Registered Nurse (RN)-Ambulatory-PACE, PRN, Days

Prisma Health•Richland, WA

4d•Hybrid

About The Position

The RN PACE is an autonomous position responsible for delivering advanced, time sensitive clinical care to frail, medically complex PACE participants across clinic and home care settings. This role provides frontline urgent and emergent clinical response, functioning as a primary decisionmaker for participant assessment, triage, treatment initiation, and escalation of care. The RN PACE routinely manages acute changes in condition, conducts urgent evaluations, and independently initiates evidence based interventions using advanced nursing judgment and approved protocols, often without direct, real time provider supervision. The role requires rapid clinical decision making to stabilize participants, prevent unnecessary emergency department visits or hospital admissions, and ensure safe, timely care delivery in non traditional clinical environments. Serving as a clinical leader, the RN PACE integrates advanced assessment skills, critical thinking, and interdisciplinary coordination to manage urgent, high risk scenarios involving complex medical, psychosocial, and environmental factors. This role is essential to acute care diversion, patient safety, and continuity of care across the PACE continuum.

Requirements

Graduate of an accredited school of Nursing program and approved by the State Board of Nursing required.
Holds a current RN compact/multistate license recognized by the NCSBN Compact State or is licensed to practice as an RN in the state the team member is working.
One (1) year experience with the frail or elderly population.
Proficient in managing acute changes in condition without immediate provider presence.
Comfort practicing independently in dynamic and unpredictable settings
Phlebotomy and medication administration/management skills.

Nice To Haves

Bachelor's degree in Nursing preferred.
Experience in urgent, emergent, or high‑acuity clinical environments (e.g., urgent care, emergency department, hospital‑at‑home, community paramedicine, or complex home health) preferred.
Experience with advanced IV, CVAD, Subcutaneous administration preferred.
Experience in advanced and complex wound care, including wound vac therapy, complex packing, and management of high-risk wounds in community-based settings preferred.

Responsibilities

Performs comprehensive, real‑time assessments for participants experiencing acute or unstable clinical conditions.
Independently triages medical concerns, determines urgency and level of care, and prioritizes interventions based on clinical acuity.
Identifies life‑threatening or rapidly evolving conditions and initiates immediate interventions per protocol.
Serves as first clinical responder for urgent participant needs in clinic or home settings.
Independently initiates advanced nursing interventions, treatments, and therapies for urgent and emergent conditions.
Manages acute exacerbations of chronic illness, post‑discharge complications, medication-related events, and functional decline.
Continuously evaluates treatment effectiveness and modifies care in real time based on participant response.
Provides stabilization and determines need for escalation to provider, EMS, or hospital-level care.
Develops and updates care plans that integrate acute risk mitigation, urgent care strategies, and transition planning.
Communicates time‑sensitive clinical changes and recommendations to providers and interdisciplinary team members.
Participates in six‑month and change‑in‑condition assessments with a strong focus on clinical risk and hospitalization prevention.
Documents urgent and emergent care encounters accurately, including rationale for clinical decisions and outcomes.
Identifies early warning signs of deterioration and implements proactive interventions to prevent escalation.
Tracks patterns in urgent care needs to inform quality improvement and risk reduction initiatives.
Delegates urgent care‑related tasks to appropriate team members and ensures safe execution.
Identifies unsafe conditions or care gaps contributing to acute events and takes corrective action.
Participates in quality, safety, and utilization initiatives aimed at reducing avoidable ED visits and hospitalizations.
Adjusts staffing and workflows in response to changes in volume and acuity.
Provides leadership and oversight, as applicable, for clinical and non-clinical team members, which may include Certified Nursing Assistants (CNAs), Licensed Practical Nurses (LPNs), Certified Medical Assistants (CMAs), and administrative staff.
Ensures appropriate supervision, delegation, competency validation, training, and performance management in alignment with scope-of-practice requirements, organizational policy, and regulatory standards.
Collaborates with clinical and operational leaders to support staff development, scheduling, workflow optimization, and quality outcomes
Provides comprehensive assessment and management of complex acute and chronic wounds across clinic and home settings, including but not limited to surgical wounds, pressure injuries (Stages II–IV), arterial/venous ulcers, diabetic foot wounds, traumatic wounds, and infected or non-healing wounds.
Performs advanced wound care interventions, including negative pressure wound therapy (wound vac management), complex wound packing, tunneling and undermining management, debridement coordination, and selection/application of advanced wound dressings in accordance with evidence-based practice and approved protocols.
Independently evaluates wound progression, identifies signs of infection, ischemia, or deterioration, and initiates timely interventions to prevent complications, hospitalization, or limb loss.
Coordinates care with providers, podiatry, vascular surgery, wound specialists, home health, and DME vendors to ensure continuity, timely escalation, and access to appropriate supplies and therapies.
Educates participants, caregivers, and team members on wound care techniques, pressure injury prevention, offloading, infection control, and device management, reinforcing adherence to care plans.
Ensures accurate, detailed documentation of wound assessments, measurements, treatments, response to therapy, and clinical decision-making within the medical record
Acts as a central clinical coordinator during urgent situations, collaborating with providers, EMS, and community partners.
Facilitates rapid care transitions and follow‑up after acute events or hospital encounters.
Represents nursing expertise in interdisciplinary discussions related to urgent care management and clinical risk.
Supports onboarding and skill development of nurses and students in urgent and emergent care response.
Contributes to development and refinement of urgent care protocols and clinical workflows.
Performs other duties as assigned.