Alyssa Mandarano

Daily Job Duties:

• Checking patients' vital signs, medications, allergies, height, and weight
• Rooming patients
• Performing various procedures including:
• Void trials.
• COVID swabs.
• EKGs.
• Specimen collection.
• Giving injections and vaccinations.
• Starting IVs and infusions.
• Monitoring patients during their infusions.

Communication Duties:

• Calling patients to:
• Confirm Telehealth appointments and conduct preliminary assessments.
• Assess pre-kidney transplant patients' status and PMH prior to initial transplant workup.

Charge Nurse Responsibilities:

• Organizing and ordering clinic supplies.
• Structuring clinic workflow.
• Delegating tasks to appropriate staff.
• Leading emergency situations, including rapid responses and codes.

Quality and Compliance:

• Ensuring adherence to infection control standards within the clinic.
• Actively participating in quality improvement initiatives to enhance patient care.

Travel Nurse Responsibilities in ICU:

• **Similar duties as my tenure as a staff nurse at FGH (see FGH experience below).
• Greater expectations for adaptability and flexibility due to the travel nurse role.

Adaptation and Learning:

• Rapid orientation in unfamiliar settings, often spanning just a few days.
• Consistent floating to diverse units including:
• Other ICU units
• PCU
• ER
• Demonstrated ability to swiftly and competently learn and adapt to new environments.

Notable Experience:

• Completed a 13-week contract in the STICU at VCU, a Level 1 University hospital in Richmond, VA.
• Gained hands-on experience with:
• Liver and kidney transplants
• ENT cases
• Trauma cases

Pre-surgery Duties:

• Admitting and preparing patients for surgery.
• Starting IVs and administering medications.
• Reviewing patients' medical history and home medications.
• Drawing and reviewing lab results.
• Performing other standard nursing tasks.

Post-surgery Duties:

• Monitoring patients post-anesthesia.
• Taking vital signs.
• Providing discharge education.

Communication:

• Maintaining consistent and effective communication with doctors and anesthesia teams.

Additional Experience:

• Assisting CRNAs with:
• Blocks.
• Moderate sedation.

Patient Care:

• Care for both ventilated and non-ventilated patients using devices like BIPAP and Vapotherm.
• Oversee patients on Continuous Renal Replacement Therapy (CRRT) and manage related complications.
• Monitor intracranial pressure through head drains, ensuring patient stability.
• Administer and monitor intra-aortic balloon pump (IABP) therapy for cardiac support.
• Monitor patient status, vital signs, and advanced hemodynamic monitoring.
• Daily care routines, including turning and positioning to prevent bedsores, wound care, and tracheostomy care.
• Administering enteral and parenteral nutrition.

Critical Procedures:

• Assist in intubation, chest tube insertion, and both CVC and arterial line insertions.
• Participate in bedside procedures like bronchoscopy, lumbar punctures, thoracentesis, and arterial sticks.
• Evaluate diagnostic test results, such as X-rays, MRIs, and blood tests.

Expertise in Critical Conditions:

• Managed and treated diverse critical conditions, from organ failure to traumatic injuries.
• Provide care and monitoring for patients after major surgeries.
• Implement and manage mechanical ventilation and sedation for patients in severe respiratory failure.

Communication and Critical Thinking:

• Constant collaboration with doctors, especially during complex decision-making situations.
• Facilitate timely and clear discussions between interprofessional teams to ensure seamless patient care.
• Use evidence-based practices to drive decision-making and interventions.
• Recognize early signs of deterioration and initiate appropriate interventions.

Clinical Improvements:

• Engage in unit-based performance improvement initiatives.
• Attend educational sessions and bring back best practices to the team.
• Contribute to the development of new protocols, with an emphasis on patient safety.

Medical Administration and Procedures:

• Safely administer high-alert medications and titrate vasoactive drips based on patient response.
• Monitor for potential complications, such as drug interactions or side effects, ensuring prompt action.
• Utilize central lines, PICC lines, and arterial lines for medication administration, monitoring, and performing arterial sticks.

Team Collaboration:

• Engage proactively in hand-offs between shifts, ensuring all pertinent information is communicated.
• Serve as a mentor for newer nurses or nursing students on rotation in the ICU.
• Collaborate with case managers and social workers to develop discharge plans, ensuring a smooth transition for patients to lower-acuity care settings.