The Center for Translational Bioethics and Health Care Policy is the outgrowth of an effort launched in 2012 to integrate bioethics across Geisinger’s key functions in research, innovation, quality improvement, education, and patient care. The Center’s overarching aim is to advance “ethics quality” at Geisinger by aligning individual, group and organizational behaviors with established or emergent norms.
Since the inception of a formal bioethics function at Geisinger, nurses have been a primary source of requests for clinical ethics advice and consultation—and a primary target for enhanced learning and training in clinical ethics and for substantive engagement in quality improvement, innovation, and research. Among the health professions, nurses stand out as key partners in achieving the Center’s overarching aim.
Reporting to the chief bioethics officer, professor and director of the Center, the individual recruited to the position of nurse ethicist will play a pivotal role in advancing the Center’s education and training programs in clinical ethics, in promoting and facilitating the work of the Clinical Ethics Advice and Consultative Service, and in designing, implementing, leading, and evaluating “learning” initiatives (quality improvement, innovation, and research) in such system and Center priority areas as serious, advanced illness and shared decision making.
MAJOR DUTIES AND RESPONSIBILITIES:
1. In in- as well as out-patient settings, nurses potentially function as crucial sources of “ethics surveillance,” identifying issues, problems, and conflicts that could potentially benefit from the services of the Center’s Clinical Ethics Advice and Consultation Service. Working under the direction of the chief bioethics officer, the nurse ethicist will develop educational and outreach strategies to capitalize upon—and realize—this potential. It is estimated that only 1 out of every 10 problems or conflicts is ultimately brought for help and resolution to an ethics consultation service, which means 9 out of 10 problems or conflicts go without potentially time- and resource-saving assistance, yielding increased costs and deficits in the quality of care. Especially in such areas as intensive and specialty care, the nurse ethicist will cultivate effective unit-based relationships and collaborations with the goal of ensuring that ethically challenging issues more readily have the benefit of expert intervention.
2. The nurse ethicist will also play a key role in staffing the 24/7, system-wide Clinical Ethics Advice and Consultation Service: upon receipt of a request for clinical ethics consultation (CEC), s/he will conduct preliminary analyses and information-gathering; meet with patients/families and team members to elicit concerns, perspectives, and needs; seek to mediate and resolve conflicts within teams, within patients’ families, and between teams, on the one hand, and patients and their families on the other; provide required follow up and communication; conduct assessments of CEC quality by administering and analyzing the results of feedback surveys; evaluate consultation trends and effectiveness (e.g., by conducting electronic health record reviews, etc.).
3. In conjunction with both Center staff and nursing leaders at multiple levels of the organization (i.e., from the level of the chief nursing officer to the level of nursing operations managers), the nurse ethicist will design, develop, implement, and evaluate education and training programs and strategies, grounded in the aim of enhancing the ethical and relational competence of nurses, as well as individuals from other health professions. Such programs and strategies will focus, in part, on improving learners’ diagnostic and assessment skills for the specifically ethical dimensions of patient care and on strengthening their capacities for addressing moral distress, intra-team conflict, and related dysfunctions in both intra- and inter-team communication.
4. In conjunction with Center staff, nursing staff, as well as staff in Quality and Safety, Clinical Innovation, and health services research, the nurse ethicist will lead initiatives in “preventive ethics” within a learning health care system framework. Examples of such initiatives include the development, implementation, and evaluation of tools, interventions, or decision aids to improve the process of shared, informed decision making and system efforts to enhance the conduct of advance care planning in patients with advanced illness.
COMPETENCIES AND SKILLS:
• Excellent oral and written communication skills, including confident, well organized public speaking as well as well organized, lucidly written prose;
• Demonstrated ability to analyze the various dimensions (clinical, communicative, ethical) of problems and challenges in patient care quality;
• Demonstrated ability to analyze and assess the ethical rationales for different goals and treatment options in the care of specific patients, including a facility with the language, concepts, and methods of clinical ethics;
• Ability to conduct and facilitate ethics-specific communications within multidisciplinary teams and between teams and patients/families;
• The skills and abilities required for highly collaborative work within the Center and across organizational units at all levels of the system.
EDUCATION AND EXPERIENCE:
• A Master’s degree in bioethics is required.
• Current RN license or eligible for licensure in the state of Pennsylvania required.
• Extensive nursing or case management experience in clinical settings devoted to the care of patients with serious illness is required—e.g., intensive and specialty care units, comfort care units and hospice.
• Experience in clinical ethics consultation is also required.
• Experience in addressing, analyzing, and resolving clinical-ethical challenges and problems is required.
• Experience in teaching and in designing educational programs in nursing, clinical ethics, and related domains is required.
WORKING CONDITIONS/PHYSICAL DEMANDS:
Work is typically performed in an office environment.
The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria considered necessary to successfully perform the job.
OUR PURPOSE & VALUES:
Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
GEISINGER MEDICAL CENTER: (GMC)
Lcated Danville, Pa., the largest tertiary/quaternary care teaching hospital in the region, is licensed for 475 beds, including 89 pediatric beds in the Janet Weis Children’s Hospital. GMC, a Magnet Hospital, maintains the region’s only Level 1 Regional Resource Trauma Center with additional qualifications in pediatrics. GMC offers an array of highly specialized medical and surgical services, including neurosciences, cardiovascular services, transplantation, women’s health (in the Women’s Pavilion), oncology and orthopaedics. The Hospital for Advanced Medicine serves as an integrated center for the most critical patients. Outpatient services are available on and off campus.
Established in 1915, Geisinger is a large integrated, non-profit healthcare system, comprised of 13 hospitals; nearly 300 primary, specialty, and urgent care clinics; a health insurance plan; and a medical school. Geisinger’s workforce of 33,000 serves 4.2 million residents in 45 counties in Pennsylvania and 6 counties in New Jersey. Recognized for clinical innovations designed to enhance the value of care, Geisinger was an early adopter of electronic health records and of such patient-centered initiatives as OpenNotes. More recently, the system has attracted widespread attention as the home of the MyCode Community Health Initiative, a biobank with 212,000 patient-participants, a diversified program of genomic discovery, and a drive to integrate genomics in clinical practice. The Center for Translational Bioethics and Health Care Policy grew out of a 2012 leadership decision to invest in the development of a formal bioethics function spanning the multiple missions of the system—research, innovation, quality improvement, and patient care.
** Does not qualify for J-1 waiver. We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.
*Domestic partner benefits not applicable at Geisinger Holy Spirit.
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Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 13 hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers.
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