Care Team RN - Med Surg - Esperanza Health Center

DEPARTMENT: Nursing

SUPERVISOR: Director of Nursing

POSITIONS SUPERVISED: Assist in training and supervision of MA's working in triage.

STATUS: Exempt

SUMMARY: Addresses needs of walk-in and call-in patients, participates in patient health education, coordinates multidisciplinary referrals and follow-up of more complex patients, and provides spiritual care to patients. Able to perform Hub MA and Back Desk duties as needed.

DUTIES AND RESPONSIBILITIES AS TRIAGE NURSE:

1. ADDRESSES NEEDS OF WALK-IN AND CALL-IN PATIENTS

* Interviews patients to determine patient care needs. Documents initial assessment and intervenes according to triage protocol.
* Responds quickly and appropriately to urgent/ emergent medical problems. Prioritizes patient needs according to level of acuity. Assists in the care and transfer of acutely ill patients to EMS services.
* Demonstrates sound clinical judgment and decision-making, not working outside level of training.
* Documents all clinical interactions completely and efficiently in patient EMR chart.
* Begins basic teaching relevant to current complaint as appropriate, i.e. review standard guidelines for care of common illnesses such as fever, URI, diarrhea, vomiting, lice, etc.
* Assists CAs in managing provider's schedules throughout the day to improve work flow and decrease patient wait time.
* Provides training and mentoring to Medical Assistants who are assisting in triage.
* Assists Head Nurse with various projects as able.

2. PARTICIPATES IN PATIENT HEALTH EDUCATION

* Provides patient education on topics such as: diet and nutrition; general patient education; self-administration of injectable medications; prevention and treatment of asthma; use of glucometer, etc.
* Performs medication reconciliations with patients who are on complex medication regimens and reviews purpose, correct dosage and any special instructions or precautions for each medication.
* Encourages and instructs patients to take the appropriate initiative in their own health, specifically encouraging them to understand and ask questions about their care, make their own appointments, follow-up with consultants and make initial contacts with insurances and vendors.
* Provide patient education to sick patients regarding when to contact clinician or seek emergency care if symptoms aren't improving or illness progresses.

3. COORDINATES MULTI-SPECIALTY CARE AND FOLLOW-UP CARE

* Arranges appointments with consultants as ordered for complex patients requiring additional assistance and communicates with patients about appointments.
* Contacts patients about critical lab results as requested by Clinicians, and explains results and any needed follow-up.
* Calls patients as requested by Clinicians to evaluate response to treatment and to encourage compliance with treatment plan.
* Communicates with other EHC teams such as Care Management, Social Services, BHC, regarding care of complex patients.
* Communicates with outside agencies including consultants, mental health services, social service agencies, insurance companies, etc., to coordinate care of patients with multiple needs.

4. ASSISTS CLINICIANS IN DIRECT PATIENT CARE

* Evaluates patients who are unable to pay for the office visit to determine if their needs should be addressed on the same or can wait until the patient has payment.
* Evaluates uninsured new patients and obtains information on health history, medication history, any health information available in TUH Epic EMR. Reviews with patients how to utilize triage, how to make appointments, etc.
* Assists Clinicians with procedures such as lumbar puncture and suturing. Assists in the care and transfer of acutely ill patients to the ER.
* Able to function as Medical Assistant if needed: escort patients in rooms, do initial intake interview, BP, temperature, weight, etc.
* Perform and document in-house lab procedures such as urine dip, urine HCG, finger stick Hgb, finger stick glucose, hemoccult test, etc., according to protocol and in compliance with OSHA standards.
* Perform EKG and administer bronchodilators via nebulizer and as ordered by provider.
* Administer oxygen as ordered by provider.
* Obtain lab specimens and prepare them for receipt by outside lab, including labels and requisitions.
* Assist MAs in care acutely ill patients.
* Assist with Back Desk role as time permits and when back desk lists are long.

5. INJECTABLE MEDICATIONS AND VACCINES.

* Administers intravenous fluids, injectable medications and vaccines as ordered.
* Familiar with protocol for maintaining viability of vaccines in the event of a power outage or appliance failure. Able to transport vaccines safely according to protocols in an emergency.
* Able to receive vaccine shipments and store appropriately.

6. EMERGENCY CLINICAL SUPPLIES.

* Familiar with uses of emergency clinical supplies.
* Performs monthly emergency cart check at K&A

7. SPIRITUAL CARE

* Provides effective spiritual intervention with patients, sharing hope and salvation through Jesus Christ, sharing helpful Biblical instruction and scriptures, praying for pts, and connecting/referring to Christian churches as appropriate and according to the leading of the Holy Spirit.
* Does not force spiritual intervention, but gives spiritually uninterested pts respect and space, continuing to provide exemplary care in all other dimensions
* Participates in personal and community spiritual growth through active participation in daily prayer meetings with EHC team.
* Offers referral to chaplain or area clergy for follow-up as requested by patient.

GENERAL EXPECTATIONS:

1. MOTIVATION

* Expresses enthusiasm and possesses a positive attitude and interest in the job.
* Exhibits self-motivation in undertaking new projects and assignments.
* Independently identifies and resolves problems.
* Pursues personal and professional development.

2. COMMUNICATION

* Verbally presents ideas and opinions in a clear and concise manner.
* Written communication is clear, concise, and well organized.
* Forms rapport with patients quickly, exhibits people focused personality.
* Able to make decisions despite situations that are not clear cut and involve ambiguity.
* Uses effective listening skills and allows others to convey ideas.
* Provides relevant information to immediate supervisor and staff regarding status of projects and programs.
* Establishes and maintains open lines of communications with other staff.
* Maintains discretion and confidentiality in communicating with others.
* Communicates the love of Christ through interactions, not complaining or arguing, but expressing hope in Christ and His promises.
* Shows respect for cultural differences and the dignity of each individual.
* Strives to put others at ease and to communicate in ways they can understand and at their educational level.
* Able to utilize negotiation skill successfully.
* Makes hospitality and responsiveness to patients and each other a habit, adding warmth to our environment.
* Notifies supervisor prior to scheduled start time if anticipating lateness or absence.

3. QUALITY / SERVICE

* Makes consistent efforts to control cost while seeking ways to increase productivity and improve quality.
* Ensures the proper completion of work activities in a timely manner.
* Recognizes critical situations and responds effectively.
* Maintains personal boundaries, taking on responsibility or tasks within limits of personal ability.

4. TECHNICAL KNOWLEDGE

* Continues to expand personal and professional growth by recognizing current trends in specialty and effectively preparing to meet anticipated changes.
* Serves as a resource person by providing technical knowledge to others seeking advice and assistance.

5. GENERAL RESPONSIBILITIES

* Works in harmonious partnership with health center staff and volunteers to further Esperanza's mission and vision, to accomplish common goals, and to coordinate various activities.
* Adheres to policies and procedures of the health center and the regulations of governing agencies as they affect the department, recommending changes where appropriate.
* Promotes "safety" practices.
* Seeks timely reconciliation with others following biblical principles when wronged or after doing wrong to someone else.
* Favorably represents Christ and His mission at Esperanza within and outside the Health Center.
* Adheres to dress code policy at all times.
* Demonstrates habit of good attendance and punctuality by reporting for work whenever scheduled.
* Participates in departmental meetings and general staff meetings.
* Reads all clinical memos promptly.

6. INTERPERSONAL RELATIONS:

As a representative of Esperanza Health Center, all comments, attitudes, actions, and behaviors have a direct effect on the organization's image and perceptions of quality service. Interaction with patients, guests, volunteers, co-workers, supervisors, and other employees must be in a manner that is friendly, supportive, courteous, respectful, cooperative, and professional. Personal and professional behavior should promote positive relations and an atmosphere which is congruent with Esperanza's Mission and Vision statements, standards, and guidelines.

I hereby certify that I have read and understand my position description. In addition, I accept the responsibility of this position and acknowledge that I have received a copy of my position description.

EDUCATION, KNOWLEDGE, SKILLS, AND QUALIFICATIONS:

1. BSN required; RN with preferably a minimum of one year post-graduate experience, preferably in a hospital setting.

2. Maintains CPR certification.

3. Solid interpersonal skills, including ability to deal with people politely, even when they are impolite. Must communicate warmth and be able to put people at ease.

4. Ability to remain calm under pressure.

5. Ability to take initiative in communication, being clear and direct, in order to effectively communicate with other staff.

6. Good oral communication skills. Must be fully bilingual in English and Spanish.

7. Some computer experience - word processing and/or other.

8. Demonstrated ability to handle many details and multiple priorities. Must show ability to organize, process, and verify details.

9. Must have a solid record of handling confidential information, as well as demonstrating trustworthiness and honesty in all transactions.

10. Solid character references, as well as no criminal record. Also, a solid record of timeliness and reliability in a work setting.

WORKING CONDITIONS:

* Requires the ability to be on your feet working in a high paced environment for 4 hours at a time.
* Requires the ability to work in a seated position on the phone for 4 hours at a time.
* Requires extensive work on a computer keyboard.
* Requires the ability to work with adults and children.
* Requires work with needles and patient's bodily fluids.
* Requires the ability to carry a 20 pound box.

Spanish immersion training is available should you qualify for this position but are not fluent in Spanish. EHC will provide further information.