A highly-skilled, technical clinician/nurse with the necessary knowledge, training, and skills to independently perform (with MD oversight) the technical management of implanted cardiac pacemaker and other ICD devices.  Manages device patients and their care and implements treatment plans in collaboration with the physician and other members of the health care team.  Able to perform basic interrogation, adjustments to programming as per protocol or specific order, and is able to troubleshoot basic, intermediate and advanced device issues. 

1. Assesses the patient clinically for device/rhythm related issues including recent symptoms, and pertinent history-specific indications related to the device.
2. Demonstrates advanced and in-depth knowledge/understanding of the device technology, the purpose of device implant, expected alteration in clinical condition, and potential device related causes for patient symptoms.
3. Interpretation of the patient’s condition and abnormal technical/clinical findings are communicated in a timely manner to the physician and/or other members of the healthcare team.
4. Collaborates with team to ensure patient issues are addressed.
5. Interrogate devices (pacemaker or ICD) fully (either in-person or remotely) to identify sub-optimal programming or, abnormal clinical findings.
6. Able to analyze device function including:  review of pacemaker parameters, testing of sensing and capture for each lead, assessing lead integrity and battery status.
7. Demonstrates understanding of the interaction between programming changes and the potential clinical outcome.
8. Able to evaluate stored and real time EGMs and identify arrhythmias, pacing or sensing problems, and identify appropriate or inappropriate device intervention for arrhythmias.
9. Documents all patient assessment and device information in patient record as required.  

10. Assumes responsibility and accountability for maintaining device database (Paceart or other system) with current, accurate information to facilitate information retrieval as needed for remote monitoring set-up, queries from other services, management of device-related recall events.
11. Ensures home monitoring transmissions on all device patients are reviewed as necessary.
12. Notify physician of abnormal cardiac monitoring findings and appropriately seek guidance with regards to management of the patient.
13. Educates patient and caregivers on device type, purpose, operations, expectations, troubleshooting, etc. and ensures patients and caregivers understand process for who to contact in case issues are identified.

DCH Standards:

• Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation.
• Performs compliance requirements as outlined in the Employee Handbook
• Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self.

• Performs essential job functions in a manner that ensures the safety of patients, visitors and employees.
• Identifies and reduces unsafe practices that may result in harm to patients, visitors and employees.
• Recognizes and takes appropriate action to reduce risks and hazards to promote safety for patients, visitors and employees.

• Requires use of electronic mail, time and attendance software, learning management software and intranet.
• Must adhere to all DCH Health System policies and procedures.
• All other duties as assigned.

1. Current Alabama RN license (nurse), or if technician NASP/HRS certification eligible
2. Advanced knowledge base supporting electrophysiology to include pacemakers, ICD’s, arrhythmias, and general cardiology.
3. Minimum 1 year experience with cardiac device management to include experience with interrogation, programming and remote monitoring or completion of Arrhythmia Technology Institute training
4. Ability to appropriately triage patients with complex, multi-system medical problems.
5. Preferred 2 years cardiology experience with at least 1 year in Electrophysiology. (RN or tech)
6. Preferred CCU or ICU experience
7. Must be able to read, write legibly, speak, and comprehend English.

WORKING CONDITIONS

Physical:  Physical presence onsite is essential.  Hearing and vision must be normal or corrected to within normal range.  Able to perform the duties with or without reasonable accommodation.  Ability to tolerate prolonged periods of sitting or standing.  Ability to lift or carry 50 pounds with occasionally carrying of objects weighing up to 25 lbs.  Is able to push stretcher/wheelchair with average adult patient.  Is able to do frequent stooping and on occasion crouching, crawling or kneeling.  Ability to reach reasonable distances in any direction.  Ability to run in emergency situations.  Must be able to move fingers in a coordinated manner.  Must have ability to feel and perceive temperature, texture, shape and size with fingertips.

Environmental:  Includes exposure to human body fluids, disease, infection, lab chemicals and hazard materials and/or cleaning solutions.  Requires wearing common protective or safety equipment.

Psychological:  Includes demonstrating leadership skills, delegating to team members, addressing conflict, communicating with all types of personalities, and being responsible for outcomes/results.