RN II - Direct Care

Texas Health & Human Services Commission • Brenham, TX

4d • $6,579 - $7,762 • Onsite

About The Position

The Direct Care RN provides routine nursing care, assessment, treatment, and support to people with intellectual and developmental disabilities who reside at a State Supported Living Center. The nurse evaluates and documents healthcare needs and issues, reports concerns to appropriate personnel, and collaborates with direct care staff, physicians or primary care providers, administrators, and nursing staff as part of an interdisciplinary team. The position also supports LVNs and Certified Medication Aides, contributes to quality assurance and improvement activities, maintains required records and reports, and responds to emergencies. Work is under moderate supervision of the Nurse Manager or Nursing Operations Officer, with limited latitude for initiative and independent judgment.

The role is based at the Brenham State Supported Living Center and is available across multiple homes. The posting identifies an evening shift, while noting availability for morning, evening, and night shifts. Work may include rotating schedules, overtime, extended hours, weekends, holidays, on-call duty, and assignments at other facility locations. Travel may be up to 5%, and telework is not eligible. Additional pay may be available for evening, night, weekend, or maximum-security work.

The position requires a current registered nurse license valid in Texas or through a state participating in the Nurse Licensure Compact. Practicing RN experience is required. Six months of RN experience in a health agency, hospital, or healthcare facility and a bachelor's degree are preferred. Applicants must pass applicable fingerprint, criminal background, drug-screen, and registry checks. Employees are subject to random drug testing.

Requirements

• Work experience as a practicing registered nurse.
• Current licensure to practice as a registered nurse in Texas, or licensure in a state that recognizes reciprocity through the Nurse Licensure Compact.
• Knowledge of nursing techniques and procedures, healthcare laws and regulations, medical diagnoses and procedures, accepted treatment programs, and community health and nursing-care principles and practices.
• Knowledge of applicable state and federal laws and ICF-IID rules, regulations, policies, and procedures for State Supported Living Centers, or ability to gain that knowledge quickly.
• Knowledge of nursing-care standards, the Settlement Agreement, and Healthcare Guidelines, or ability to gain that knowledge quickly.
• Skill in patient care and treatment and in using computers, software, and electronic health record systems.
• Strong verbal and written communication skills, including the ability to present ideas clearly and concisely.
• Ability to provide patient care; maintain records; interpret policies, procedures, and healthcare regulations; and recognize patterns of medical-necessity treatment.
• Ability to demonstrate working knowledge of emergency procedures and emergency equipment.
• Ability to interact appropriately with individuals with intellectual or developmental disabilities, their family members, and staff.
• Ability to work independently and productively with all levels of staff and provide support and coaching to LVNs, CMAs, and DSPs.
• Ability to make decisions and recommendations to SSLC leadership, including on-call administrators.
• Must pass fingerprint criminal background, pre-employment drug-screen, and applicable registry checks, including CANRS, Nurse Aide, Medication Aide, Employee Misconduct, and HHS LEIE checks.
• Must be willing to work weekends and holidays; flexibility in work hours, overtime, and extended hours may be required.
• Must be at least 18 years old for employment at a state-operated facility.
• Males aged 18–25 must be registered with the Selective Service.
• SSLC employees are subject to random drug testing.

Nice To Haves

• At least six months of experience as a practicing registered nurse in a health agency, hospital, or healthcare facility.
• Bachelor's degree.

Responsibilities

• Perform routine nursing tasks and procedures in accordance with HHSC, SSLC, and state regulations, including tracheostomy care, gastrostomy/jejunostomy care, wound care, and breathing treatments.
• Collect specimens for laboratory examination and conduct requested screening tests.
• Administer medications, immunizations, and treatments, and observe individuals for unusual symptoms and reactions.
• Make rounds or home visits as needed and work at other SSLC locations as needed.
• Monitor individuals' weight, diet, feedings, vital signs, and signs and symptoms of illness; use nursing judgment and initiate acute care plans when appropriate.
• Evaluate nursing intervention outcomes and provide input and recommendations to the healthcare team.
• Instruct direct support professionals in post-treatment or post-procedure monitoring using applicable instruction sheets.
• Accurately and promptly document treatments and observations in electronic or paper medical records and prepare required reports.
• Assist LVNs and Certified Medication Aides with services, recommendations for improvement, and familiarization with individuals' needs and preferences.
• Assist LVNs with protocols and programs related to health and safety, including follow-up assessments, guidelines, acute care plan interventions, injury reports, restraints, and medication variances.
• Support Nurse Managers with reviews and follow-up involving controlled drug and medication counts, emergency checklist logs, refrigerator temperature logs, and glucose controls.
• Assist the Infection Control Nurse with disease-prevention measures and the Quality Assurance Nurse with therapeutic nursing programs; participate in facility QA/QI initiatives.
• Respond to emergencies to help ensure the safety and care of individuals and staff, follow facility safety and infection-control procedures, and provide staff education and safety training upon request.
• Provide treatment to HHS employees injured in the course and scope of employment.
• Attend work regularly, follow assigned or rotating schedules, and perform other duties as assigned, including disaster response, recovery, or Continuity of Operations support that may require a different shift or location.
• May serve in a rotating on-call status as required by facility needs.

Benefits

• 100% paid employee health insurance for full-time eligible employees.
• Defined benefit pension plan.
• Generous time off benefits.
• Opportunities for career advancement.
• Free continuing education units (CEUs) and updated nursing resources through Lippincott access.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed