RN - ACC Clinic

				Overview:

Assumes responsibility and accountability for patient screenings; triage; pain management; falls prevention, nutritional and psychosocial, discharge planning and other interventions to restore, maintain or promote patients' physical health. Utilizes the nursing process in the provision of direct patient care. Assists all patients, families/significant others through the healthcare system by acting as a patient advocate and navigator. Responsible and accountable for prescribing, delegating, and coordinating all care provided to assigned patients. Executes medical plan of care, at the direction of the treating clinician, in accordance with licensure of a Registered Professional Nurse. Utilizes nursing diagnoses to treat human responses to actual and potential health problems through such services as case finding, health teaching, health counseling, and provision of care supportive or to restorative of life and well-being. Supervises patient care provided by Licensed Practical Nurses (LPN), Medical Office Assistants (MOAs), Nursing Attendants (NAs), technicians, and supplemental staff. Supports patients' self-management of disease and behavior modification interventions. Coordinates continuity of patient care with external healthcare organizations and facilities, including the process from admission to discharge and referrals from the primary care provider to the specialty care provider. Promotes clear communication amongst a care team and treating clinicians by ensuring awareness regarding a patient's plan of care. Participates on a team for data collection, health outcomes reporting, clinical audits, and programmatic evaluation related to Patient-Centered Medical Home and ambulatory care initiatives.  Assists in the prior authorization process for clinical and pharmacy related orders. Demonstrates the ability to function as part of an interdisciplinary health care team.

Responsibilities:

* Assesses the immediate and continuing care needs of the patient/families/significant other.
* Develops comprehensive and current plans of care which include physical needs, patient teaching, discharge planning and psychosocial/spiritual needs.
* Provides direct patient care based on assessed needs and the medical regimen. Oversees and ensures the provision of all aspects of care for the patient.  Supervises the care provided by other nursing personnel including Licensed Practical Nurses (LPN), Medical Office Assistants (MOAs) and Nursing Attendants (NAs), as defined in the scope of practice.
* Participates in Quality Improvement activities related to patient care delivery and the development of nursing/hospital/ambulatory care standards.
* Observes, evaluates, documents, and communicates to relevant team members the patient's response to illness and/or therapeutic modalities as related to diagnosis. Ensures timely reassessment of patient responses to treatment and when significant changes occur in patient condition and/or diagnosis.
* Provides Patient and Family education, as needed.
* Coordinates the overall plan of care to ensure implementation of nursing interventions and consistency with medical regimen.
* Establishes priorities for care in collaboration with the multidisciplinary team and initiates follow-up, as indicated, to ensure timely provision of patient care and therapeutic modalities.
* Assures the plan of care integrates age-specific care needs (e.g. pediatrics, geriatrics) as defined in the unit scope of care.
* Demonstrated ability to communicate effectively, manage stressful situations appropriately and facilitate interpersonal relationships with other disciplines.
* Ensures that patients receive timely and appropriate care within the delivery system and assists with facilitating internal and external referrals
* Communicates with pharmacies as well as insurance companies related to patient treatment plans and approvals of medications and/or procedures/Diagnostic Imaging.
* Demonstrates compliance to infection control protocols and maintains a safe, clean and therapeutic work environment.
* Performs vital signs: T-P-R, O2 Sat, as required and weight, height and blood pressure, as needed.
* Performs diagnostic testing: EKG, point of care testing, as needed.
* Administration of medications and immunizations at the direction of the physician.
* Initiate medication reconciliation as well as need for prescription refills for Provider review and approval.
* Nurses will conduct an assessment on all new patients and, current patients, as applicable, to include: Chief Complaint; Review current medications; Allergies; Pain Assessment.
* Allergy: Supervise and/or complete room set up including allergens; syringes; reorder supplies and medications/allergens, patient education includes pre-allergen testing requirements.  Nurse availability in the event of a medical emergency.
* Anticoagulation: Supervise Medical Office Assistants; notification of abnormal VS for assessment.
* Cardiology: Prior Authorization assistance, initiated by Patient Service Associate (PSA), when advanced clinical information is required.
* Dermatology: Assisting with procedures and medication administration; punch biopsies, assessment of common skin disorders.
* Endocrine: Medication administration; Point Of Care Testing; patient education on nutrition, glucometer use and insulin administration.
* Gastroenterology: Vaccine administration; patient education for lab work; AITU, TLC and HIV Rapid testing referrals; patient education for Colonoscopy; Endoscopy; Barium Enema; Gastrointestinal Series; CT Scan.
* Adult GU: Medication administration; assessment of indwelling catheters; skin assessment; patient education includes Cystoscopy; Prostate Biopsies; CT Scan; 24 hour urine collection; Fertility sperm collection.
* Hematology/Oncology: Assessment of disease progression; Chemotherapy treatments; obtain Prior Authorizations for testing/procedures; Assist with bone marrow biopsies.  Medication administration, referrals to AITU outpatient infusion therapy services.
* Medical Management: Supervise Medical Office Assistants (MOAs) and/or complete Vital signs and Finger stick monitoring; medication administration.
* Neurosurgery: Assists with Pain Management referrals.
* Adult Pulmonary: Medication administration; Confirmation of surgical procedure reservations as per protocol; Prior approval process (initiated by PSAs) for additional clinical information; Patient education including smoking cessation - NRT programs, exercise and observation/use of patient's portable O2 tanks.
* Adult Renal/Hypertension: Medical/surgical history assessments; lab prep and review; observation.
* Trauma Surgery: Room set up; Provider assistance as requested; pre and post op education.
* Vascular Surgery: Pre and post op education; dressing changes including Unna boot prep and Provider assistance, as requested.
* Support services to: Rheumatology/Lupus; Pediatric Developmental; Podiatry; Audiology; Dysplasia; ENT; Neurology; and Rehab ACC Clinics, as requested.
* Review care plan with patient (prescriptions, diagnosis, allergies) in conjunction with the Provider.
* Participates in interdisciplinary planning for patient care.
* All other duties as assigned.

Qualifications:

Education / Experience:

Internal & 1199 SEIU:

* Graduate of accredited nursing program(s).
* Bachelor's Degree in Nursing preferred.
* Minimum three (3) years' experience in outpatient clinics with adult population and one (1) year with pediatric populations.
* Phlebotomy experience preferred.

Non 1199 SEIU Candidates:

* Bachelor's Degree in Nursing (BSN) required.
* Master's Degree in Nursing, preferred. 
* Minimum three (3) years' experience in outpatient clinics with adult population and one (1) year with pediatric populations.
* Will Accept Associate's Degree with minimum five (5) years of clinical experience in outpatient clinics.
* Phlebotomy experience preferred.

New Graduates:

* Bachelor's Degree in Nursing (BSN) requ
			

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The Brookdale Hospital Medical Center