Registered Nurse (49687)

WESTCARE INC•Marathon, FL

16d•$37 - $37•Onsite

About The Position

Person in this position will be responsible for providing professional nursing care to clients who are voluntarily and involuntarily admitted to the crisis stabilization and detoxification units of the clinic. Essential Job Functions: Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures 100% of the time Makes daily rounds at least twice every shift to assess patient needs, unit safety, and reports any unsafe conditions or compromised quality of care to Lead Registered Nurse Continually assesses patients’ medication needs; focusing on detoxification, PRN psychotropic, side effects and documenting such findings in progress notes per policies and procedures 100% of the time Assesses client in seclusion and restraints per policy and procedure at required intervals 100% of the time Completes nursing assessment, initial treatment plan (including any nursing/medical problems) and the Individual Treatment Plan to establish treatment needs according to the standards of care 100% of the time Completes nursing assessment for every assigned client including Mental Status Exam on all new admissions Demonstrates the ability to identify and evaluate an individual’s strengths, barriers, problems, and needs for the development of Preliminary/Initial Wellness and Recovery Plan Initiates assessment of patient needs and provides appropriate treatment/medical care utilizing MD when appropriate 100% of the time Initiates emergency screening protocol and decides when to consult on-call staff in accordance with on-call procedures Participates in report between shifts highlighting client behavior, medical condition, medication status and client census 100% of the time Meets at least once per shift with designated behavioral health technician to coordinate client activities and deploy appropriate staff 90% of the time Participates in Treatment Team and the development or revision of patient Individual Treatment Plan (day shift) Participates in familiarizing self with treatment plans/case reviews and implementing all features (evening and night shifts) Provides 1x1 counseling and other direct care for patients every shift per treatment plan and policies and procedures Responds promptly per treatment plan and policies and procedures to inappropriate, withdrawn, agitated, or vegetative client behavior 100% of the time Applies TACT techniques properly and effectively 100% of the time in response to client aggression Facilitates scheduled therapeutic and educational groups at least once per week Participates in staff meetings, client conferences, and treatment teams to coordinate management of medical and nursing client care at least weekly or as assigned by Unit Director Communicates pertinent client information to medical staff, unit coordinator, and other disciplines when appropriate,100 % of the time Responds to client questions and requests in a timely fashion 90% of the time Implements behavior modification plans as required 100% of the time Provides nursing interventions appropriate to patient medical and psychosocial needs, i.e., health education, STD, HIV, First Aid, DM, injury, other chronic or acute illness per individualized treatment plan and nursing assessment Reviews MD’s orders and documents as per policy and procedure 100% of the time Assumes role of charge nurse as assigned, per P &P, 100% of the time Documents the following on all patients; patient insurance status and precertification, patient admission assessment, insurance identifying problems, established priorities for treatment and care, initial treatment plan for each client, Transcription o medication orders, discharge summary, progress note per policy and procedure manual 100% of the time Inventories controlled drugs at the beginning and end of each shift and report any discrepancies 100% of the time Assures that informed consents for medication for each client are signed and in chart prior to administering medication 100% of the time Administers medication without error to unit clients per policy and procedure 100% of the time Administers PRN and OTC medications per physician orders, documents and observes effects Participates in discharge plan for all assigned clients as part of multidisciplinary team (including client’s family) and documents discharge summary as per policy and procedure Reviews and evaluates effectiveness of interventions and implementation of nursing care Applies knowledge of the inter-relationship among substance abuse disorders, mental health disorders, and chronic medical conditions Demonstrates the ability to evaluate the impact of substance use, mental health problems, and chronic medical conditions on the client’s functioning in major life areas Documents and reports client outcomes and responses resulting from nursing interventions, treatment procedures, interpersonal interactions, and patient/family education 100% of the time Evaluates and documents client progress towards goals and objectives every shift Updates and revises patient care problem list and individualized client care standards based on client and family responses, progress toward goals, and/or change in medical and mental status every shift Evaluates client length of stay and related transfer and discharge planning needs based on anticipated problems and needs, internal or community resources and support systems for all assigned clients Evaluates progress of other RNs, BHT’s, student’s or staff persons being oriented as assigned Acts as a role model and resource person for colleagues Participates in required staff development / training activities. Maintains up-to-date knowledge of clinical area of practice. Participate in trainings on trauma informed care, assessing and treating victims of domestic violence, trauma-focused cognitive behavioral therapy, motivational interviewing and Seeking Safety Completes all orientation and mandated training activities, including E-Learning Courses, within required timeframes, and in accordance with the criteria established for this position. Demonstrates a high degree of dependability. Maintains a good attendance record. Observes working hours. Exhibits characteristics of good workmanship, and integrity on the job. Work time is always productive. Establishes and maintains effective and positive working relationships with clients, co-workers, and other job-related representatives. Readily develops and maintains therapeutic relationships with clients. Effectively interacts with client’s family and significant others. Shows flexibility and is responsive to requests from supervisor. Works independently with minimal supervision. Is courteous to clients, staff, and all others. Cooperates with others both within and outside the Guidance/Care Center. Demonstrates tact at the appropriate time. Works well with supervisor; accepts direction and supervision. Maintains a positive attitude toward work. Ensures and maintains a safe working environment. Work area is clean and orderly. Verbalizes, understands and adheres to Center safety procedures. Demonstrates appropriate use of Unusual Incident Reports, in accordance with the Center’s reporting procedures. Presents a positive personal image. Dresses and maintains a professional demeanor Performs other duties as requested. Miscellaneous duties are performed according to instruction.

Requirements

Must hold valid Registered Nurse or ARNP License in the state of Florida in good standing.
Graduation from an accredited four-year college with a Bachelors of Science in Nursing field is preferred; Associate of Science in Nursing from an accredited college is required.
Two (2) years of experience in providing nursing care to target population is preferred
Proficient in performing nursing physical assessment and mental status exams
During your tenure with WestCare there may be new requirements, including, but not limited to vaccinations that are issued by local, State, Federal, and/or Funders that WestCare may have to comply with. Should this occur Human Resources or appropriate personnel will inform you.
CPR Certification, First Aid Certification and an annual Tuberculosis test.
Ability to provide an Affidavit of Good Moral Character
Ability to meet GCC insurance requirements for driving an agency vehicle
Clearance in Pre-Employment Drug Testing and Criminal Records Checks, as required.
Possesses sufficient means of independent mobility.
Excellent communication skills
Demonstrates the ability to use DSM V diagnostic criteria to provide substance use, mental health, and behavioral diagnoses
Demonstrated knowledge of theoretical and practical concepts of individual, group and family behavior
Demonstrated ability to deal with crisis situations
Knowledge to deal with difficult people
Demonstrated ability to handle a client concern/grievance according to agency protocol.
Demonstrated ability to establish and maintain effective working relationships with clients, co-workers, external partners, and regulatory agencies
Demonstrated ability to manage change and achieve results
Demonstrated ability to expedite a voluminous flow of detailed work
Demonstrated ability to prepare clear and precise reports
Demonstrated ability to follow and interpret instructions
Demonstrated ability to appropriately and efficiently identify, prioritize and follow through on assignments
Maintains confidential files and records
Working knowledge of behavioral health terminology
Knowledge of WestCare Mission, goals and values
Knowledge of Incident Reporting
Knowledge of HIPAA, Professional Ethics, Consumer Rights and Confidentiality
Familiarity with WestCare services and programs
Understands that different cultural and ethnic groups have different perceptions of health, wellness, behavioral health, and preventive health services
Ability to use trauma informed care principles including ensuring consumer safety, preventing/avoiding re-traumatization, maximizing trustworthiness, enhancing consumer choice, maximizing collaboration, and emphasizing empowerment
Ability to identify and describe key signs, symptoms, impact and manifestations of trauma
Aware of the differences between trauma informed and trauma-specific services
Understands the bidirectional relationships among substance use and mental disorders and trauma
Ability to read, analyze, and interpret agency and grant required documents
Ability to respond effectively to the most sensitive inquiries or complaints
Ability to collect data, establish facts, and draw valid conclusions.
Understands, communicates (both verbally and in writing), and collaborates effectively and with precision, given the time constraints of each task.
Understands the differences among various kinds of abuse and trauma, including: physical, emotional, and sexual abuse; domestic violence; experiences of war for both combat veterans and survivors of war; natural disasters; and community violence

Responsibilities

Determines need for insurance precertification upon admission and implements process in accordance with precertification policies and procedures 100% of the time
Makes daily rounds at least twice every shift to assess patient needs, unit safety, and reports any unsafe conditions or compromised quality of care to Lead Registered Nurse
Continually assesses patients’ medication needs; focusing on detoxification, PRN psychotropic, side effects and documenting such findings in progress notes per policies and procedures 100% of the time
Assesses client in seclusion and restraints per policy and procedure at required intervals 100% of the time
Completes nursing assessment, initial treatment plan (including any nursing/medical problems) and the Individual Treatment Plan to establish treatment needs according to the standards of care 100% of the time
Completes nursing assessment for every assigned client including Mental Status Exam on all new admissions
Demonstrates the ability to identify and evaluate an individual’s strengths, barriers, problems, and needs for the development of Preliminary/Initial Wellness and Recovery Plan
Initiates assessment of patient needs and provides appropriate treatment/medical care utilizing MD when appropriate 100% of the time
Initiates emergency screening protocol and decides when to consult on-call staff in accordance with on-call procedures
Participates in report between shifts highlighting client behavior, medical condition, medication status and client census 100% of the time
Meets at least once per shift with designated behavioral health technician to coordinate client activities and deploy appropriate staff 90% of the time
Participates in Treatment Team and the development or revision of patient Individual Treatment Plan (day shift)
Participates in familiarizing self with treatment plans/case reviews and implementing all features (evening and night shifts)
Provides 1x1 counseling and other direct care for patients every shift per treatment plan and policies and procedures
Responds promptly per treatment plan and policies and procedures to inappropriate, withdrawn, agitated, or vegetative client behavior 100% of the time
Applies TACT techniques properly and effectively 100% of the time in response to client aggression
Facilitates scheduled therapeutic and educational groups at least once per week
Participates in staff meetings, client conferences, and treatment teams to coordinate management of medical and nursing client care at least weekly or as assigned by Unit Director
Communicates pertinent client information to medical staff, unit coordinator, and other disciplines when appropriate,100 % of the time
Responds to client questions and requests in a timely fashion 90% of the time
Implements behavior modification plans as required 100% of the time
Provides nursing interventions appropriate to patient medical and psychosocial needs, i.e., health education, STD, HIV, First Aid, DM, injury, other chronic or acute illness per individualized treatment plan and nursing assessment
Reviews MD’s orders and documents as per policy and procedure 100% of the time
Assumes role of charge nurse as assigned, per P &P, 100% of the time
Documents the following on all patients; patient insurance status and precertification, patient admission assessment, insurance identifying problems, established priorities for treatment and care, initial treatment plan for each client, Transcription o medication orders, discharge summary, progress note per policy and procedure manual 100% of the time
Inventories controlled drugs at the beginning and end of each shift and report any discrepancies 100% of the time
Assures that informed consents for medication for each client are signed and in chart prior to administering medication 100% of the time
Administers medication without error to unit clients per policy and procedure 100% of the time
Administers PRN and OTC medications per physician orders, documents and observes effects
Participates in discharge plan for all assigned clients as part of multidisciplinary team (including client’s family) and documents discharge summary as per policy and procedure
Reviews and evaluates effectiveness of interventions and implementation of nursing care
Applies knowledge of the inter-relationship among substance abuse disorders, mental health disorders, and chronic medical conditions
Demonstrates the ability to evaluate the impact of substance use, mental health problems, and chronic medical conditions on the client’s functioning in major life areas
Documents and reports client outcomes and responses resulting from nursing interventions, treatment procedures, interpersonal interactions, and patient/family education 100% of the time
Evaluates and documents client progress towards goals and objectives every shift
Updates and revises patient care problem list and individualized client care standards based on client and family responses, progress toward goals, and/or change in medical and mental status every shift
Evaluates client length of stay and related transfer and discharge planning needs based on anticipated problems and needs, internal or community resources and support systems for all assigned clients
Evaluates progress of other RNs, BHT’s, student’s or staff persons being oriented as assigned
Acts as a role model and resource person for colleagues
Participates in required staff development / training activities.
Maintains up-to-date knowledge of clinical area of practice.
Participate in trainings on trauma informed care, assessing and treating victims of domestic violence, trauma-focused cognitive behavioral therapy, motivational interviewing and Seeking Safety
Completes all orientation and mandated training activities, including E-Learning Courses, within required timeframes, and in accordance with the criteria established for this position.
Demonstrates a high degree of dependability.
Maintains a good attendance record.
Observes working hours.
Exhibits characteristics of good workmanship, and integrity on the job.
Work time is always productive.
Establishes and maintains effective and positive working relationships with clients, co-workers, and other job-related representatives.
Readily develops and maintains therapeutic relationships with clients.
Effectively interacts with client’s family and significant others.
Shows flexibility and is responsive to requests from supervisor.
Works independently with minimal supervision.
Is courteous to clients, staff, and all others.
Cooperates with others both within and outside the Guidance/Care Center.
Demonstrates tact at the appropriate time.
Works well with supervisor; accepts direction and supervision.
Maintains a positive attitude toward work.
Ensures and maintains a safe working environment.
Work area is clean and orderly.
Verbalizes, understands and adheres to Center safety procedures.
Demonstrates appropriate use of Unusual Incident Reports, in accordance with the Center’s reporting procedures.
Presents a positive personal image.
Dresses and maintains a professional demeanor
Performs other duties as requested.
Miscellaneous duties are performed according to instruction.