Senior Direct Care Registered Nurse

Texas Health & Human Services Commission • Harlingen, TX

12d • $7,533 - $8,886 • Onsite

About The Position

The Senior Direct Care Registered Nurse (ADN) provides complex nursing care, assessment, and integrated treatment to individuals residing at a State Supported Living Center (SSLC). The role performs technical nursing procedures and assessments; administers medications, immunizations, and treatments; interprets diagnostic tests; collects specimens; communicates clinical findings; coordinates nursing services; monitors individuals’ health; and documents care in the electronic medical record. The nurse also provides consultation, training, and technical assistance to staff, and offers leadership, oversight, coaching, and monitoring to LVNs and RNs. The position works independently under the limited supervision of a Nurse Manager or other designated supervisor, using initiative and independent judgment in coordination with nurses, healthcare providers, and the interdisciplinary team.

The role is based at the Rio Grande State Supported Living Center in Harlingen, Texas. The facility provides campus-based services and support to people with intellectual and developmental disabilities who may be medically fragile or have behavioral challenges. The position is a regular, full-time, exempt role on the day shift, is not eligible for telework, and may require travel up to 5%. It may require flexible hours, rotating or extended shifts, overtime, weekends, holidays, and alternate shift or location assignments during disaster response or continuity-of-operations activation. Additional pay may be available for work performed on evenings, nights, and/or weekends.

Applicants must have an ADN, at least two years of practicing RN experience in a health agency, hospital, or healthcare facility, experience assessing and documenting health status, and a current Texas RN license or qualifying Nurse Licensure Compact license. A current CPR certification must be maintained. Specialized training or experience with complex medical and behavioral health issues, and experience with individuals with intellectual or developmental disabilities, are preferred. Hiring checks include fingerprint criminal background, drug screen, and registry checks.

Requirements

• Associate degree in nursing (ADN).
• At least two years of experience as a practicing registered nurse in a health agency, hospital, or healthcare facility.
• Experience assessing and documenting health status.
• Current licensure to practice as a registered nurse in Texas, or in a state that recognizes reciprocity through the Nurse Licensure Compact.
• Maintain current CPR certification.
• Knowledge of, or ability to quickly gain knowledge of, state and federal laws and ICF-IID rules, regulations, policies, and procedures applicable to State Supported Living Centers.
• Knowledge of evidence-based practices for treating individuals with developmental disabilities and of emergency procedures and equipment, including CPR.
• Advanced knowledge of nursing techniques, standards, and procedures; healthcare laws and regulations; medical diagnoses and procedures; accepted treatment patterns; community health and nursing care principles; program regulations; and utilization review and control measures.
• Skill in patient care and treatment, computer and software use, and electronic health record systems.
• Ability to work with individuals with complex physical and nutritional management needs, behavioral challenges, and varying communication methods.
• Excellent verbal and written communication skills, including the ability to present ideas clearly and concisely.
• Ability to provide patient care; maintain records; organize, coordinate, and evaluate nursing activities and health service delivery; interpret policies, procedures, and healthcare regulations; and recognize patterns of medical necessity treatment.
• Ability to interact appropriately with individuals with intellectual and developmental disabilities, their family members, and staff.
• Ability to work independently and productively with all levels of staff; train, coach, monitor, and instruct staff within scope of practice; and make nursing decisions and recommendations to the team.
• Must have the strength and flexibility to safely perform CPR and safe use of restraint and Ukeru techniques once trained.
• Pass required fingerprint criminal background check, pre-employment drug screen, and registry checks.
• Applicants 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.
• Must be willing to work weekends and holidays; flexible hours, overtime, or extended hours may be required.

Nice To Haves

• Specialized training or experience working with individuals with complex medical and behavioral health issues.
• Experience working with individuals with intellectual and/or developmental disabilities.

Responsibilities

• Provide assessment, care, and integrated treatment to individuals residing at the SSLC.
• Perform complex nursing procedures, including tracheostomy care, gastrostomy/jejunostomy care, wound care, and breathing treatments; administer medications, immunizations, and treatments; and observe for unusual symptoms or reactions.
• Collaborate with the assigned RN Case Manager on initial assessments for new admissions and present relevant findings to providers and the interdisciplinary team.
• Interpret and evaluate diagnostic tests, collect specimens, conduct requested screening tests, and communicate findings and recommendations to nurses, primary care providers, and other staff.
• Coordinate nursing services for assigned homes or units; observe individuals; monitor weight, diet, feedings, vital signs, and signs of illness; initiate acute care plans as appropriate; make rounds; and raise concerns with the appropriate supervisor.
• Provide consultation, instruction, training, and technical assistance to direct support professionals and other treatment-team members about individuals’ care needs, treatments, medications, and monitoring requirements.
• Develop in-service training and health education strategies, and instruct, counsel, and assist individuals in meeting their healthcare needs when warranted.
• Provide leadership and oversight in assigned areas; coach and monitor LVNs; act as an RN preceptor when assigned; train new nurses; and serve as Nurse Manager in the manager’s absence when appointed.
• Support Nurse Managers with day-to-day supervision and review of controlled drug and medication counts, emergency checklist logs, refrigerator temperature logs, and glucose controls.
• Assist with implementation of protocols and programs and follow-up work involving assessments, acute and chronic care plans, injury reports, restraints, medication variances, and chronic care plan interventions.
• Document and report treatments and observations accurately and promptly in the electronic medical record, and oversee required documentation when training others.
• Work with staff and departments to address routine and non-routine situations; support infection control, quality assurance, and therapeutic nursing programs; participate in quality initiatives; and recommend process improvements.
• Analyze data, evaluate nursing intervention outcomes, and provide input to the interdisciplinary team to assist in assessing treatment plans.
• Attend or provide information for meetings concerning the status and care of assigned individuals, and communicate pertinent diagnoses and treatment plans to SSLC staff and, when directed, guardians or legally authorized representatives.
• Respond to emergencies, follow facility safety and infection-control procedures, provide requested safety education to staff, and treat HHS employees injured in the course and scope of employment.
• Participate in disaster response, recovery, or continuity-of-operations activities as assigned; this may require an alternate shift pattern or work location.
• Attend work regularly and perform other duties as assigned.

Benefits

• 100% paid employee health insurance for eligible full-time employees.
• Defined benefit pension plan.
• Generous time off benefits.
• Opportunities for career advancement.
• Additional pay may be available for work performed on evenings, nights, and/or weekends.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: Associate degree