Clinic Nurse III

JOB DESCRIPTION

POSITION TITLE:

Clinic Nurse III

POSITION SUMMARY:

As a member of the primary care team in the nursing department, the Clinic Nurse III provides support for patients, medical providers, and other nurses. The desired candidate has a pleasant and welcoming personality, is a licensed nurse with 3 or more years of experience as a nurse and willing to learn new skills. The Clinic Nurse III may also specialize/Champion within the primary care clinic (e.g. pediatrics, Diabetes education, Office Based Addiction Treatment, Farmworker program, contraceptive care/SRH program, ordering and inventory of medical supplies/vaccine supply, 340b program, Quality or Care Management). This person will support CHCFC’s mission, vision, and values and contributes to a work environment that is caring, collaborative, and innovative.

REPORTS TO:

Lead Clinic Nurse

FLSA STATUS:

Non-exempt

PRIMARY RESPONSIBILITIES:

1. Clinic Nursing
   • Administers vaccines and clinic medications as directed by primary care provider for pediatric and adult patients.
   • Provides patient education on topics including, but not limited to proper use/storage of medications, healthy lifestyle for prevention of chronic disease and chronic disease management.
   • Provide contraception and pregnancy options as directed by the primary care provider or sexual and reproductive health director.
   • Coordinates in-clinic services between providers, the lab, MAs, and nurses, to assist with timely patient flow.
   • Understands and maintains standard precautions in all clinical activities, uses PPE appropriately.
   • Demonstrates teamwork and works to build cohesive, professional relationships with all CHCFC staff and patients.
   • Maintains current CPR certification.
   • Assists in emergencies as trained, calls for outside help as directed.
   • Conducts triage, including phone, EMR tasks, and in-person triage.
   • Schedules appointments for triaged patients, as appropriate.
   • Supports Vaccine Coordinator in inventory, ordering and storage & handling of state supplied vaccines
   • Participates in the ordering and maintaining of adult vaccines
   • Reviews incoming documents from specialists, updates the electronic medical record (EMR) as needed, and notifies the PCP of any urgent medical follow-up that may be required.
   • Documents all patient care appropriately in the EMR per health center protocols.
   • Communicates with outside resources/services in the community included, but not limited to: Dept of Children and Family Services, CHD, LifePath, CSO, DPH and other Specialty offices to ensure equitable and quality care.

1. Quality Improvement
   • Participates in quality improvement and quality assurance activities.
   • Acts as a Quality Champion for assigned measure(s), leads and participates in quality improvement objectives and activities.
   • Periodically reviews the health care quality measures for the assigned patient panel and works collaboratively with the primary care team to complete recommended health maintenance activities.

1. Maintains Clinic Cleanliness and Order
   • Maintains equipment in working order and notifies supervisor of broken equipment.
   • Informs person responsible for ordering supplies when stock is below PAR level.
   • Assists in weekly/monthly inventory, restocks, and rotations of stock to prevent expired stock/shortages.
   • Cleans and sanitizes exam rooms after use.

1. Provides phone and clerical support for general patient inquiries and tasks.
   • Assists with scheduling appointments for follow-up care as needed.
   • Clearly documents all phone calls, interactions with patients, and attempts to contact patients in a timely manner.
   • Coordinates care as directed via phone, patient portal, and/or letters as needed.
   • Responds to tasks from team members in a timely, professional manner.
   • Assists with the completion and faxing of forms and paperwork including, but not limited to: FMLA, disability, work/school excuse notes and other forms required for continuity of care

1. Conducts collaborative provider/nurse visits.
   • Works in collaboration with providers to assess patients’ basic health status, participates in analyzing and interpreting recorded data, and making informed judgments as to the specific elements of nursing care.
   • Conducts nurse-escalated visits under defined clinical protocols (see appendix A for comprehensive list). Nurse visits may include but are not limited to: suture/staple removal, pediatric and adult immunizations, ear flushes, cognition assessments, therapeutic injections, wound care, office based addiction treatment, blood pressure checks, INR visits, tuberculosis testing and interpretation, new patient initial visits, pregnancy tests/emergency contraception counseling and quick starts and diabetes education
   • Collaborates with providers and care managers in the planning and implementation of patient care plans and incorporating prescribed medical regimen in the plan of care.
   • Coordinates and plans out health teaching to maintain an optimal level of health care and evaluating outcomes of basic nursing interventions and initiates change to the care plan as needed in collaboration with providers and registered nurses.
   • Collaborates with other health center disciplines including, but not limited to: community health workers, behavioral health, Farmworker program, SRH program, Quality/Population health, insurance navigators and patient services to ensure equitable and specialized care
   • Coordinates follow up care for patients after a hospital discharge.
   • Analyzing and interpreting recorded data and make informed judgments.

1. Care Coordination: Transitions of Care
   • Conducts transitions of care according to CHCFC policies, including reviewing hospital or skilled nursing facility notes/discharge summaries, contacting hospitalists/discharge planners/specialists as needed to coordinate care, and contacting patients within the required timeframe to perform medication reconciliation and ensure that patient is medically stable and has follow-up appointments scheduled as needed with PCP and/or specialists. Documents transition of care activity per standard protocol and communicates with the primary care team.

1. Delegates to unlicensed personnel.
   • When appropriate, Clinic Nurse III may delegate nursing activities to unlicensed clinical staff (MA I – MA III).

1. Other specialty duties and competencies as assigned, if specializing.

• Evaluates/participates in creation and revision of workflows to improve patient care with the support of the lead clinic nurse
• Maintains VFC (Vaccine For Children) certification in compliance with DPH

1. Effectively communicates with patients and staff across departments.

1. Cross-coverage and attendance

• Provides cross-coverage during nursing colleagues’ time away from the office (including paid time off, scheduled, and unscheduled days off). In-person attendance including reassignment to other satellite sites as needed to maintain appropriate staffing.

1. Mentors and trains colleagues.

• Participates in student, MA I, MA II, and/or MA III, Nurse I, or Nurse II orientation.
• Acts as a role model in the clinical setting.
• Supports the new learner in developing triage skills including: phone, EMR tasks and in-person
• Supports new learner in navigating workflows and processes in the clinic
• Collaborates with supervisor and new learner to review the progress of the new learner toward meeting learning objectives.
• Helps create an environment conducive to learning. This includes a friendly environment for the new learner to ask questions and report and correct mistakes made.
• Demonstrates skills and “think out loud” for new learner to observe clinical process and problem solving.
• Assists Lead Clinic Nurse with assessment and sign off on competencies.

1. Attends and actively participates in health center medical team meetings and other staff meetings as required.

REQUIRED SKILLS, EDUCATION & EXPERIENCE:

Education: Successful completion of an accredited nursing program and active and unrestricted nurse license in Massachusetts. Proficiency in written and spoken English. Bi-lingual English/Spanish, English/Moldovan, or English/Russian a plus.

Experience: 3+ years of experience as a nurse, or 2+ years of experience as a Clinic Nurse II at CHCFC. Primary care office-based experience or community health experience preferred.

Skills:

• Exceptionally organized.
• Ability to work harmoniously with ethnically, culturally, racially, and gender diverse staff and patients.
• Ability to efficiently operate basic office equipment (multi-line phone, fax, photocopier)
• Ability to use Microsoft Office Suite (Word, Excel, and Outlook) and Internet.
• Understands and is familiar with medical terminology.

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to stand, walk, sit, use the hands to finger, handle or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; taste or smell. Must be able to lift and/or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus.

WORKING CONDITIONS:

While performing the required duties of this job, the employee is exposed to weather conditions prevalent when traveling between Health Center locations where medical care is provided. This position performs tasks that involve exposure to blood, body fluids or tissues.

This job description is subject to review in the light of changing circumstances and is not intended to be rigid and inflexible but should be regarded as providing guidelines within which the employee works. Performs other duties as assigned.

Clinic Nurse III.docx