Cardiology Clinic Nurse, RN – INR and Triage

Date Posted:  April 28, 2021
Reports to:  INR Lead
Location: Mercy Hospital – Mercy & Unity campuses
Job Status/Hours:  Part time or full time

Position Summary:

This position is responsible for working with the physician(s), assisting licensed practitioners by providing RN care management skills in the cardiology and INR clinic while teaming up with clinic staff to maintain clinic flow and prompt responses to patient needs.


  1. Demonstrates an understanding of the coagulation process, the role of Vitamin K, thrombogenesis, hypercoagulable states and antithrombotic therapy.
  2. Identifies cardiovascular indications for anticoagulation therapy.
  3. Understands the mechanism of action of warfarin and other anticoagulants used in clinic setting.
  4. Describes the impact of medications, disease states, diet and lifestyle/activity on anticoagulation therapy.
  5. Understands how socioeconomic, behavioral, psychological and environmental factors impact patient compliancy and adherence to anticoagulation therapy.
  6. Understands and properly uses the Point-of-Care capillary blood-testing machine (Protime).
  7. Understands the meaning of prothrombin time (PT), International Normalized Ratio (INR), and International Sensitivity Index (ISI) and how they relate to each other.
  8. Provides initial and ongoing education to patients regarding warfarin, other medications, health status, diet and activity level.
  9. Interprets INR and adjusts warfarin dosing, using practice guidelines and clinical judgment for each patient.
  10. Assesses for signs and symptoms of bleeding, thromboembolism and appropriately refers to physician.
  11. Identifies, triages or manages other medical problems through the appropriate health care provider.
  12. Determines appropriate action for interrupting and/or reversing anticoagulation, collaborating with physician when indicated.
  13. Communicates and coordinates with other anticoagulation providers regarding mutual patients to provide continuity of care.
  14. Provides pre- and post-procedure warfarin management for patients undergoing invasive procedures, i.e. angio, device placement, PVD, GI and dental procedures, steroidal injections and surgery.
  15. Develops individualized Lovenox bridging schedules for patients requiring interruption of anticoagulation therapy.
  16. Instructs patients on Lovenox administration.
  17. Manages MCC patients preparing for cardioversion with weekly INR’s until AHA guidelines are met.
  18. Monitors all incoming INR’s, referring to proper provider if necessary, tracking INR’s for cardioversion, notifying provider and/or scheduler when ready.
  19. Telemanages patients requiring short-term home health care, hospice or rehab nursing home care.
  20. Provides lab slip and instructions for patients traveling or going to winter/summer homes.
  21. Manages patients who perform weekly self-testing from home, communicating any dosage changes.
  22. Records all INR’s, doses, changes in medications, diet or activity level, any adverse reactions/events related to warfarin, patient communications, in the separate INR chart.
  23. Maintains electronic database updating status of patient.
  24. Tracks overdue or noncompliant patients with phone calls and letters, documents in INR chart and provides written update in clinic chart.
  25. Resource for clinic nursing staff for any anticoagulation questions, issues, enrolling in INR Clinic, assisting with warfarin refills, providing patient education packets.
  26. Resource for nurse clinicians and MD’s for hospitalized patients on warfarin.
  27. Collaborates and adjusts appointments to meet patients’ needs, i.e. rehab, MD appointments, device checks, research, work/driving issues.
  28. Manages and orders all INR supplies.
  29. Participates in continuing education pertinent to anticoagulation, maintains BLS and/or ACLS status.
  30. Travel between sites.
  31. Other duties as assigned.


  • RN license required.
  • Five to seven years of RN experience.
  • Advanced Medical and Cardiology Terminology.
  • Clinical assessment, planning, intervention, and evaluation.
  • Medication injections and blood draws
  • Experience with EPIC or other Electronic Medical Record strongly preferred.
  • Demonstrated strengths in the following competencies:
    • Patient Focus
    • Integrity and Trust
    • Interpersonal Savvy
    • Problem Solving
    • Action Oriented
    • Adaptability
    • Composure
    • Humor
    • Standing Alone
    • Time Management
    • Communication
    • Intellectual Horsepower

MHVI offers a full benefit package, including:
– Competitive pay
– Uniform (scrub) allowance
– Employer HSA contribution
– 401k profit sharing and ongoing contribution – no employee contribution needed
– PTO plus paid holidays
– Medical insurance, including access to free online/at-home care

To apply, submit your resume to

As an EEO/Affirmative Action Employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, veteran or disability status.