Staff Nurse

4 weeks ago

New York, United States NYC Health + Hospitals Full time

**About NYC Health + Hospitals**:
NYC Health + Hospitals/Gotham Health is one of the largest Federally Qualified Health Center (FQHC) in the country, providing coordinated world-class primary and specialty care with dignity and respect for all New Yorkers, without exception. At Gotham Health, we practice a person-centered caring culture that values delivering compassionate, quality healthcare in partnership with our patients, community organizations, and staff. Gotham Health is focused on high-quality, affordable care to everyone regardless of ability to pay or immigration status. Gotham Health serves the community through a two-pronged approach: providing treatment to those who need it while at the same time emphasizing prevention. We strive to deliver services in a way that maximizes each patient's opportunity to achieve successful health outcomes, we believe in every person's right to participate in their care plans, we facilitate partnerships with other community resources to meet the needs of our patients beyond healthcare, and we celebrate and recognize the compassionate care of our committed staff. Join our team if you want to be part of our Gotham Health Family, a person-centered, fully integrated, and innovative ambulatory care network that enables all New Yorkers to live their healthiest lives.

**PURPOSE OF POSITION**

The Registered Nurse will provide professional nursing care including diagnosing and treating human responses to actual and potential health problems through case finding, health teaching, counseling and the provision of care supportive of or restorative to life and well-being in accordance with their scope of practice.

**Summary of Duties and Responsibilities**

**Assessment**
- Completes patient assessment according to established guidelines.
- Identifies patient problems and barriers to providing optimal care (e.g., language, culture, and behavioral health issues) and incorporates patient’s perception of illness.
- Prioritizes the data and information collected based on the patient’s condition and preferences, situation, and/or anticipated needs.

**Diagnosis**
- Formulates nursing diagnosis based on identification data.
- Identifies the nursing diagnosis, actual or potential based on the analysis of assessment data and information, current ambulatory care RN knowledge, and evidence-based practice.

**Outcomes Identification**
- Involves the patient, family, and health care team in establishing goals/outcomes that are realistic/measurable/mutually set and expected.
- Defines expected outcomes in terms of the patient values, preferences, spiritual, emotional, cultural and ethical considerations, age-related issues, and situational environment.
- Specifies a time estimate for attainment of measurable expected outcomes.

**Planning**
- As a member of the health care team, participates in pre-visit planning, daily clinical huddles, and other activities to meet Patient Centered Medical Home Standards.
- Identifies Care Gaps and works with the team to close gaps through proactive outreach, patient education, referrals, and needed services.
- Develops an individualized ambulatory nursing plan for patients seeking care for health promotion, health maintenance, or health-related situational problems.
- Considers patient or population needs in terms of age, gender, race, cultural values and practices, ethical and legal considerations, physiological, psychological, and environmental factors, and the anticipated risks and benefits of interventions for individualized plan development.
- Incorporates a timeline for ambulatory care nursing plan implementation and goal achievement, reevaluation or reassessment, follow-up care, and care coordination as appropriate.
- Provides a plan of care that is clear and understandable to patient, family, and/or caregivers.

**Implementation**
- Develops and implements an individualized teaching plan based on the patient’s preferences, resources, motivation, and anticipated needs.
- Utilizes evidence-based, ambulatory care-specific interventions to achieve agreed upon outcomes during clinical visits, nurse visits, telephone encounters, and electronic communications.
- Provides culturally sensitive care to patients and families in collaboration with other health team members.
- Assists with diagnostic tests and procedures within scope of practice and facility policy.
- Communicates and documents pertinent information to the health care team.
- Adheres to standard work flows and completes EPIC work queues as identified.

**Coordination of Care**
- Applies effective teamwork and collaboration skills to overcome identified barriers to produce quality and effective patient outcomes.
- Utilizes an interprofessional approach to engage patient, caregivers, and providers in implementing and coordinating the plan of care across care settings.
- Manages high-risk individuals and/or population(s) with the aim of preventing or delaying adverse

outcomes, utilizing

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