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The Exercise Specialist provides clinical support to Cardiovascular Services and/or Cardiac / Pulmonary Rehabilitation.

Cardiovascular Services: Performs all physician ordered non-invasive cardiology tests, such as 12 lead and signal averaged EKGs, a variety of cardiac stress tests in CVS and Nuclear Medicine, Holter and event monitoring, EKG's, supervises stress tests, assists physicians and other professionals in stress testing or particularly delicate or sensitive testing situations. Supervises pharmaceutical stress tests and administers Lexiscan and Definity per department policy.

Cardiac/Pulmonary Rehabilitation: Supervision of Cardiac Rehabilitation Phase II and Phase III monitoring of patients. Prescribing phase II patients with exercise prescription per department policy. Working with cardiac rehab Phase II and Phase III patients supervising patient exercise, determination of patient exercise prescriptions and performance of body fat analysis. Documents patient performance and individual treatment plans. Employees providing direct patient care must demonstrate competencies specific to the population served.

Qualifications: Employees providing direct patient care must demonstrate competencies specific to the population served.

EDUCATION AND/OR EXPERIENCE

• Bachelor's degree in Exercise Science or a related field required.
• Previous 1 year experience in exercise testing of low and high-risk patients preferred.
• Satisfactory completion of Basic EKG and Advanced EKG courses within 12 months of hire.

LICENSES, REGISTRATIONS, CERTIFICATIONS

• BLS certification required upon hire or within the first 90 days of employment.
• ACLS certification required within 6 months of hire.
• Certified by the American College of Sports Medicine preferred.

WORK ENVIRONMENT

• While performing the duties of this job, the employee regularly works in a clean, well-lighted & temperature controlled environment. The employee is occasionally exposed to cutting instruments or other hazardous conditions, infectious disease from blood/airborne pathogens, fumes or airborne particles, and toxic or caustic chemicals. The noise level in the work environment is usually mild.

PHYSICAL DEMANDS

• The employee is required to regularly talk and hear, stand and walk and use of hands to perform fine motor skills. He/She is occasionally required to stoop, crouch of kneel, lift and/or move up to 50 pounds and move quickly to gather equipment and medication to respond to emergency situations. Specific vision abilities required by this job include close vision, color vision, depth perception, peripheral vision, and ability to adjust focus.

INTERPERSONAL REQUIREMENTS

• Regularly works with patients where social sensitivity and the ability to communicate effectively are definitely required. Must be able to work and communicate with all managers, employees, physicians, and customers with which the department does business. The specialist must be able to work well with in a small work group which includes: communicating effectively with team members, assertively handling conflict, diplomatically resolving issues, participating in problem-solving. Individuals in this position must treat everyone in a professional manner.

ESSENTIAL DUTIES AND RESPONSIBILITES

• Demonstrates proficiency in managing PC applications.
• Strong organizational skills to manage multiple priorities simultaneously
• Strong assessment skills to determine appropriateness of patient test protocol
• Critical thinking skills to determine end points of test
• Recognition of critical arrhythmias.
• Regularly works with patients where social sensitivity and the ability to communicate effectively are definitely required.

FUNCTIONS  OF EXERCISE SPECIALIST IN NONINVASIVE CARDIOLOGY

• Familiarizes patient with test to be performed and preparation for the test; obtains any relevant information from the patient and available clinical records, check that labs are negative, and evaluate medication list.
• Monitors equipment during testing and makes adjustments as necessary; informs physician or other members of the professional staff of EKG abnormalities. 
• Performs EKGs when patient condition warrants.
• Supervision and administration of Stress tests for review by the Physician; observes the monitor; operates recording devices; monitors the patient for signs of distress; performs other activities requested by the physician; starts an IV line according to procedure.
• Evaluates patient for appropriateness of the test and discuss potential alternatives with the ordering physician. 
• Opens up the labs performing duties on the opening list to prepare rooms for the cases of the day.
• Prepares patient for procedure; places electrodes and leads on patient; applies pulse ox; applies B/P equipment.
• Prepares and administers Lexiscan per procedure and all IV tubing required for the test. Properly explains procedures to the patients and answers all questions.
• Obtains appropriate medication from Pyxix for Nuc Med Stress Tests. 
• Administers Definity per protocol during Exercise Stress Echo and Dobutamine Stress Echo. 
• Performs clerical functions; answers phones, schedules cases, arrange for transport, copies studies on to CD, acquires patient demographic information in history; and sends daily schedules to other hospital departments.
• Attaches electrodes to patient's arms, legs, and chest area, connects electrode leads to appropriate testing equipment.
• Applies event and Holter monitors and instructs patient in appropriate use.
• Performs Holter scanning of tape from Holter monitor worn by patient; adjusts scanner controls and observes screen to identify irregularities or verifies data provided by computer program; prints sections of abnormal heart patterns or full disclosure tape for interpretation by physician.
• Enters necessary patient information test results, charges and other appropriate information into computer.
• Performs minor preventive maintenance on equipment, cleans and stocks cardiac testing department.

FUNCTIONS OF EXERCISE SPECIALIST IN CARDIAC AND/OR PULMONARY REHABILITATION

• Demonstrates thorough knowledge of the principles and practices of cardiopulmonary rehabilitation.
• Completes an intake assessment, re-assessment and discharge paperwork in timely manner.
• Attends case review meetings with physicians and coordinates patients care accordingly.
• Works with insurance companies to obtain prior authorizations and extensions as needed.
• Coordinates case review meetings with the staff and physicians and coordinates patient care accordingly.
• Familiarizes patient with evaluation to be performed and preparation for the evaluation; discuss Rating of Perceived Exertion (RPE) chart, Shortness of Breath (SOB) chart, and Pain scale with patient acknowledgement of understanding of each, obtains any relevant information from the patient about recent activity level, pain, limitations to exercise, and available clinical records.
• Teaches patient or attaches electrodes to patient's chest area, connects electrode leads to appropriate monitoring equipment. Discuss cleaning of equipment when done with the session. Obtains any relevant daily information i.e. medication changes, daily weights, blood sugars.
• Monitors equipment during exercise and makes adjustments as necessary; informs appropriate departments of equipment abnormalities.
• Presentation of "Exercise" education forum , presenting information on exercise intensity, duration and frequency. Provides an atmosphere designed for patient interaction and questions.
• Supervises Phase III Cardiac rehabilitation patients; evaluating changes in each patients heart rate zone, evaluating appropriate BP and BS response, evaluating EKG strip for rhythm changes, Monitoring weight changes and Medication changes discussing these changes with patient, Documentation of changes in the patients medical history.
• Performs Phase II floor responsibilities; Setting equipment appropriately based on patient Exercise Rx, evaluating RPE, SOB, and pain as well as HR for appropriate changes to Exercise Rx, Evaluation of patient for problems with activity taking appropriate action in decreasing intensity or stopping exercise, Evaluate THZ for appropriateness and make changes when necessary, Documentation of changes on the daily worksheet.
• Monitoring of Phase II classes with evaluation of; Rhythms for abnormalities and documenting when necessary, Patient HR and if in THZ evaluating the necessity of changing THZ based on patients performance, adjusting equipment settings for patient/HR tolerance, weekly and daily weight changes, Fasting/Pre/Post blood glucose levels for appropriateness of exercise and response to exercise, taking appropriate action when abnormal, proper documentation of patients performance.
• Opens and closes exercise room; Unlocking cupboards, retrieving patient charts, performing daily Defibrillator check, daily Glucometer test, preparation for new patients, participates in "team huddle" to discuss assignment of daily tasks.
• Prepares and gives exercise prescriptions; Evaluates each patients THZ and appropriately assigns home exercise parameters, discuss patient goals for home activity and apply appropriate setting for home equipment when possible. Dispense information on purchase of home equipment such as Treadmills, Bikes, and Pulse meters.
• Supervises exercise evaluations providing Exercise Rx following each evaluation for the Cardiologist to approve.
• Completes exercise portion of Individualized Treatment Plan (ITP) for review by the Physician, to establish patient goals and treatment plan for achieving these goals.
• Performs EKGs when patient condition warrants.
• Maintains proficiency with Glucose meter and performs patient tests when needed, and understands how and when to treat based on results. 
• Documents patient status and goals in patient's chart and computer.
• Performs clerical functions; answers phones, completes charges, schedules cases, acquires patient demographic information in history; sends daily schedules to other hospital departments.

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