Performs advanced neurophysiologic intraoperative monitoring to assist in the assessment of the peripheral and/or central nervous systems during vascular, ENT, general, orthopedic, and neurosurgical operative procedures.
SUPERVISORY ACCOUNTABILITY: None
NATURE AND SCOPE:
This position interacts with the neurodiagnostic services staff, physicians, nursing, allied health staff, patients, and family members.
Supports the mission, vision, and values of the hospital.
Responsible for working in a safe and protective manner at all times, keeping in mind that safety and environmental hazards are the responsibility of all employees for themselves, other staff members and patients.
Helps plan, schedule, and assign priorities according to caseload and clinical urgency.
Must be able to provide intraoperative neurophysiologic intraoperative monitoring as set forth by the ASNM, ASET, and ABRET guidelines, or demonstrate substantial reasoning in the deviance from said guidelines.
Must be extremely proficient in the assessment of each individual surgical procedure in providing the appropriate neurodiagnostic modalities.
At an advanced level, performs complex Orthodromic and Antidromic SSEP, TceMEP, tEMG, EMG, BAER, VER, CSA, BAER, and EEG modalities intraoperatively and clinically.
Performs a risk assessment of the patient and procedure.
Provides a technical description of pre-operative data and the attenuation of operative data to the surgeon and anesthesiologist accurately, appropriately, and in a timely manner.
Directs, trains, and delegates other technologists in less complicated IOM procedures.
Provide educational assistance regarding IOM and neurodiagnostics to the medical, nursing, and allied health staff as needed.
Provides consultation as to the planning and budgeting of the IOM program.
Assists with the recruitment, hiring, and evaluation of neurodiagnostics employees.
Reviews daily work with staff and suggests technical changes and clinical correlation.
Displays an excellent understanding of neurophysiology, medical terminology, anatomy, and their relevance to each surgical procedure.
Exhibits a professional knowledge of END recording equipment and the operating room environment.
Verifies the correct patient, obtains a patient history from the chart, and interviews the patient.
Recognizes artifacts and either eliminates them without the attenuation of data, or monitors them within appropriate parameters.
Observes and notes any clinical changes seen in the patient and selects the appropriate montage to investigate possible electrographic changes.
Provides an accurate and appropriate description of the preoperative and postoperative data to the surgeon and anesthesiologist in a timely manner.
Uses the appropriate modality and montage for each surgical procedure.
Accurately identifies and labels obligate waveforms.
Demonstrates the ability to assess the anesthetic influence on each modality used intraoperatively.
Has an excellent understanding of each surgical procedure monitored and the surgical events that effect neurodiagnostic data.
Has a clear understanding of all tests performed in neurodiagnostics, including clinical utilities and interpretation of results and interfering drugs.
Contributes to the maintenance of department records, billing, and patient records.
Maintains adequate inventory of supplies.
Keeps current with new procedures and techniques. Continues education by reading journals, attending seminars, conferences, etc.
Performs and assumes personal responsibility for related duties as required and/or assigned.
Attends in-services and is compliant with essential education without prompting from manager.
Applies knowledge related to growth and developmental status when interacting with neonatal, pediatric, adolescent and geriatric patients.
Meets age-specific physical and psychosocial needs of neonatal, pediatric, adolescent, and geriatric patients.
Uses hospital criteria to report suspected abuse or neglect.
Follows department policy and standards for use of behavior management techniques, including application of restraints.
Adapts to meeting the special needs of patients based on their age.
Understands the contraindications of each modality used relevant to the patient's medical history and surgical procedure.
Has the ability to troubleshoot recording equipment, software, and hardware in the extreme O.R. environment.
Has knowledge of risks associated with specific disorders and surgical procedures.
Has the knowledge of montage modification and alternate stimulus and recording sites.
Understands the metric system.
Understands digital instrumentation concepts as well as characteristics of the differential amplifier.
Has knowledge of electrical and patient safety techniques in surgery.
Ensures that the on-going and non-physiologic documentation of factors pertaining to the intraoperative monitoring and surgical procedure is comprehensive.
Communicates the monitoring plan to the medical staff, nursing staff, and patient in a manner consistent with their ability to understand in order to reassure the patient, establish rapport, and elicit cooperation.
Confirms the surgical plan and monitoring requirements with the surgical team in order to determine if adjustments must be made.
Performs assessment and evaluation of peripheral systems relevant to test modalities.
Modifies or adjusts recording strategies and/or instrument parameters based on the monitorist's evaluation of recorded data and the progress of the surgical case.
Determines the equipment and supplies required for IOM.
Reviews patient history and medical conditions to identify pre-existing conditions that may affect the monitoring or outcome of the surgery.
Performs a risk assessment by reviewing planned intraoperative procedures to determine the structures at risk and the modalities that should be monitored.
Obtains and reports pre-incision baseline values based on risk assessment.
Provides IOM monitoring observing the ABRET Code of Ethics.
Must be able to communicate effectively and professionally with physicians, administration, vendors, and professional societies.
Must demonstrate the ability to supervise, manage and maintain rapport with other employees, as well as patients and families.
Must exercise discretion in handling confidential information.
Must have excellent hand-eye coordination and physical agility while observing sterile fields.
Must be able to see and read test instruments and evaluate patient status.
Must have the manual dexterity to manipulate small pieces of equipment and physical capabilities to push large equipment to patient areas.
Must be able to communicate with patients and compile written information for physicians.
Certified Neurophysiologic Intraoperative Monitorist (CNIM) credentialed by the American Board for the Registration of Electroneurodiagnostic Technologists (ABRET).
Current BLS Certification from American Heart Association or American Red Cross.
Four (4) or more years of advanced intraoperative monitoring in surgical specialties such as ENT, vascular, cardio-thoracic, general, orthopedic, and neurosurgery.
CCIRH IS A DRUG AND NICOTINE FREE WORKPLACE
The policy of Cleveland Clinic and its system hospitals (Cleveland Clinic) is to provide equal opportunity to all of our employees and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. Job offers will be rescinded for candidates for employment who test positive for nicotine. Candidates for employment who are impacted by Cleveland Clinic's Smoking Policy will be permitted to reapply for open positions after 90 days. Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic facility.
Cleveland Clinic is pleased to be an equal employment employer: Women/Minorities/Veterans/Individuals with Disabilities