Supplemental Registered Nurse at Maddies Place – Spokane, Washington

Department: Nursing

Reports to: Director of Nursing (DON)

FLSA: Non-Exempt

Schedule: Supplemental RN's fill shifts as needed for call outs, times of increased census and PTO, and are not scheduled on a regular basis. Demand and scheduling needs will fluctuate.

Position Summary

Provide oversight and direct patient care to infants at Maddie’s Place using a team-based approach. The RN delivers evidence-based care for infants experiencing Neonatal Abstinence Syndrome and Neonatal Opioid Withdrawal Syndrome (NAS/NOWS), performs comprehensive nursing assessments including NAS/NOWS assessments, and supports and guides Infant Care Specialists (ICS) and Volunteer Cuddlers.

Position Responsibilities

Clinical Care

• Provide nursing coverage within assigned shifts and complete admission head-to-toe assessments and NAS/NOWS assessments, then reassess per protocol and clinical need.
• Obtain and trend vital signs per protocol during acute withdrawal and thereafter.
• Provide continuous cardiorespiratory monitoring during stabilization and when clinically indicated.
• Consult with the Medical Director or on-call provider as needed and implement care pursuant to provider orders.
• Manage NAS/NOWS using the Eat-Sleep-Console model and other evidence-based nonpharmacologic techniques; administer medications when ordered.
• Perform nursing interventions and delegated procedures per provider orders.
• Support feeding plans, including infant-driven feeding, reflux management, higher-calorie formulas, G-tube and NG-tube feeds when ordered; monitor weights daily until birth weight is regained, then weekly.
• Develop and update individualized plans of care in collaboration with the interdisciplinary team.
• Assist with direct infant care as needed and appropriate.
• Follow the approved staffing plan and ratios policy.

Care Coordination

• Coordinate care among specialists, primary care, OT and PT and feeding therapies, community resources that promote access, continuity of care and assist with smooth transitions to the home.
• Verify referrals are placed as directed by the provider.
• Ensure completion of a comprehensive medical exam within 24 to 72 hours of admission and appropriate well child visits, facilitating as needed.
• Coordinate weekly early support and other therapy visits in partnership with day shift and social work leads.
• Confirm community service referrals prior to discharge in collaboration with social work.

Family Education

• Reinforce principles from the individualized discharge education plan developed by the care team.
• Coach caregivers on recognizing infant cues, safe sleep, soothing strategies, and when to contact a provider.
• Provide guidance on feeding plans and managing environmental stimulus at home.
• Share Period of PURPLE Crying resources per facility protocol.

Collaboration, Professionalism, and Culture

• Demonstrate a positive, professional, and collaborative presence; communicate assertively and request help when needed.
• Contribute ideas and solutions that improve quality, safety, and the family experience.
• Uphold Maddie’s Place values and our commitment to building communities of hope by putting babies first, championing families, valuing character, pursuing excellence, fostering teamwork, and collaborating with our community.
• Correct unsafe or inappropriate behavior by ICS or Volunteer Cuddlers. Provide private in the moment coaching when feasible. Report concerns to Nursery Management and the Volunteer Manager. Examples include incorrect care practices (e.g., unsafe sleep, infection-control lapses), unprofessional conduct, and policy violations (e.g., privacy/HIPAA).

Qualifications

• Current, unencumbered RN license in the state of Washington.
• Age appropriate BLS required.
• CPR and First Aid Certification required
• Experience in newborn, pediatrics, NICU, postpartum, or similar setting preferred.
• Familiarity with NAS/NOWS assessment frameworks and the Eat-Sleep-Console model preferred.
• Strong communication, teamwork, and critical thinking skills.

Physical and Schedule Requirements

• Ability to safely lift, position, and carry infants and equipment per policy.
• Ability to stand and move for extended periods and to perform fine motor tasks required in infant care.
• Work hours per assigned schedule; may include weekends and holidays consistent with the approved staffing plan.