Psychiatric Nurse I/II/III

The Butte County Behavioral Health Psychiatric Health Facility (PHF) is seeking nurses (RN) to provide direct client care to patients receiving inpatient psychiatric treatment in our facility treating our community members in psychiatric crisis. Care includes, but is not limited to, consultation with providers, participating in multidisciplinary team meetings, medication administration, managing admissions and discharges, oversight of facility functioning and providing quality documentation. Pay does include a 10% site differential and scheduling is based on applicant availability.

The eligibility list created from this recruitment will be used to fill regular help full-time and part-time vacancies, as well as extra help. 

Extra Help means this may be a Part-Time or Non-Permanent position. The number of hours worked per week may vary and depend on the needs of the department. For terms and conditions concerning Extra Help with Butte County, see Section 6.13c of the Butte County Personnel Rules.

Employees assigned to the Psychiatric Health Facility (PHF) or Crisis Services will receive a 10% site differential and those assigned as part of the Resiliency Empowerment Team (Rest) will receive a 5% site differential on top of the base salaries listed below. 

This recruitment is for Level I, Level II and III. 

The salary rage for level I is $2671.20 - $3579.20 biweekly ($33.39 - $44.74 per hour). 

The salary range for level II is $2950.40 - $3954.40 biweekly ($36.88 - $49.43 per hour). 

The salary range for level III is $3101.60 - $4156.00 biweekly ($38.77 - $51.95 per hour). 

FLSA: Non-Exempt

DEFINITION

Under direction, performs and provides professional nursing and psychiatric care to individuals striving to overcome behavioral health challenges; collaborates with other medical staff and interdisciplinary health treatment teams to evaluate and prepare treatment plans; and performs related duties as assigned.

SUPERVISION RECEIVED AND EXERCISED

Receives direction from assigned supervisory or management personnel. Exercises no direct supervision over staff.

CLASS CHARACTERISTICS

Psychiatric Nurse I: This is the entry-level classification in the Psychiatric Nurse series. Initially under close supervision, incumbents learn and perform routine professional nursing and psychiatric care. As experience is gained, assignments become more varied and complex; close supervision and frequent review of work lessen as an incumbent demonstrates skill to perform the work independently. Positions at this level usually perform most of the duties required of the positions at Psychiatric Nurse II-level but are not expected to function at the same skill level and usually exercise less independent discretion and judgment in matters related to work procedures and methods. Work is usually supervised while in progress and fits an established structure or pattern. Exceptions or changes in procedures are explained in detail as they arise. 

Psychiatric Nurse II: This journey level classification is responsible for performing direct nursing services in support of the County’s in-patient or out-patient psychiatric health facilities. Positions at this level exercise judgment and initiative in their assigned tasks, receive only occasional instruction or assistance as new or unusual situations arise and are fully aware of the operating procedures and policies of the work unit. This class is distinguished from the Senior Psychiatric Nurse in that the latter performs the more complex work assigned to the series, such as reviewing psychiatric nursing work practices and providing lead technical and functional direction over lower level staff.

Psychiatric Nurse III:This is the advanced journey-level classification in the Psychiatric Nurse series responsible for the oversight of psychiatric nursing services at an assigned clinic and/or performing the most complex and specialized work assigned to the series. Incumbents regularly work on tasks which are varied and complex, requiring considerable discretion and independent judgement. Positions in the classification rely on experience and judgement to perform assigned duties. Assignments are given with general guidelines and incumbents are responsible for establishing objectives, timelines, and methods to deliver services. Work is typically reviewed upon completion for soundness, appropriateness and conformity to policy and requirements.

Positions in the Psychiatric Nurse class series are flexibly staffed; positions at the II- and III-levels may be filled by advancement from the I- and II-levels, respectively; progression to the next level in the series is dependent on (i) management affirmation that the position is performing the full range of duties assigned to the classification; (ii) satisfactory work performance; (iii) the incumbent meeting the minimum qualifications for the classification including any licenses and certifications; and (iv) management approval for progression to the II-level.

EXAMPLES OF TYPICAL JOB FUNCTIONS

Typical functions may include any of the following tasks, knowledge, abilities, and other characteristics. The list that follows is not intended as a comprehensive list; it is intended to provide a representative summary of the major duties and responsibilities. Incumbent(s) may not be required to perform all duties listed, and may be required to perform additional, position-specific tasks.

Some duties, knowledge, skills, and abilities may be performed in a learning capacity for entry-level (I Level) positions.

• Assesses patients upon admission to unit and makes presentation of physical and behavioral condition findings to attending physicians. May provide support to multiple nursing areas. 
• Provides professional nursing care to patients; observes and charts vital signs, including temperature, blood pressure, pulse, and respiration.
• Provides equipment and supplies required for patient examination or treatment; observes and records patient reactions and behaviors and explains procedures.
• Administers oral and hypodermic medications and observes and records their effects; obtains and records all orders from physician to facilitate patient treatment.
• Participates in the preparation of the nursing component of patient treatment plans, including physical assessments on new patients, as a member of an interdisciplinary treatment team; oversees and participates in evaluation and therapeutic activities.
• Performs crisis intervention, in person and on the phone, management of assaultive behavior, and general counseling; coordinates or arranges for the provision of needed services including emergency detention when patient is in danger to self or others.
• Provides supportive services including individual, group or family counseling, and various group activities such as exercise and art.
• Confers with medical, behavioral health and inter-agency staff regarding client needs and ways of improving staff's ability to positively impact clients; serves as case coordinator for assigned patients or clients, as needed.
• Participates in case conferences and provides input regarding behavioral health cases and problems.
• Provides medication refills per physician’s orders and policies and procedures; provides needed information to pharmacies and insurance companies.
• Coordinates care with primary providers, pharmacies, laboratories, schools, medical facilities and personnel, probation, social services, and other government agencies.
• Accepts report of previous shift and updates new admissions and medications; makes appropriate nursing notes on patients charts and writes medication orders; assures that patient charts contain accurate and complete documentation; performs and documents end-of-shift narcotics count.
• Organizes, assigns, reviews and evaluates the work of staff on scheduled shift, as assigned.
• Maintains prescribed standards of behavioral health treatment and ensures services are rendered in conformance with policy and procedural guidelines.
• Adheres to the confidentiality standards of the Privacy Act of 1974 (U.S.C. § 552a), as amended.
• Performs related duties as assigned.

Knowledge of:

• Principles and practices of general psychiatric nursing care, as defined by the State of California licensing requirements.
• Principles of providing functional direction and training.
• Techniques for working with individuals striving to overcome behavioral health challenges and their families.
• Medical and psychiatric terminology and first aid methods and procedures.
• Psychiatric medicines, including narcotics, and their effects on patients.
• Standard medical recordkeeping, including patient charting and the processing and maintenance of required documentation.
• Principles, practices and methods of community behavioral health treatment including interviewing, assessment and family and group counseling.
• Knowledge of social, psychological and physical factors or mental and emotional disorders. 
• Knowledge of infectious disease and control.
• Principles and techniques for working with groups and fostering effective team interaction to ensure teamwork is conducted smoothly. 
• Medi-Cal documentation standards.
• Principles and practices of utilization review.
• Techniques for providing a high level of customer service by effectively dealing with the public, vendors, contractors, and County staff.
• The structure and content of the English language, including the meaning and spelling of words, rules of composition, and grammar.
• Modern equipment and communication tools used for business functions and program, project, and task coordination, including computers and software programs relevant to work performed.

Ability To:

• Conduct psychiatric assessments and evaluations and report physical and behavioral condition findings to medical staff.
• Assign, direct, review and evaluate the work of assigned staff and train on work procedures.
• Assess behavioral and/or emotional health status and develop effective patient treatment plans. 
• Perform crisis intervention, manage assaultive behavior, respond promptly to patient emergency situations and take effective action to control potentially violent incidents.
• Perform utilization review and infection control functions for compliance with standards.
• Recognize the signs and symptoms of psychiatric disorders in children, adults and families.
• Use clinical judgment to determine if an action needs to be taken.
• Prepare clear and concise reports, patient documents and written correspondence.
• Understand client rights as they relate to treatment options.
• Understand, interpret, and apply all pertinent laws, codes, regulations, policies and procedures, and standards relevant to work performed.
• Effectively represent the department and the County in meetings with governmental agencies; community groups; various business, professional, and regulatory organizations; and in meetings with individuals. 
• Independently organize work, set priorities, meet critical deadlines, and follow-up on assignments.
• Use tact, initiative, prudence, and independent judgment within general policy, and procedural, guidelines.
• Effectively use computer systems, software applications relevant to work performed and modern business equipment to perform a variety of work tasks.
• Communicate clearly and concisely, both orally and in writing, using appropriate English grammar and syntax.
• Establish, maintain, and foster positive and effective working relationships with those contacted in the course of work.

Education and Experience:

Any combination of training and experience that would provide the required knowledge, skills, and abilities is qualifying. A typical way to obtain the required qualifications would be:

Equivalent to an Associate’s degree from an accredited educational institution with major coursework in nursing, psychology, or a related field; and

Psychiatric Nurse I: One (1) year of experience in psychiatric nursing.

Psychiatric Nurse II: Three (3) years of psychiatric nursing experience equivalent to the County’s Psychiatric Nurse I.

Psychiatric Nurse III: Four (4) years of psychiatric nursing experience equivalent to the County’s Psychiatric Nurse II.

Certifications and Licenses:

• Possess and maintain a valid Registered Nursing license issued by the State of California Board of Registered Nursing.
• Possess and maintain a valid CPR certification.
• A position assigned to this class may require possession of a valid California Driver's License.

PHYSICAL DEMANDS

• Mobility to work in a standard office setting, or clinical setting, and use standard office equipment, including a computer, and medical equipment; standing in work areas and walking between work areas may be required, and travel to visit outpatient and rural clinics may be required; occasionally bend, stoop, kneel, reach, push, and pull drawers open and closed to retrieve and file information; ability to lift, carry, push, and pull materials and objects up to 45 pounds or heavier weights, in all cases with the use of proper equipment and/or assistance from other staff.
• Vision to assess emergency situations, including medical incidents and to read printed materials and a computer screen.
• Hearing and speech to communicate in person, before groups, and over the telephone
• Finger dexterity is needed to access, enter, and retrieve data using a computer keyboard, typewriter keyboard, or calculator and to operate standard office and medical equipment.

WORKING CONDITIONS

• Employees work in an office, out-patient, clinic, jail, juvenile facility or locked psychiatric facility environment with moderate noise levels, controlled temperature conditions, and no direct exposure to hazardous physical substances. 
• Employees may work outdoors and are occasionally exposed to loud noise levels and cold and/or hot temperatures.
• Employees interact with clients with behavioral disorders/erratic and assaultive behavior, including those which require emergency crisis intervention. 
• Incumbents may be exposed to blood and body fluids in performing their assigned duties. 
• Employees may interact with upset staff and/or public and private representatives in interpreting and enforcing departmental policies and procedures.

EQUIPMENT AND TOOLS UTILIZED

• Equipment utilized includes a motor vehicle, medical equipment utilized in the course of work (ex. stethoscope, blood pressure monitoring equipment, injection supplies), personal protective clothing, personal computer, fax machine, and standard office equipment.

Disaster Service Worker

All Butte County employees are designated Disaster Service Workers through state and local law (California Government Code Section 3100-3109). Employment with the County requires the affirmation of a loyalty oath to this effect. Employees are required to complete all Disaster Service Worker related training as assigned, and to return to work as ordered in the event of an emergency.