Mich Nurse (Mobile Integrated Community Health Nurse)

State of Maryland•Kent, MD

13d•Onsite

About The Position

The Nurse serves as the primary nursing professional for the Kent County Health Department’s Mobile Integrated Community Health (MICH) Program in Chestertown, Maryland. The role provides community-based nursing assessment, care coordination, health education, chronic disease management support, and follow-up for adults who frequently call 911 or use emergency medical services. The Nurse collaborates with EMS personnel, EMTs, pharmacists, healthcare and behavioral health providers, social service agencies, and other community partners to address medical, behavioral, social, and environmental factors associated with frequent EMS use and barriers to appropriate healthcare. The position conducts in-home and community-based nursing assessments, develops individualized care plans, identifies health and safety concerns, provides general and disease-specific education, coordinates referrals, monitors client progress, and connects clients with healthcare and community resources. The initial caseload is anticipated to be approximately 10 clients, with size adjusted based on program needs and client complexity. During community visits, the Nurse works alongside EMS personnel; responsibilities are divided according to each client’s needs and the purpose of the visit. During approximately the first year of MICH Program implementation, or until the program is fully operational, the Nurse will also conduct assigned Assessment, Evaluation and Review Services (AERS) evaluations. These include in-home assessments, identification of health and functional needs, documentation, service coordination and referrals, and participation in interdisciplinary care planning. The Nurse maintains accurate clinical and program documentation, participates in quality improvement and program evaluation, and helps identify service gaps and ways to improve health outcomes and reduce avoidable emergency-service use.

Requirements

Bachelor’s degree in nursing from an accredited college or university, or an accepted substitution: a bachelor’s degree in a related field and one year of experience as a Registered Nurse; two years of experience as a Registered Nurse; or qualifying U.S. Armed Forces military service as a commissioned officer in Nursing classification or Nursing or Health Care Specialist specialty codes in the Nursing field, substituted year for year for the required education.
Current Registered Nurse license from the Maryland State Board of Nursing.
Must provide the facility with a telephone number at which the employee can be reached.
A valid Maryland motor vehicle operator’s license is required if assigned duties include operating a motor vehicle.

Responsibilities

Provide community-based nursing assessment, care coordination, health education, chronic disease management support, and follow-up services to adults who frequently use 911 or emergency medical services.
Collaborate with EMS, EMTs, pharmacists, healthcare and behavioral health providers, social service agencies, and other community partners.
Conduct in-home and community-based nursing assessments, including comprehensive nursing assessments, health histories, and physical assessments.
Develop individualized care plans and identify health and safety concerns.
Provide general health education and disease-specific education.
Coordinate referrals and connections to appropriate healthcare and community resources, and monitor client progress.
Maintain an assigned MICH caseload, initially anticipated to be approximately 10 clients and adjusted based on program needs and client complexity.
Work alongside EMS personnel during community visits, dividing clinical and operational responsibilities according to the client and visit needs.
Conduct assigned AERS evaluations during the MICH Program’s initial implementation, including in-home assessments, identification of health and functional needs, documentation, service and referral coordination, and participation in interdisciplinary care planning.
Maintain accurate clinical and program documentation.
Participate in quality improvement and program evaluation activities.
Identify service gaps and opportunities to improve health outcomes and reduce avoidable emergency-service utilization.