The Adult Bone Marrow Transplant Program Outpatient Treatment Facility provides a continuum of care for patients who will undergo or have undergone comprehensive treatments for solid tumors, hematological malignancies and selected genetic disorders.

N/A

Adult Cardiac Cath Labs has six procedural rooms for patients undergoing coronary arteriograms, angioplasty and stent deployment, congenital and peripheral diagnostic and interventional procedures; 24/7 coverage for acute MI management. RN will be assisting during the procedure with scrubbing circulating and monitoring.

Ages served:
13 years through 45 years
Newborn

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

Method of Care Delivery:
Multidisciplinary

1. Normal spontaneous vaginal delivery(NSVD) with/without complications
2. C-section with/without complications
3. Normal newborn
4. PIH/HELLP
5. Preterm labor with/without complications
6. Multiple gestation
7. Diabetes
8. Cardiac disease
9. Placenta previa with/without complication
10. Intrauterine fetal demise (IUFD)
11. Premature rupture membranes
12. Fetal anomalies/syndromes
13. Metabolic complications of pregnany

The Registered Nurse staff has an average seniority of seven years. The OB Technician provides surgical scrub support, as well being a NAII. Non-licensed unit support staff include: Health Unit Coordinators, Dietary Technicians, Spanish Interpreters and Environmental Services personnel. Additional support includes three (3) Nurse Managers and a Staff Education liaison. OB Social Work and Lactation Consultant team also provides coverage for these units. Patient Resource Managers assist with the management of all obstetrical patients.

There is one OB/GYN practice affiliated with the Duke Birthing Center. The hospital also has a division of Maternal Fetal Medicine. In addition, Duke Family Practice physicians have delivery privileges. Certified Nurse Midwifes provide supervision and patient care in OB triage and LDRP and assist with Intern orientation and education. Dedicated obstetrical Women’s Anesthesia services are also provided. There is 24/7 in-house attending and resident MD coverage and OB Women’s Anesthesia medical providers.

Requirements: North Carolina nursing license.
Familiarity with OB TraceVue bedside monitoring a plus

The Pediatric Procedure unit is located in the McGovern Davison Children’s Health Center (CHC). Procedure unit staff work collaboratively with subspecialty providers, anesthesia and PACU to assist with various procedures including: endoscopy, bronchoscopy, lumbar punctures, bone marrow aspiration, circumcision and joint injections.

Moderate sedation and general anesthesia cases are performed on the procedure unit. Registered nurses provide patient and family education, assist with care during procedures and coordinate patient care. The CHC offers the unique opportunity to utilize specialized nursing skills and knowledge in an outpatient setting.

Specialty practices include Cardiology, Pulmonary, Endocrinology, ENT, Infectious Disease, Rheumatology, GI, Pre-Operative Screening, General and Plastic Surgery, Genetics, Speech & Audiology, Special Infant Care, Nephrology, Neurology, Neurosurgery and Urology.

MDiagnostic services, including echocardiography, pulmonary function testing, sleep studies and a full service audiology lab are on site, as are pharmacy and laboratory services.

Pediatric and adult patients receiving care in the following therapeutic areas: Allergy/Immunology, Anesthesiology, Cardiac Surgery, Cardiology, Endocrinology, Gastroenterology, General Surgery, Geriatrics, Hematology, Hematology, Infectious Disease, Medical Genetics, Nephrology, Neurology, Neurosurgery, Oncology, Ophthalmology, Psychiatry, Psychology, Pulmonary Medicine, Radiation Oncology, Rheumatology and Urology.

Types of studies performed on DCRU include: Phase I – II, proof-of-concept, special populations, bioavailability, bioequivalence, PK/PD, rising dose tolerance, drug metabolism, functional imaging, molecular imaging medical imaging, complex experimental medications, first-in-human, healthy volunteers, drug-drug interactions, drug-food interactions, biomarkers, QTC prolongation, long-term confinement studies, bio-nutritional studies and complex PD endpoints.

DCRU will be adding a 17, 000-square foot, 30-bed confinement unit with five exam/procedure rooms in the fall 2009, which will be located in South 3rd Floor Red Zone.

Primarily serves adult and pediatric patients from all inpatient units and specialties

The unit focuses on patient and family education, and delivers care using a collaborative and multidisciplinary care model. Staff members acquire and maintain excellent assessment skills and gain exposure to a wide variety of patient populations. Staff members are encouraged and supported to advance their practice professionally and academically. Our unit consistently achieves high scores in nursing and patient satisfaction.

Primarily serves adult and pediatric patients from all inpatient units and specialties.

The unit focuses on patient and family education, and delivers care using a collaborative and multidisciplinary care model. Staff members acquire and maintain excellent assessment skills and gain exposure to a wide variety of patient populations. Staff members are encouraged and supported to advance their practice professionally and academically. Our unit consistently achieves high scores in nursing and patient satisfaction.

ECT involves the use of a brief, controlled electrical current to produce a seizure within the brain. This seizure is believed to bring about certain biochemical changes which may cause patients who suffer from depression to diminish or to disappear. A series of seizures, generally 6-12 (although sometimes a smaller or larger number may be necessary), given at a rate of 3 per week) is a required to produce such a therapeutic effect. These treatments can be done on an inpatient or outpatient basis. An increasing awareness that patients can be stabilized on ECT has led to the development of outpatient ECT programs. Nurses working in this area do not necessarily need experience in psychiatry, but must have an interest in this area. Nurses should have a strong background in medical-surgical and or perioperative nursing, because many patients have a high acuity in medical co-morbidity. ACLS is required.

Current North Carolina RN License and BLS / ACLS certification is required. Prefer acute Cardiac Care and/or Cath Lab experience with knowledge of cardiac arrhythmias. Must satisfactorily complete the Clinical Electrophysiology Laboratory orientation.

81 Total: (4 Multifunctional resuscitation/trauma bays, 18 Dedicated pediatric emergency department monitored beds, 36 Adult emergency department monitored beds, 8 Dedicated Psychiatric emergency department beds. 11-Bed clinical evaluation unit, 3 Multifunctional consults rooms; 4 Mulitversatile triage bays, 1 Dedicated sexual assault nurse examiner room, 1 Dedicated central telemetry station)

7:00 AM – 7:00 PM, 7:00 PM – 7:00 AM, 11AM-11PM. Self schedules are flexible. 1-2 weekends/month, depending on shift.

Arnie Boardwine

The Emergency Department at Duke University Medical Center is an urban academic, Level One Trauma Center and regional tertiary care facility located on the campus of Duke University in Durham, North Carolina. We are an 81-bed department which includes treatment areas dedicated to Adult, Pediatric, Trauma, Psychiatry, and an 11 bed Clinical Observation Unit. The Emergency Department at Duke University has an average annual census of 71,000 visits.

Comprehensive New Graduate Nurse Orientation: Six month program consisting of clinical and didactic work. Upon successful completion of the orientation program the new graduate nurse has completed ACLS, PALS, TNCC, ENPC and ED core courses.

Requirements: Unit based certification requirements include: BLS, ACLS, PALS. (ACLS and PALS certifications must be acquired within the first year of employment.) The team concept in the ED is well developed and imperative to the overall efforts to provide quality emergency care and services in an efficient and timely manner. Staff recruited must be committed to the role of patient advocate and must be patient focused. The nursing staff has a great deal of responsibility for activating standing orders and coordinating the care provided patients; so Nurses must maintain a high index of suspicion and be prepared to intervene in life-threatening situations. A premise in maintaining quality patient care and efficiency is the flexibility of the unit and the flexibility of each member of the staff within the team to work toward a common goal. Security in the ED is excellent. There is a zero tolerance for violent behavior and the security systems include staff education in de-escalation techniques, facility lockdown and restricted access, metal detectors, and Duke Police Officers on duty at all times in the ED.

The Endoscopy/Bronchoscopy Units mission is to meet our patient's needs through quality health care. The staff provide quality, state of the art patient care and technical assistance for all patients undergoing diagnostic and therapeutic endoscopy/bronchoscopy procedures. We are seeking motivated and energetic candidates.

Ophthalmology/Surgery Services

7:00 AM - 3:30 PM; 8:30 AM - 5:00 PM (Monday-Friday); Required call

The Eye Center OR handles approximately 2,600 surgeries per year, including outpatient, inpatient and same-day admits. A small amount of maxillo-facial, plastic surgery, orthopedic, and otolaryngological - pediatric procedures are also performed. The operating room staff is comprised of registered nurses, operating room technicians, surgical attendants, and clinic coordinator.

7:30 AM - 5:00 PM Monday, Tuesday & Friday; 8:00 AM - 5:00 PM Wednesday & Thursday; 24-hour on call coverage on weekends and holidays

The PACU-EC is designed to provide highly skilled nursing care and treatment to the post-anesthesia patient utilizing the nursing process and specialized equipment.

6:00 AM - 2:30 PM; 10:00 AM - 6:30 PM

Consists of neonatal of geriatric requiring treatment for surgical interventions for vitroretina disease, cataracts, corneal transplants, retinal detachments, glaucoma, muscle and oculoplastic ophthalmology procedures. Patients are outpatient, same-day admits, or 23 hr recoveries. Plastic surgery, maxillogacial, orthopedic, and pediatric otolaryngological patients are also treated.

Staff consists of registered nurses, licensed practical nurses, health unit coordinators, messengers.

12-Hour Day/Night rotation;
1 - 2 Weekends every 4 weeks; Weekend option offered as available.

Inter-collaborative teamwork is an important part of the success of this unit. The diversity of the patient population provides a strong foundation to the new graduate, while offering continuous challenges for the more experienced nurse as well.

12-Hour Day/Night rotation;
1 - 2 Weekends every 4 weeks; Weekend option offered as available.

Inter-collaborative teamwork is an important part of the success of this unit. The diversity of the patient population provides a strong foundation to the new graduate, while offering continuous challenges for the more experienced nurse as well.

12 hours

12-hour shifts; 6:45 AM - 7:15 PM

Major medical diagnoses treated include, but are not limited to, prematurity, respiratory distress syndrome, persistent pulmonary hypertension, transient tachypnea of the newborn, pneumonia, pneumothorax, sepsis, surgical abnormalities, metabolic derangements, and chromosomal or genetic abnormalities.

12-hour Day/night rotations; One weekend per month

Requires North Carolina Nursing license and a BSN Associates degree of diploma from an accredited school.

12-hour shifts; 7:00 AM – 7:00 PM & 7:00 PM – 7:00 AM,
8 –hr evening shifts.

Requires one year of IV experience

Days, 8 hours, M-F

Registered nurses collaborate with providers, direct clinic flow, perform patient care and teaching functions, and perform procedures.

7:00 AM - 7:30 AM; 7:00 PM - 7:30 AM; 10:00 AM - 10:30 PM.

Physical Requirements * Height/Weight Restrictions * Minimum 3 years (preferred 4 years) Critical Care/ED experience ICU * 2 years commitment to program (minimum)

12-hour Day/night rotation.

12-hour Day/night rotation; 1 - 2 Weekends every 4 weeks. Weekend option offered as available.

This unit also supports the neurosurgical patient by providing preoperative care and postoperative care of the stable neurosurgical patient. The diversity of the patient population provides a strong foundation to the new graduate, while offering continuous challenges for the more experienced nurse as well.

12-hour Day/night rotation

12-hour Day/night rotation; 1 - 2 Weekends every 4 weeks; Weekend option offered as available.

Currently, unit staff participate in self scheduling. All new staff work 12-hour shifts with a day/night rotation for the first year. During this time, we try to keep the schedule such that you work two weeks of nights and two weeks of days in rotation. You are expected to work one to two weekends out of four. Staff who have been here a year and completed all of their requirements may request to be placed on a preferred shift with minimal rotation by turn, based on unit needs. Orientation: For new graduates we offer 8 weeks of a comprehensive orientation with designated preceptors that work with you to identify your learning needs. You will have weekly orientation reviews and a final end of orientation session with your primary preceptor. Granted, you will not know everything after orientation, but you will be provided the opportunity to continuously learn! A supportive leadership/orientation staff views your success as their own.

12-hour Day/night rotation

Adult hematology/oncology patients 18 years of age and older. Our patients are experiencing any stage of the disease process from diagnosis to end-of-life situations. They receive aggressive treatment including chemotherapy, symptom management and end-of-life care for leukemia, lymphoma, and solid tumors.

12-hour Day/night rotations

9300 is a comprehensive oncology unit dedicated to delivering high quality patient care in an efficient manner. We are advocates of collaborative practice, open communication and individual/team responsibility.

The Oncology Treatment Clinic (OTC) is an outpatient, hospital-based infusion center that provides cancer therapies to adults with many different types of cancer or infusion services for non-oncology patients. Patients may receive standard chemotherapy, investigational chemotherapy, blood product transfusions, and a variety of other infusions and injections. Our staff is composed of registered nurses who have specialized knowledge in oncology nursing. Our commitment is to provide the highest quality of care that is safe, compassionate, and patient-focused.

NC RN license & BLS required; prefer oncology infusion experience, IV skills, OCN certification, & ONS Chemotherapy/Biotherapy Provider card

Patients ages 18-65+, across all stages of the transplant continuum of care. Our patients have received or will receive transplants for diseases, such as leukemia, lymphoma, multiple myeloma and some autoimmune disorders.

Primarily 10 and 12 hours, with limited 8-hour shifts available. Evening, night and weekend shifts available for experienced nurses and surgical technicians. No on-call for main OR. Call required for Cardiothoracic nursing service.

A transplantation program is available for needs including: heart, lung, liver, kidney and pancreas.

Melissa Polkinghorne, Linda Taylor, Betsy Stewart, Judy Saunders Marsha Porter.

A transplantation program is available for needs including: heart, lung, liver, kidney and pancreas.

12-hour Day/night rotations. If unit staffing allows, preferred shift with minimal rotation by turn is usually granted after probationary period. Unit expectations are to work 1-2 weekends out of 4.

The orthopedic patient population consists of both trauma and elective surgeries.

Duke's orthopedic services are ranked 6th in the nation, and the nurses on 6100 play an integral part of that recognition. We have several nurses who are Nationally Certified in Orthopedics. Annual Orthopedic core classes are available to all staff. This unit offers full-time/part-time, as well as permanent or casual positions.

12-hour Day/night rotation

Patients may be diagnosed with a malignant, a serious hematologic or immunologic disease, or a disabling metabolic disease. Average length of stay is between 30-60 days. Each patient has marrow ablative and/or radiation therapy prior to transplant. Medication therapy is dependent on the type of transplant the patient receives as the PBMTU performs several types of cellular transplants including umbilical cord, matched sibling bone marrow, autologous, and matched unrelated donor. PBMTU nursing practice represents the front line of new medication trials and research studies.

The mission of the Pediatric Blood and Marrow Transplant (PBMTU) is to give children with life threatening illnesses the chance for a new beginning through transplant and cell therapy. Patients may be diagnosed with a malignant disease, a serious hematologic or immunologic disease, or a disabling metabolic disease.

We support the primary care nursing model allowing patient and families to have the opportunity to have consistent care and great advocacy if required. Our nursing orientation is 8-10 weeks allowing the RNs to have a strong orientation entailing critical skills assessment, medication review, and attending important core classes. Our unit has computerized physician order entry and charting system.

12-hour rotations; 0645-1915 & 1845-0715

The PICU, with an admission rate of 1200 patients a year, provides care for a wide variety of critically ill medical and surgical patients. Specific patient populations include infants and children ages 0-18 years with neurosurgical defects, bone marrow transplants, solid organ transplants, general surgery and trauma.

Available advanced treatment modalities include negative pressure ventilation, nitric oxide, and ECLS (ECMO). The Pediatric Intensive Care Unit (PICU) at Duke University Medical Center is an exciting, fast pace 16- bed Level I Trauma Center and regional referral facility.

12-hour rotations; 7:00 AM - 7:00 PM & 7:00 PM - 7:00 AM

The Stepdown unit is designed to provide care for those who need less monitoring than those in the Critical Care or Intensive Care units, but still require more monitoring than those on the medical or surgical units. This area cares for complex patients with diagnoses such as Pre/Post surgical cardiothoracic, liver ,bowel and heart transplant, traumatic brain and /or spinal cord injuries, respiratory failure, and chronic ventilator patients. Patient age ranges from birth to 18 years of age.

Telemetry is used to monitor patients’ heart rhythms at the Stepdown Unit nurses’ station, 24 hours a day, by an arrhythmia technician. We also have NCA's on each shift. The stepdown unit has a small group of nurses ( 21) and teamwork is very evident.

The Radiology Department provides a large number of CT and MR procedures to pediatric patients who receive moderate sedation for the procedure. Post procedure, the pediatric patient is monitored in the Radiology pediatric holding area until the child is awake, alert, and back to baseline status prior to discharge.

Patient Population: Infants, children and adolescents with hematologic, oncologic and immulogic disorders. Also general pediatrics, neurology and renal and plastic patients and their families are admitted to this unit. Our average length of stay is 8 days; with some patients and families staying 30 + days. We commonly see patient/families return frequently especially among our hematology/oncology population.

The care needs of our patient population include: careful assessment for change in patient condition, antibiotic therapy, blood transfusion, pain management, patient/family teaching and psychosocial support as well as many other nursing activities.

All ages of pediatric patients admitted under the following specialties: Cardiology, Cardiothoracic, Pulmonary, GI, ENT, Neurosurgery, Urology. Orthopedic, Short Gut Transplantation and General Surgery.

5300 practices the team concept of nursing. We do have NCAs on each shift. Family centered care is strongly supported.

All Surgery Recovery Patients, Adults and Pediatrics.

The PACU facilitates the safe recovery of neonate to geriatric patients undergoing operative or invasive procedures. The PACU recovers all patient acuities ranging from intermediate to stepdown to ICU.

Patients suffer from a variety of psychological disorders, including: schizophrenia, manic-depressive illness, dually diagnosed, substance abuse and/or mental illness or mental retardation, personality disorders and depression. The average length of stay on our unit is seven days.

Our mission is to provide admitted adults or adolescents and their families/caretakers acute stabilization and comprehensive assessment of multiple psychiatric illnesses. Our multidisciplinary team includes:

* Attending Physician
* Resident Physician
* Psychiatric Social Worker
* Psychiatric Nurses
* Psychologist
* Psychology Interns
* Recreational Therapist
* Hospital School Teacher
* Psychiatric Case Manager
* Substance Abuse Counselor

A variety of patients undergoing MR, Interventional (tube placements, myelography, biopsy procedures, and arteriograms of any region of the body) and Diagnostic Radiology treatments.

Qualifications include (1) BLS and ACLS certification, (2) Good IV skills, (3) Previous nursing experience preferably in a Recovery or PACU type setting.

Pulmonary patients age 19 and older. Pulmonary Transplant patients age 14 and older. Patient populations include: respiratory failure, pulmonary hypertension, interstitial lung diseases, cystic fibrosis, pulmonary and renal transplants, and acute and chronic renal failure.

Our Urology services include the Robotic Prostatectomy and Urology Oncology. Our Plastic services provide care to large wounds and utilize Duke's Hyperbaric chamber. Otolaryngology services include trachs and radical neck dissections. Our Ophthalmology service has few inpatients and is limited to those who need specialized ophthalmic care. Our GYN population includes patients with ovarian and cervical cancer, also benign diseases such fibroid tumors.

Because of the variety of patient populations, 6300 is a site for many nursing school rotations. According to a recent Work Culture survey, 6300 is among the Top Ten places at Duke Medicine to work. Offers full-time/part-time as well as permanent or casual positions.

Adult: multi-system trauma; vascular surgery; kidney, kidney-pancreas, liver transplants, complex GI surgeries.

Adult through geriatric general and vascular surgery: AAA; Flaps; fem-pops; endarterectomy; kidney, liver, kidney-pancreas transplant, small bowel transplant; post-ICU; trauma

Adults

Adult & Pediatric

Pain Management, Neurological Disorders, Neurosurgery, Psychology/Biofeedback, Memory Disorders, Palliative Care

Adults

Infectious Diseases, HIV, Pre-op Screening, Drug Addiction Management

Adults

Lung Transplants, Cardio-Thoracic Surgery, Hematology Diseases

Adults

Primary Care

Prenatal-Geriatric

Chemotherapy, Autoimmune Diseases

Adult

GI, Endocrinology, Nephrology, Pulmonary Lung Transplant

Adult

Wound Management Treatment

Adult & Pediatric

Rheumatology & Gynecology