VECRA Inc

COMPANY DESCRIPTION
VECRA, Inc. is a service-disabled veteran-owned small business (SDVOSB), woman-owned small business (WOSB), minority business enterprise (MBE) consulting firm implementing proven methodologies that help our clients drive growth, transform businesses, and innovate breakthrough ideas. VECRA’s extensive experience with healthcare management and consulting, medical coding, medical billing, auditing, and credentialling, reporting systems, facilities management, program management and staffing support services are always:
Vigilant * Efficient * Collaborative * Responsive * Accurate

JOB SUMMARY
VECRA, Inc. has a requirement for a Temporary Private Duty Nurse (PDN) to deliver continuous skilled nursing services in a school setting.  The PDN will serve a critical role in bridging the gap between acute care-home care-school are, to ensure that patients receive the necessary support to maintain their health and quality of life.  The duties of the PDN require ongoing skilled nursing assessment and may not be reduced to task-based supervision.  Services must be provided by a licensed Registered Nurse (RN), or a Licensed Practical Nurse (LPN) under direct RN supervision. 

ROLES and RESPONSIBILITIES 
1. Continuous monitoring of airway patency due to tracheostomy status and chronic respiratory conditions.
2. Real-time assessment of respiratory effort, oxygen saturation, coughing, secretion management, and signs of distress.
3. Immediate intervention when oxygen saturation falls below 92%, including activation of emergency oxygen protocol and calling 911 as required.
4. Ongoing clinical judgment regarding:
a. Risk of tracheostomy obstruction or decannulation.
b. Emotional escalation resulting in coughing out tracheostomy.
c. Respiratory changes associated with exertion or weather conditions.
5. Sterile tracheostomy care (suctioning and dressing changes).
6. Monitoring and management of gastrostomy tube feedings and dumping syndrome.
7. Immediate emergency reinsertion of gastrostomy tube in the event of dislodgement to prevent stoma closure and potential surgical intervention.
8. Maintenance of #4.5 Shiley trach with backup #4.0 trach at all times.
9. Maintenance of emergency respiratory kit, suction machine, and Ambu bag at all times.
10. Active clinical monitoring during school-related transportation.
A. The PDN is responsible to Maintain Accurate and Adequate Health Records per the following:
1. Document all assessments, interventions, medication administration, and observations.
2. Maintain logs of vital signs, oxygen saturation readings (PRN), suctioning, feedings, and skin integrity.
3. Document trach or G-tube dislodgement events.
4. Maintain compliance with physician orders.
5. Participate in IEP-related documentation as requested.
6. Maintain confidentiality per FERPA and HIPAA.

B. The PDN is responsible to Administer Medications as Prescribed in accordance with physician orders and Maryland nursing law, per the following:
1. Inhaled medications
2. Tracheostomy-administered medications
3. Gastrostomy tube medications
4. Topical medications
5. PRN medications requiring nursing assessment
6. Medication administration must be performed by licensed personnel when calculation, assessment, or an unpredictable response is involved.

C. Maintain Student Health Environment and Equipment per the following:
1. Ensure emergency equipment remains functional and immediately accessible.
2. Maintain sterile trach supplies.
3. Inspect and maintain feeding supplies and the GT site.
4. Ensure safe participation during transitions, physical activity, and weather exposure.
5. Participate in emergency drills while maintaining clinical supervision.
6. Ensure the student remains NPO and prevent unsafe oral intake.

D. Provide Auxiliary Duties Related to Student Safety and Access per the following:
1. Provide direct supervision to prevent removal of the tracheostomy or gastrostomy tube.
2. Provide active clinical monitoring during school-related transportation.
3. Collaborate with the school nurse, IEP team, and staff.
4. Participate in RN supervision and quality assurance processes.
5. No tasks are delegable at this time due to high-risk, non-delegable nursing functions.

QUALIFICATIONS and REQUIRED SKILLS:

• Licensed Registered Nurse (RN) or Licensed
• Practical Nurse (LPN under RN supervision)
• Able to provide service during the student’s full school day
• Able to provide service during the student’s school-related transportation or school-related programming activities.
• Experience with tracheostomy decannulation and gastrostomy and active clinical monitoring.
• Experience with Emergency Gastrostomy Reinsertion
• Must be able to commit to a negotiated schedule as shared or intermittent nursing coverage is not sufficient given patient’s clinical profile.
• Compliance with COMAR, the Maryland Nurse Practice Act, and IDEA.