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Care Transition Nurse Resume Example

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CARE TRANSITION NURSE
Professional Summary

Passionate and conscientious Care Transitions Nurse with exceptional diagnostic and analytical ability. Highly organized with proven success in coordinating transitional care and ongoing patient support in acute settings. Offering 13 years of nursing experience and exceptional communication skills. Driven, hardworking, adaptable and resilient with strong attention to detail. Seasoned nursing professional offering proven clinical knowledge, natural interpersonal strengths and technical abilities. Knowledgeable about EMR charting, and interdisciplinary collaboration focused on optimizing patient care and support. Quality-focused and efficiency-driven leader. Enthusiastic Registered Nurse eager to contribute to team success through hard work, attention to detail and excellent organizational skills. Clear understanding of Care Transitions and Case Management. Motivated to learn, grow and excel.

Skills
  • Patient and family advocacy
  • Strong clinical judgment
  • EMR / EHR
  • Acute care expertise
  • Interdisciplinary collaboration
  • Needs assessment
  • Case Management
  • Scheduling
  • HIPAA Compliance
  • Discharge Planning
  • Insurance Knowledge
  • Emotional Support
  • Quality Management
  • Patient Care Coordination
  • Patient Evaluation
  • Detail-oriented
Work History
Care Transition Nurse, 05/2015 to Current
St Mary's Health System – Portland
  • Coordinated with physicians and caregivers to establish and initiate follow-up contact in cases of concern for patient well-being following transition.
  • Worked closely with nurses and social workers to provide transitional care for patients moving between care settings or from inpatient to outpatient treatment.
  • Collaborated with transition team to assess status of primary care patients, scheduling follow-up visits and developing discharge plans.
  • Initiated and facilitated referral processes, serving as liaison between current and prospective care providers and processing any needed paperwork.
  • Assessed patients to establish condition and monitor intervention outcomes, assessing impact on transition schedule.
  • Promoted patient and family comfort during challenging recoveries to enhance healing and eliminate non-compliance problems.
  • Participated in Patient Experience Committee to discuss policies, propose revisions and implement changes.
  • Assessed patients to determine baseline mobility, strength of family support system, access to primary care provider, status of medical insurance coverage, available DME , existing Home Health Care services
  • Initiated Disability, Medicaid and Guardianship applications and affidavits
  • Communicated barriers to discharge with ancillary teams
  • Worked successfully with diverse group of coworkers to accomplish goals and address issues related to patient outcomes
Lead RN, 04/2010 to 05/2015
New Season – Hickory , NC
  • Provided skilled, timely and level-headed emergency response to critically-ill patients.
  • Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
  • Performed frequent checks on life support equipment and made necessary adjustments to preserve optimal patient conditions.
  • Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
  • Directed nursing activities for Medical Surgical department, providing guidance to nurses to deliver outstanding care and optimal patient satisfaction.
  • Sustained quality standards by performing routine medication audits and upholding internal and industry best practices.
  • Reported findings to quality departments after conducting routine restraint audits and worked with team to devise corrective actions for deficiencies.
  • Implemented interventions, including medication and IV administration, catheter insertion and airway management.
  • Quickly responded to situations impacting safety and security to unit, actualizing crisis prevention interventions to control and de-escalate situations.
  • Completed schedules for RN's and Care Techs
  • Assigned nursing staff to their patient assignments
  • Attended bed meetings with staff from ICU, ER, and OR to determine bed availability and patient placement
  • Completed time cards, entered Paid Time Off requests, entered ill calls and sick leave time
  • Assisted staff with discharge and admissions
Staff RN, Medical Surgical Unit 6 West, 09/2007 to 04/2010
Nebraska Medicine 4350 Dewey Ave – City
  • Conferred with physicians to discuss diagnoses and devise well-coordinated treatment approaches.
  • Performed emergency medical procedures such as BLS, ACLS and other condition stabilizing interventions.
  • Worked within interdisciplinary health care team to develop, implement and make adjustments to patient care plans, individualizing strategies and methods to improve health and meet recovery goals.
  • Monitored hemodynamic variances to identify signs of life-threatening complications.
  • Monitored patient vital signs to perform thorough condition assessments.
  • Updated patient charts with data such as medications to keep records current and support accurate treatments.
  • Delivered medications via oral, IV and intramuscular injections, monitoring responses to address new concerns.
  • Observed and reported patient condition, progress and medication side effects to accurately document updates.
  • Vaccinated patients to protect individuals from measles, pneumonia, influenza and other illnesses of concern.
  • Taught patients how to improve lifestyle choices, dramatically reducing chance of symptom reoccurrence.
  • Informed patients and families of effective treatment options and at-home care strategies, enhancing long-term outcomes.
  • Verified patients had information necessary for ongoing care, providing guidance on diagnoses, management of medications and prevention methods.
  • Provided health education to patients and families regarding discharge instructions and plans of care.
  • Educated patients and answered questions about health condition, prognosis and treatment.
  • Managed patient pain relief and sedation by providing non-pharmacological and pharmacological interventions.
Education
General Education StudiesIowa Western Community College - City, State
General Education StudiesUniversity of Nebraska At Kearney - City, State
Bachelor of Science: Nursing, 08/2007
Nebraska Methodist College Of Nursing And Allied Health - City, State
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Resume Overview

School Attended

  • Iowa Western Community College
  • University of Nebraska At Kearney
  • Nebraska Methodist College Of Nursing And Allied Health

Job Titles Held:

  • Care Transition Nurse
  • Lead RN
  • Staff RN, Medical Surgical Unit 6 West

Degrees

  • General Education Studies
    General Education Studies
    Bachelor of Science : Nursing , 08/2007

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