Nurse III-SDCRN with ADN

TX-HHSC-DSHS-DFPS

49d•Onsite

About The Position

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. The state supported living centers serve people with intellectual and developmental disabilities who are medically fragile or who have behavioral problems. The centers provide campus-based direct services and supports at 13 centers located throughout the state. The Senior Direct Care Registered Nurse with Associate’s Degree in Nursing (ADN) performs highly complex (senior level) nursing work providing for the assessment, care and integrated treatment of individuals residing at the SSLC. This role involves performing highly complex and technical nursing tasks, procedures, and assessments, administering medications, immunizations and treatments in accordance with HHSC, SSLC and state regulations. The nurse interprets and evaluates diagnostic tests, collects specimens, and communicates findings and recommendations. They make rounds, coordinate, and organize nursing services and activities, monitor and report the health of individuals. The position also provides consultation, training, instruction, and technical assistance to others, develops in-service training and health education strategies, and provides leadership, oversight, coaching and monitoring to tasks performed by LVNs and RNs, acting as a preceptor as assigned. The role requires timely and accurate documentation, independent and productive work with all levels of staff and departments, and the ability to identify and implement various courses of action for routine and non-routine situations. The nurse analyzes data, evaluates nursing intervention outcomes, and provides input to the interdisciplinary team (IDT) to assist in assessing the treatment plan. They attend assigned meetings, communicate results, respond to emergency situations, and provide treatment to HHS employees injured in the course and scope of employment as needed. The position works under the limited supervision of the Nurse Manager or other designated supervisor, with considerable latitude for initiative and independent judgment.

Requirements

Knowledge of state and federal laws and Intermediate Care Facility for individuals with intellectual disabilities (ICF-IID) rules, regulations, policy and procedures related to State Supported Living Center or ability to quickly gain that knowledge.
Knowledge of evidence-based practices applicable to treatment of individuals with developmental disabilities.
Knowledge of emergency procedures and emergency equipment, i.e., Cardiopulmonary Resuscitation (CPR), and ability to assess and care for residents and/or staff members in emergency situations.
Advanced knowledge of nursing techniques, standards, and procedures.
Knowledge of health care laws and regulations.
Knowledge of medical diagnoses and procedures.
Knowledge of accepted medical treatment patterns.
Knowledge of community health and nursing care principles, best practices, and procedures.
Knowledge of program regulations and procedures.
Knowledge of utilization review and control measures.
Advanced knowledge of nursing care standards and Healthcare Guidelines.
Skill in the care and treatment of patients.
Skill in the use of computer/software and an electronic health record system.
Skill in working with individuals with complex physical and nutritional management needs, behavioral challenges and varying methods of communication.
Excellent verbal and written communication skills and the ability to present ideas clearly and concisely in both written and oral communications.
Ability to provide patient care.
Ability to prepare and maintain records.
Ability to organize, coordinate, and evaluate nursing activities and delivery of health services.
Ability to interpret policies and procedures.
Ability to interpret health care regulations.
Ability to recognize patterns of medical necessity treatment.
Ability to interpret regulations and communicate them effectively both orally and in writing.
Ability to appropriately interact with individuals with intellectual/developmental disabilities, with their family members, and with staff members.
Ability to work independently and productively with all levels of staff.
Ability to train, in-service, coach, monitor and instruct all levels of staff in accordance with the scope of practice.
Ability to make nursing decisions and recommendations to the team.
Must maintain current CPR certification.
Must have strength and flexibility to safely perform CPR, safe use of restraint (SUR) and Ukeru techniques (once trained).
Licensed to practice as a registered nurse in the State of Texas (or a state that recognizes reciprocity through the Nurse Licensure Compact).
Associate degree in nursing (ADN) is required.
At least two (2) years of experience as a practicing registered nurse in a health agency, hospital, or health-care facility.
Experience in assessment and documentation of health status.

Nice To Haves

Specialized training or experience working with individuals with complex medical and behavioral health issues.
Experience working with Individuals with Intellectual and/or Developmental Disabilities (IDD).

Responsibilities

Perform highly complex (senior level) nursing work providing for the assessment, care and integrated treatment of individuals residing at the SSLC.
Perform highly complex and technical nursing tasks and procedures in accordance with HHSC, SSLC and state regulations, such as tracheostomy care, gastrostomy/jejunostomy care, wound care, and breathing treatments.
Administer medications, immunizations, and treatments and observe patients for unusual symptoms and reactions.
For new admissions, in collaboration with the assigned RN Case Manager, provide a detailed initial assessment and review of data to present key findings to providers and other members of the interdisciplinary team.
Interpret and evaluate diagnostic tests to identify and assess individuals’ response to planned care, as appropriate to the scope of practice.
Collect specimens for laboratory examination and conduct appropriate screening tests when requested by lab personnel.
Communicate findings and recommendations to other nurses, Primary Care Providers (PCP) and other staff.
Coordinate and organize the nursing services and activities they provide for individuals on their assigned home/unit to ensure tasks are completed effectively and efficiently.
Observe individuals and gather pertinent information.
Monitor individuals’ weight, diet, feedings, and vital signs.
Monitor for signs and symptoms of illness and use appropriate nursing judgement to provide adequate care for the individual, including initiating acute care plans.
Make rounds and/or to other homes/units as needed and work in other locations at the SSLC as needed.
Discuss any pressing issues or concerns that are found with the appropriate supervisor.
Communicate effectively, and provide consultation, training, and technical assistance to direct support professionals (DSPs) about individuals’ unique care needs.
Instruct DSPs on how to monitor individuals after a treatment or procedure using instruction sheets such as that used for post-sedation monitoring of signs and symptoms.
Answer questions from DSPs and other members of the treatment team, related to treatment or medication, within the scope of practice.
Develop in-service training and health education strategies related to the assigned individual(s) when needed including signs and symptoms to observe for and report to a nurse.
Instruct, counsel, and assist individuals in meeting their health care needs when warranted.
Assist the Nurse Manager by providing leadership and oversight within the assigned home/unit/department such as overseeing the work of, coaching and monitoring services provided by Licensed Vocational Nurses (LVNs) assigned to the nursing department.
Act as a preceptor for other registered nurses, as assigned.
Train/instruct new nurses to perform nursing functions at the SSLC, including acclimating them to the individuals, their needs and preferences.
Serve as a Nurse Manager in their absence, as appointed.
Provide support to Nurse Managers by providing day-to-day supervision including reviewing and following up on controlled drug counts, medication counts, emergency checklist logs, refrigerator temperature logs, and glucose controls.
Assist LVNs and RNs with implementation of protocols, procedures and programs to improve overall health and safety of staff and individuals.
Assist with completing follow up assessments, guidelines, acute care plan (ACP) interventions, interventions in the chronic care plan, injury reports, restraints, and med variances.
Assist in monitoring the completion of chronic care plan interventions.
Timely and accurately document and report pertinent treatments and observations in the individual’s electronic medical record (EMR) in accordance with SSLC procedures and protocols.
Oversee the completion of required documentation when training others.
Work independently and productively with all levels of staff and departments.
Identify and implement various courses of action for routine and non-routine situations and work in conjunction with other nurses and health care providers.
Assist the Infection Control nurse by implementing measures that prevent the spread of disease.
Assist the Quality Assurance Nurse in developing and implementing quality assurance programs.
Assist in the implementation of therapeutic nursing programs.
Participate in facility Quality Assurance/Quality Improvement initiatives.
Make recommendations to supervisors on how to improve processes to ensure quality services for individuals.
Analyze data, evaluate nursing intervention outcomes, and provide input to other members of the interdisciplinary team (IDT) to assist in assessing the treatment plan.
Attend and/or provide information to a designee for meetings related to the status and care of assigned individuals such as daily morning medical, Incident Management Review Team (IMRT), or IDT meetings to ensure nursing issues or concerns are addressed promptly.
Follow local SSLC policies and protocols to ensure pertinent information, such as diagnoses and treatment plans is clearly communicated to SSLC staff and, when instructed to do so, to guardians/Legally Authorized Representatives (LARs).
Respond to emergency situations to ensure safety of individuals.
Follow safety and infection control procedures of the SSLC.
Provide educational and safety training to SSLC staff upon request.
Provide treatment to HHS employees injured in course and scope of employment.
Actively participate and/or serve in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation.