REGISTERED NURSE - TRIAGE PHONE NURSE / ORTHOPEDIC JOINT NAVIGATOR (RN - CLINIC)

Description

STATEMENT OF PURPOSE

Coordinates total nursing care for patients of all ages utilizing the nursing process; directs patient and family teaching; provides leadership by working cooperatively with ancillary nursing and other patient team personnel in maintaining standards for professional nursing practice in the clinic setting.

$10,000 SIGN ON BONUS AVAILABLE FOR NEW EMPLOYEES 

Full-time, benefited position working 80 hours per two week pay period. Days of work are Monday - Friday from 7:30am - 4:30pm with no nights, weekends or holidays   

JOB FUNCTIONS

• Maintains the standards of nursing care and implements the policies and procedures of the hospital and Clinical Services.
• Provides direct and indirect patient care for patients of all ages including pediatrics, adult and geriatrics, utilizing the nursing process including assessment, planning, intervention and evaluation.
• Develops a plan of care for the patient and prescribes appropriate nursing interventions to achieve expected patient outcomes.
• Evaluates patient outcomes and modifies plan of care as patient’s needs or condition changes. 
• Routinely perform administrative and clinical tasks to keep the office and clinic running smoothly. 
• Performs telephone triage nursing, helps patients determine what type of care they need over the phone. Provide a cursory assessment of the patients and help decide if emergency treatment is necessary, make an appointment with a provider, treat themselves at home and/or coordinate additional resources.
• Obtains appropriate information for prescription refills or phone messages.  
• Manage provider In basket communication for specialty clinic.
• Schedule appointments and/or schedule patients for return appointment or referrals.  
• Orders specialized non-stock and stock items
• Have an understanding of billing charges
• Schedules surgeries for patients. Gives patient required information; obtains insurance pre-authorization. Directs patient in scheduling pre-op physicals, and post-op call to patients etc.
• Coordinates supplies, scheduling, and registration of patients for satellite clinics and assists with patient care.
• Obtains medical charts from Health Information Services.
• Sets up exam rooms, prepares equipment and instruments in anticipation of scheduled appointments. Checks supplies before patient schedule begins.
• Update patient medical record in computerized charting system 
• Collects and documents data from patient, including chief complaint, medication and allergy history, and vital signs. Communicates information to the physician.
• Assists patients to and from exam tables; assists patient with removal and replacement of clothing. Performance of tasks shall consider the age and ability of the patient. 
• Explains treatment procedures to patients, 
• Assists the physician by prepping patients for specific procedures. Has knowledge of physician preference and step by step procedure. Prepares tables, instruments and supplies as required for specific procedures.  
• Prepares and maintains the sterile field for the surgical and office procedures.
• Decontaminates equipment/instruments and room in readiness for the next patient 
• Prepares medications as directed by physician for administration.
• Provides patient education related to the examination, procedures, and other treatments as prescribed. 
• Completes lab and x-ray order entry and escort patient to appropriate department.
• Authorizes drug refills as directed by the physician 
• Changes dressings as directed by the physician
• Maintains clinical experience by completing annual competency evaluations and attending educational offerings. Ensures re-certifications are kept current and appropriate to position/policies.
• Follows disaster procedures. Utilizes standard precautions and aseptic techniques. Follows guidelines for infection control and isolation. Investigates and reports incidents per risk management policy.
• Maintains supplies, equipment and materials for the practice as needed.
• Specific to Phone Nurse: Has a basic understanding of all Specialty Clinic departments and acts as the triage nurse with all departments.
• Performs other related duties as assigned or requested.

Specific to Podiatry/Orthopedics:

• Coordinate ordering and dispensing orthotics through appointments and mailing of supplies
• Refurbish orthotics and cut shoe inserts according to physicians order
• Performs fitting and application of specialized patient appliances, such as Cam walkers, splints, etc.
• Assist in castings. Remove casts. Check instruments for wear and order new when needed.
• Assures medical equipment (Doppler and rechargeable grinder) is recharged
• Prepare charts for day-make up new charts
• Specific to Joint Navigation: Joint Navigator guides and coordinates patients through the entire continuum: preoperative, surgical and postoperative care. The Joint Navigator will collaborate with the medical staff to provide individualized care to the patient and perform all duties involved in the management of the daily operations of the joint replacement program. Organize and coordinate orthopedic joint education class working collaboratively with providers and nutritional services for optimal education.

Specific to OB/GYN:

• Attends physician during physical examination and procedures.
• Interviews Obstetric patients, assisting physician with completion of prenatal visit documentation utilizing nationally recognized ACOG prenatal form.
• Assists with monitoring of established patient’s preventive screening such as routine mammogram and Pap smears.
• Administers medications parenterally, orally or via inhalation as ordered by the physician.
• Availability for extensive training required for involved nursing procedures.

Specific to Urology:

• Assist physician during clinic procedures.
• Demonstrates critical thinking skills required for assessment and completion of nurse visit procedures.
• Demonstrates skill in use of equipment relevant to position, verbalize knowledge of appropriate safety procedure requirements.
• Diagnoses equipment problems; fixes or seeks out someone to fix
• Competent in equipment set up and handling required for procedures as well as appropriate transfer of equipment for sterilization.
• Competent in handling and administration of medication within the JRMC Clinic in correlation to safety regulations. 
• Availability for extensive training required for involved nursing procedures. 

Specific to Wound Care:

• Assess, determine classification, and measure wounds accurately and in accordance with policy.
• Assess compliance to the Clinical Pathway and communicate to the Physician Formulate desired outcomes specific to patient’s problems and Wound Clinic protocols.
• Implement wound care and HBO protocols as clinically indicated.
• Complete new patient review form and participate in weekly meeting.
• Accurately complete the superbill and ensure that all orders and charges are initiated accurately.
• In collaboration with the Physician and other Wound Clinic employees, revise the plan of care and continuously reassess and evaluate until desired outcome is obtained.
• Complete the 4-week reviews in the Multi-Disciplinary Plan of Care and communicate findings with Physician. Revise Plan of Care as indicated and consistent with Healogics Clinical Pathway

Specific to Oncology:

• Competent in handling and administration of medication within the JRMC Clinic in correlation to safety regulations. 
• Demonstrates skill in accessing, preparing and using information as relevant to position.
• In correlation with the patient, develops a plan of care based on nursing assessment and diagnosis that prescribes interventions to attain expected outcomes. This includes identifying the holistic needs of the patient, treatment decisions and priorities. Identifies community resources needed for continued care and make referrals.
• Implements the plan of care and the nursing interventions for the patient by writing nursing orders, giving direct care, assisting with care, determining the responsibilities that can properly and safely be assigned or delegated, providing an environment conducive to safety and health, communicating interventions and responses to other members of the health care team and executing the regimen prescribed by a licensed practitioner.
• Evaluates the responses to nursing interventions by documenting and communicating evaluation data to appropriate members of the health care team, utilizing data as a basis for reassessing client health status, measuring outcomes and goal attainment, modifying nursing diagnoses, revising strategies of care and prescribing changes in nursing interventions. 
• Availability for extensive training required for involved nursing procedures. 

Specific to ENT:

• Assist physician during clinic procedures.
• Demonstrates critical thinking skills required for assessment and completion of nurse visit procedures.
• Demonstrates skill in use of equipment relevant to position, verbalize knowledge of appropriate safety procedure requirements.
• Diagnoses equipment problems; fixes or seeks out someone to fix
• Competent in equipment set up and handling required for procedures as well as appropriate transfer of equipment for sterilization.
• Competent in handling and administration of medication within the JRMC Clinic in correlation to safety regulations. 

Requirements

QUALIFICATIONS/REQUIREMENTS FOR THIS POSITION:

1. PREPARATION AND TRAINING - Work requires a professional level of knowledge acquired by completing an accredited RN nursing education program. Must hold an unencumbered RN licensure from the ND State Board of Nursing for the current year. Position requires completion of BLS CPR. Position is required to attend Crisis Prevention Intervention (CPI) training in the appropriate timeframe according to department orientation checklist.
2. WORK EXPERIENCE - Previous work experience in a clinic. Preference for a minimum of six months experience in a related position in a health facility or clinic. Time to reach competency on the job: Three weeks to three months. 
3.  ATTENDENCE - Punctual and regular attendance is an essential responsibility of each employee at JRMC. Employees are expected to report to work as scheduled, on time and prepared to start working. Employees are also expected to remain at work for their entire work schedule. 
4. ANALYTICAL ABILITY - Required to gather and interpret data in situations such as clinical observations, contributing to care plan, interpreting routine data and carrying out physician directed assignments. Must be able to determine priorities within area of assignment. Must have the ability to access, manipulate, organize and relay information in meaningful ways using email, word processing, spreadsheets, presentation software, and database management.
5. INDEPENDENT JUDGEMENT - Independent nursing judgment is often required by the professional RN based on established policies and procedures. Substandard performance in nursing skills or judgments may adversely affect patient care, patient welfare, and hospital goodwill.
6. CONTACTS AND INTERPERSONAL SKILLS - High degree of duties involve contact with others; imperative that this person maintain good relationships with co workers, patients’ families, and visitors; must be tactful and maintain telephone courtesy; must be able to exchange information on a factual basis, dispatch verbal or written messages as directed on a timely basis and perform other activities which require courtesy and tact. Must have excellent and clear communication skills, ability to adapt to quick change, and be well organized.
7. SUPERVISING THE WORK OF OTHERS - Required to plan, assign work to and check the work of others. Responsible for own work. Little or no responsibility for the work of others.
8. RESPONSIBILITY FOR WELFARE OF OTHERS - High frequency with which work performed by the staff RN may result in very serious physical or emotional harm to others. It is the responsibility of the professional RN to continuously uphold the highest degree of performance within currently defined and acceptable nursing practice standards. High degree of contact with other employees that may result in minor discomfort and delay to patients and co-workers. Activities during the day impact the welfare of patients and employees. Responsible for maintaining absolute confidentiality of information; may be required to assist a team member if needed.
9. MENTAL/VISUAL EFFORT - Must be able to speak and write the English language in an understandable and legible manner. Must demonstrate physical and emotional ability to meet agreed upon work schedule and performance standards required by the position. Ability to adapt to change. Work regularly requires the employee to exert a high level of mental/visual effort. Visual acuity necessary for performing clerical duties and working with medical devices and equipment. Color perception necessary for interpreting testing procedures involving color comparisons.
10. WORKING CONDITIONS - OSHA job classification: This position is defined as a Category I in which the employee does have exposure to bloodborne pathogens. Position requires exposure to patients with infectious diseases and odor. Must practice aseptic techniques and observe Standard Precautions. Participates in and complies with Hospital Safety Management program. Position is subject to frequent interruptions. Work may be beyond normal working hours and/or temporarily in other positions when necessary. Risk of exposure to elements and hazards related to travel and work in satellite clinics. Must hold a current, unencumbered North Dakota driver's license. Working areas are clean and vented, but on occasion the position requires tasks that will expose individual to grinder dust.
11.  PHYSICAL AND SENSORY EFFORT - Frequent standing or walking. Lifts, positions, pushes and/or transfers patients and/or equipment. Frequent reaching, stooping, bending, kneeling and crouching. Needs finger dexterity when handling equipment and performing nursing related functions.
12. PROMOTION - No formal line of promotion.
13. BACKGROUND CHECK - Background check is required.
14. PHYSICAL REQUIREMENT - These are physical requirements of the position that may be performed as part of daily duties. Inability to meet one or more of these physical requirements will not automatically disqualify a candidate or employee from the position. Upon request for a reasonable accommodation, JRMC may be able to adjust or excuse one or more of these requirements, depending on the requirement, the essential functions to which it relates, and the proposed accommodation.

EMPLOYEE REQUIRMENTS

• Visual Observation - Continuously
• Standing - Continuously
• Walking - Continuously
• Sitting - Continuously
• Hands and Finger Dexterity - Continuously
• Reaching with Hands and Arms - Continuously
• Climbing - Never
• Stooping/Kneeling/Crouching/Crawling - Frequently
• Hearing/Listening - Continuously
• Tasting or Smelling - Occasionally
• Working Inside - Continuously
• Working Outside - Never
• Working in Extreme Heat - Never
• Working in Extreme Cold - Never
• Working with Hazardous Materials - Occasionally
• Noise - Continuously
• Working in Dirt/Dust - Rarely
• Driving - Rarely

Lifting / Carrying / Pushing / Pulling:  

• Up to 10 pounds - Occasionally
• Up to 25 pounds - Occasionally
• Up to 50 pounds - Occasionally
• Up to 75 pounds - Occasionally
• Up to 100 pounds - Occasionally
• Over 100 pounds - Occasionally