Clinical Nurse - Same Day Appt (DH4607)

Navajo Preference Employment Act

In accordance with Navajo Nation and federal law, TCRHCC has implemented an Affirmative Action Plan pursuant to the Navajo Preference in Employment Act.  Pursuant to this Plan and corresponding TCRHCC Policy, applicants who meet the necessary qualifications for this position and (1) are enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe will be given preference in hiring and employment for this position, (2) are legally married to enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe and meet residency requirements will be given secondary preference, and (3) are enrolled members of other federally-recognized American Indian Tribes will be given tertiary preference.
Overview

POSITION SUMMARY

The Ambulatory Care Nurse in collaboration with other health care professionals, address patient wellness, acute illness, chronic disease, disability, and other outpatient needs. The nurse will perform a problem focused assessment of the patient’s primary concerns in the clinical or telemedicine setting. Integrate into the practice the finding of quality of care and performance improvement initiatives. Ambulatory Care Nurse performs a variety of nursing care procedures requiring nursing competency and assessment for specific patient conditions and treatments, with the ability to complete electronic health data entry tasks.  The Ambulatory Care Nurse will carry out physician’s orders, adhere to high, quality standards of care, follow nursing policies and procedures and TCRHCC hospital policies.

Qualifications

NECESSARY QUALIFICATIONS

Education:

Associate’s or Bachelor’s Degree in Nursing

License/Certification:

• Must have a valid, current, full and unrestricted Professional Nursing License to practice nursing in any state of the United States of America, The Commonwealth of Puerto Rico, or a territory of the United States
• Must maintain a current valid certification of the following throughout employment:
  • Basic Life Support (BLS) from the American Heart Association

Experience:

Must have one (1) consecutive year of nursing experience in outpatient and/or acute healthcare setting

Other Skills and Abilities:

A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers.  All employment references must address and indicate success in each one of the following areas:

• Positive working relationships with others
• Ability to prioritize competing responsibilities while under pressure.
• Ability to communicate and interact effectively with patients and co-workers.
• Ability to work independently; reports to work as scheduled without excessive absences.
• Ability to work in a computerized environmental setting; computer skills required.
• Knowledge of normal growth, development, and life cycle changes. This also includes knowledge of the physical, psychosocial, and behavioral characteristics of the age specific group for which care is provided.
• Knowledge of disease entities to recognize complications and therapeutic interventions required.
• Knowledge of pharmaceuticals to recognize the desired effects, side effects and complications on their use, with emphasis on vasopressors and emergency medications titration of these medications.
• Knowledge of infection control procedures, Personal Protective Equipment (PPE) and safety precautions.
• Successful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of TCRHCC a record of satisfactory performance and that the applicant can perform the essential functions of the job.
• Successful completion of fingerprint clearance requirements, physical examinations, and other screenings indicating that the applicant is qualified to be employed by TCRHCC and demonstrating to the satisfaction of TCRHCC that the applicant can perform the essential functions of the job.
• Submission of all required employment-related documents, application, resumes, references, and other required information free of false, misleading or incomplete information, as determined by TCRHCC.

MENTAL AND PHYSICAL EFFORT

The physical and mental demands described here are representative of those that must be met by an   employee to successfully perform the essential functions of this job.  Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Physical:

Work requires prolonged periods of standing; walking; talking or hearing; sitting watching, observing, concentrating on computer monitors and equipment; use of hands to finger, handle, feel; bending, stooping, kneeling, crouching; reaching with hands and arms; and, taste or smell.  Agility and the ability to lift, pull and bend are required to move patients to and from beds, wheelchairs, stretchers, et cetera, and in moving equipment and medical supplies. Must be able to lift up to 50 lbs frequently through entire shift. Most be able to move, pull/push, lift, maneuver more than 100 lbs. when caring for patients and must be able to use proper body mechanics and lifting equipment when available. Must be able to discern when working with over a hundred pounds when, how, and who to ask for assistance to protect and prevent self-injury. Must have the ability to hear and recognize alarms on equipment; client calls; instructions from physicians/department staff; and, hear overhead pages through loudspeaker. This position requires vision required to see close; distant; colored; peripheral; and depth perception. Must be able to adjust visual focus as needed. to ask for assistance. This position requires the ability to perform repetitive motion actions in both hands including prolonged grasping of simple/light action; intermittent grasping of firm/heavy action; and prolonged ability of fine dexterity. 

Mental:

Contacts often require tact and sensitivity as those related to stressful situation such as death, dying, and catastrophic illnesses.  Must be able to prioritize and use good judgment.  Must be able to coordinate a variety of issues while being frequently interrupted. Must be able to work with the attitude of team building with other staff; collaborate with multiple departments and job positions. Must be willing to assist when able and as needed with other team players. 

Environmental:

Will be working occasionally around fumes or airborne particles; toxic or caustic chemicals; and, risk of electric shock. Typical environmental noise level is moderate. As with any area of a Health care setting, must be able to work around and with infectious diseases. 

Responsibilities

ESSENTIAL FUNCTIONS

1. The Ambulatory Care Nurse is fully accountable in all ambulatory care settings for all nursing services and associated patient outcomes provided under their direction.
2. Responsible for the initial and long-term assessment of patients in an outpatient setting and instructing on wellness/prevention methods to illness and support of patients.
3. Responsible for working in outpatient settings and able to respond to high volumes of patients in a short-term time spans.
4. Provides age specific care in a compassionate, caring, culturally and ethically sensitive manner.
5. Utilize competent, evidence-based ambulatory care nursing intervention during clinic visits, telephone or telemedicine and electronic health communication encounters.
6. Interviewing patients and family members; consults and coordinates with providers and other members of the health care team to assess, plan, implement, and evaluate patient care plans carries out treatments and procedures per scope of practice.
7. Provides counseling and education to patients and families or surrogates on preventive, curative and rehabilitative measures related to their health care needs. Serve as patient advocate by supporting the basic rights, values and beliefs of the patient.
8. Maintain accurate health records by documenting observations, nursing interventions and therapeutic measures administered in an accurate, efficient, and timely manner.
9. Recognizing and respond to adverse patient signs and symptoms promptly, especially in emergency situations including the execution of life saving procedures.
10. Participating in the development, implementation and evaluation of standards of care, quality assurance and infection control activities. Contribute to positive working relationships within the Outpatient Department (OPD) team and other supplemental departments in the hospital.
11. Delivers clinical nurse patient care with adherence to the PCMH model and in conjunction with ambulatory nurse strategy and competencies.
12. Monitoring and initiating corrective action to maintain the environment of care including equipment and material resources.
13. Accepts responsibility, when delegated by the Program Director or designee, as team leader to providing direction to ancillary nursing and other personnel. Serve as charge nurse for a group of patients or staff when assigned.
14. Participates in orientating new employees. Fosters a collaborative environment, using a team approach, in which ideas are shared and valued to promote safe, patient centered care.
15. Maintains professional knowledge and proficiency in nursing through continuing education, staff meetings, workshops and serving on nursing committees.
16. Floats to other Outpatient Department’s clinical areas to meet patient care needs during staffing shortages.
17. Ensure proper PPE is worn at all times while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield.
18. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates.
19. Completes all electronic health record entries accurately and timely pertinent to patient care role.
20. Participates in departmental workflow and or testing teams as related to electronic health record or other project initiatives
21. Performing other duties as assigned.