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Hematology Nurse, Anticoagulation, Per Diem

Brigham and Women's Hospital
United States, Massachusetts, Boston
45 Francis Street (Show on map)
May 16, 2025
CLINICAL DUTIES AND RESPONSIBILITIES Has broad knowledge of the field of anticoagulation management and other hematologic disorders. Collaborates in health care education within the division. Responsible for routine nursing aspects of the division's anticoagulation program: clinical care, monitoring, documentation, and follow-up of patients on anticoagulation. Acts as a liaison between other providers to ensure continuity and collaborative care. Other duties and responsibilities may include assessment and triage of urgent patient messages/visits, assistance in routine and urgent patient care management of division patients. The focus of this position is managing anticoagulation therapy under Pharmacology & Therapeutics (P&T) approved guidelines for scope of practice. This includes warfarin dose adjustments based on the INR lab results, development of peri-operative plans for medication interruption, responding to critical lab values, and counseling and educating patients on a full range of issues pertaining to anticoagulation as per the Joint Commission National Patient Safety Goals. This work includes indication for therapy, laboratory tests for monitoring, signs and symptoms of hemorrhagic or thromboembolic complications, dietary interactions, alcohol consumption, medication interactions and how underlying medical conditions affect anticoagulation therapy. Patients on anticoagulation therapy will be evaluated in the clinic, via telephone or other virtual communication regarding their anticoagulant. For all INR results received, including from external sources, uses established protocols and dosing algorithms, experience, education and critical thinking skills to make dosing changes as necessary to assist in maintaining patient's therapeutic regimen. Makes clinical decisions to manage anticoagulation during acute illnesses and surgeries. Reassesses and modifies plans as needed after review of results and history with each result. Confers with managing physician / medical director for clinical direction as outlined by protocols and continues to educate patients as needed, allowing them to be active participants in their care. In collaboration with the nurse practitioner demonstrates a high level of autonomy and expert skill in the assessment, dosing and plan of care for those patients on anticoagulation therapy. Participates in the day-to-day operations and evaluation of the DFCI AMS program. Functions as the primary nursing contact for care delivered within the physician's practice setting in collaboration with the nurse practitioners and pharmacists from DFCI. Evaluates patient care in the program and collaborates with the other disciplines to facilitate appropriate clinical decision-making and to implement change when necessary. RESEARCH DUTIES AND RESPONSIBILITIES Participates in design of new studies and/or identifies on-going studies that are appropriate for the DFCI AMS. Responsible for fully informing patients and/or their families along with the patients' providers about eligibility criteria for protocols, takes time to explain their rights as research subjects on the intellectual level of the patient. Independently assesses eligibility of patients for protocols and ensures that informed consents are obtained. Accurately and safely provides for administration of prescribed medications and therapies, including approved investigational drugs, as outlined in established protocols. Provides skillful observation of patients for possible adverse reactions to drugs which may require emergency treatment or revision of the prescribed regimen. Exercises sound judgment in initiating emergency measures and interpreting observations to physicians. Works with minimal supervision, but keeps the responsible physicians informed about relevant developments concerning patients and trends in laboratory results. Reviews patients' charts to collect relevant clinical data. Analyzes trends in patient responses. Recognizes patient issues that demand physician's immediate attention. QUALIFICATIONS Education: Graduate of an approved school of nursing with current registration in Massachusetts. For newly licensed nurses, a Bachelor of Science Degree in Nursing is required. Experience: 1. Five years of experience as a nurse required. 2. One year of anticoagulation nurse experience required. 3. One year of hematology experience required. 4. Previous experience as a research nurse preferred. 5. Experience with chart reviewing and new referral triaging required. 6. RN degree required with three years of experience as a nurse. 7. Massachusetts Board of Registration in Nursing license. 8. Advanced data management and computer skills. 9. Ability to work collaboratively and function as an effective member of the health care team. SKILLS AND ABILITIES Position requires full professional knowledge of the principles, theories, techniques and practices of nursing and broad knowledge of the field of hematology and anticoagulation management. Works collaboratively and functions as an effective member of the health care team. Monitors the environment of care and complies with regulatory agency standards. Advanced data management and computer skills are important. Clinical practice is consistent with nursing policies, procedures and standards. Adapts interactions/care based on age-specific needs of the adult/elderly patient. Has a strong knowledge of anticoagulation medications. Has the ability to anticipate, recognize, and meet the needs of patients and their families. Has good communication skills with both patients, colleagues, and physicians from other departments within both BWH and DFCI. Listens openly and clearly conveys messages and information verbally. Writes clearly using appropriate grammar, symbols, and medical terminology. Can work effectively with others to accomplish objectives and goals. Offers assistance to others in need. Ability to multi-task, and shift focus from one task to another and back again without delays. WORK ENVIRONMENT Incumbent works in the inpatient and outpatient areas at both BWH and DFCI. Gowns, masks and gloves will sometimes be worn. Seminars and informal teaching sessions may be held in other hospitals or educational institutions. In addition, it may be necessary to travel to other medical facilities for the purpose of recruiting, consenting and examining patients for protocols, obtaining blood specimens, reviewing charts for data relevant to protocols, and presenting relevant results to patients and hospital personnel. Desk space and access to support services are available. The Brigham and Women's Hospital, Inc. is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.