education and Development
- Career Planning and development.
- Continuing professional development.
- Personal and professional opportunities
- Opportunities for attendance at professional association meetings, conferences and seminars.

Requirements

Registered Nurse with current nursing license from country of origin

Two years recent acute care nursing experience

About the Company

Professional Connections International Healthcare Recruitment Agency

Professional Connections, often referred to as Profco, is an international healthcare recruitment specialist. Profco is working to help placing credentialed nurses, doctors and allied health professionals in exciting opportunities with leading hospitals around the world. International assignments are a great way for nurses and other healthcare professionals to broaden their experience and to see how healthcare is delivered in other countries, while at the same time enhancing their career prospects as they gain experience in different parts of the world.

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Nurse salaries in Saudi Arabia

Average monthly compensation
SAR 5,500

Breakdown available for industries, cities and years of experience