Nurse

The Arc Montgomery County•Derwood, MD

4h•$74,117

About The Position

For a limited time, all new hires are eligible for the benchmark incentive payments totaling up to $1000.00!! More information is on our Employee Benefits page on our website. Come join us and find out what it's all about! Per COMAR, the Organization’s Nurse must be a Registered Nurse (RN). Under the supervision of the Director of Quality Assurance, The Arc Montgomery County Organization’s Nurse is responsible for the nursing care management of people supported by The Arc Montgomery County’s Employment & Meaningful Day and Personal Support programs. The organization’s nurse will not be a direct care provider but will act in monitoring and delegating capacities for employees (CMTs and/or LPNs) who provide direct care. The organization’s nurse will be advocate for quality health care at The Arc Montgomery County. The organization’s nurse will perform all nursing functions in accordance with current Maryland Board of Nursing (MBON) regulations and as described in The Arc Montgomery County Policies and Procedures. Job-Specific Duties and Responsibilities Perform Nursing Assessments Perform comprehensiveinitialnursing assessmentwhen first assigned toa newperson who is supported by The Arc Montgomery County and receives services requiring nurse delegation. Based on theinitialassessment, write aNursing Care Plan (NCP) describing the CMTs intervention step by step,and document staff training on the NCP. Perform45-day nursing assessmentsandreviseCare Planas needed at aminimumof every45-days for the assigned peopleby Performing physical evaluations, SupervisingcompliancetoMTTPregulations;and Supervisingother medical documentation follow-upwithappropriate staff. Monitor upcomingappointments and necessary medical follow-up withsupervisory staff. Perform afocused nursing assessmentandrevise the NCPaftera person supportedhas received urgent care, emergency care, or seen bytheirPCP and given a new diagnosis, medication or there is anexacerbation of an existing conditionwithin48 hours. Review Medical Records Evaluate Professional Medical Order Forms (PMOFs)to ensure Licensed Health Care Providers (LHCPs)orderare current and signed by LHCP. Compare current PMOF withlast PMOF to note changes in medication (i.e., new ordiscontinued), dosage, discontinuation, and how medication is to be given. Check all medication storage of prescribed medications includingSchedule 4 for compliance with MTTP regulations. Perform 3-waycheck of: (1) PMOF; (2) Pharmacy Label; (3) CMTcorrectly documenting administration of medications and explaining omissions. Document any non-compliancetoMTTP and Maryland Board of Nursing COMAR regulations and implement the Medication Error Action Plan as described in The Arc Montgomery County Policies and Procedures. Re-train staff andutilizethe MedicationErrorand Procedures, Section 6: Health Care Monitoring to address medication errors made by CMTs Delegate Nursing Tasks and Train Staff Delegatenursing tasks to trained staff asdesignatedby Maryland State Regulations 10.27.11, Delegation of Nursing Functions, and the NursePractice Act.Thisincludes:Completion of Nursing Assessment forms; Completion ofNursing Care Plan and revising as needed; Assessment of needed Nursing Delegated tasks to staff; documented training of staff; document supervision of staff competency levels in performing delegated nursing tasks.Transcribe verbal orders from LHCPs onto PMOFs asneeded andobtain LHCP signature on an as needed basis. On an as needed basis,will request the needed MTTP training materials from DDA and willconduct the 20-hour MTTP class and the 4-hour MTTP Refresher class for agency staff whoare required totake this class to fulfill DDAtrainingrequirements for their position.On an as needed basis,share inthe responsibility of nursing coverage with nursing consultants. Communication Be available via telephonetoanswer questions and provide telephone triage to staffregardinghealth concerns or the people receiving support. Useorganization’semail and check messagesfrequentlytorespond to staff as soon as possible after a message is received. Act as a liaison between the personreceivingsupports, family members, employees, and medical professionalstoclarify health-related informationand advocate for the person receivingsupports. Complete the Delegating Nurse/Case Manager Report with attachedNCP copy and send to the Assistant Director of the program, Coordinator, andthe assignedPCP Specialist at least one (1) week before the scheduled PCP meeting. When necessary, attendthe PCP meeting or other meetingvirtually, via telephone, or in personasrequiredto advocate for the health needs pf the person receivingsupports Other duties as assigned, such as: Attend andparticipateas a member of theAdmissions, Discharge & Review Committee Providerecommendationsand concernsfor admissionstoand dischargesfrom the organization Attend andparticipateas a member of the Human Rights Committee Provide recommendationsand concernsfor Tier III Behavior Plans, Chemical Supports and Mechanical Supports for people supported by the organization Whenrequested, participate in theinitialintake meeting of a person seeking services from The Arc Montgomery County Ensure all health-related information is clarified Provide recommendations and concernsto ensure the organization can meet the healthneeds of the person requesting servicesand safety Upload nursing assessment, NPC,documentation of staff training,and all other nursing documentation into the agency’s database (CIMS) of the person supported Update the PCP Spreadsheet as nursingassessments,NPCs, and staff training are completed. Assist with COVID testing as needed.Obtain and provide results to theappropriate ProgramDirector.

Requirements

Registered Nurse (RN) with current licensure in the state of Maryland, current CPR certification, and some professional experience in nursing.
Must be able to provide telephone triage for persons supported within a timely manner, 24 hours a day, 7 days a week.
Must have the ability to travel independently to all agency sites and/or homes of the people supported
Must be personally responsible for MBON RN license renewal and for maintaining the Registered Nurse/Case Manager/Delegating Nurse (RN/CM/DN) certification per Developmental Disabilities Administration (DDA) requirements.
Work locations, caseload, and hours will be flexed to meet the organization’s needs.

Nice To Haves

DDA residential and home health experience preferred.

Responsibilities

Perform comprehensive initial nursing assessment when first assigned to a new person who is supported by The Arc Montgomery County and receives services requiring nurse delegation.
Write a Nursing Care Plan (NCP) describing the CMTs intervention step by step, and document staff training on the NCP.
Perform 45-day nursing assessments and revise Care Plan as needed at a minimum of every 45-days for the assigned people.
Monitor upcoming appointments and necessary medical follow-up with supervisory staff.
Perform a focused nursing assessment and revise the NCP after a person supported has received urgent care, emergency care, or seen by their PCP and given a new diagnosis, medication or there is an exacerbation of an existing condition within 48 hours.
Evaluate Professional Medical Order Forms (PMOFs) to ensure Licensed Health Care Providers (LHCPs) order are current and signed by LHCP.
Compare current PMOF with last PMOF to note changes in medication (i.e., new or discontinued), dosage, discontinuation, and how medication is to be given.
Check all medication storage of prescribed medications including Schedule 4 for compliance with MTTP regulations.
Perform 3-way check of: (1) PMOF; (2) Pharmacy Label; (3) CMT correctly documenting administration of medications and explaining omissions.
Document any non-compliance to MTTP and Maryland Board of Nursing COMAR regulations and implement the Medication Error Action Plan as described in The Arc Montgomery County Policies and Procedures.
Re-train staff and utilize the Medication Error and Procedures, Section 6: Health Care Monitoring to address medication errors made by CMTs
Delegate nursing tasks to trained staff as designated by Maryland State Regulations 10.27.11, Delegation of Nursing Functions, and the Nurse Practice Act.
Transcribe verbal orders from LHCPs onto PMOFs as needed and obtain LHCP signature on an as needed basis.
Request the needed MTTP training materials from DDA and conduct the 20-hour MTTP class and the 4-hour MTTP Refresher class for agency staff who are required to take this class to fulfill DDA training requirements for their position.
Be available via telephone to answer questions and provide telephone triage to staff regarding health concerns or the people receiving support.
Use organization’s email and check messages frequently to respond to staff as soon as possible after a message is received.
Act as a liaison between the person receiving supports, family members, employees, and medical professionals to clarify health-related information and advocate for the person receiving supports.
Complete the Delegating Nurse/Case Manager Report with attached NCP copy and send to the Assistant Director of the program, Coordinator, and the assigned PCP Specialist at least one (1) week before the scheduled PCP meeting.
When necessary, attend the PCP meeting or other meeting virtually, via telephone, or in person as required to advocate for the health needs pf the person receiving supports
Attend and participate as a member of the Admissions, Discharge & Review Committee
Provide recommendations and concerns for admissions to and discharges from the organization
Attend and participate as a member of the Human Rights Committee
Provide recommendations and concerns for Tier III Behavior Plans, Chemical Supports and Mechanical Supports for people supported by the organization
When requested, participate in the initial intake meeting of a person seeking services from The Arc Montgomery County
Ensure all health-related information is clarified
Provide recommendations and concerns to ensure the organization can meet the health needs of the person requesting services and safety
Upload nursing assessment, NPC, documentation of staff training, and all other nursing documentation into the agency’s database (CIMS) of the person supported
Update the PCP Spreadsheet as nursing assessments, NPCs, and staff training are completed.
Assist with COVID testing as needed. Obtain and provide results to the appropriate Program Director.