RN, Triage Nurse

JOB TITLE: Triage Nurse, RN FLSA STATUS: Exempt DEPARTMENT: Medical Services SUPERVISED BY: Nurse Manager

I. POSITION FUNCTION SUMMARY

Under the general direction of the Nurse Manager, has primary responsibility for supervising clinical duties within the nursing area and for coordinating and communicating activities between the medical support staff, medical providers, and front office staff, ensuring the delivery of quality patient care in a responsive and caring environment.

II. ESSENTIAL DUTIES AND RESPONSIBILITIES

This position may have various work assignments within HICHC. This description is intended to be generic in nature, and as such it does not detail all of the duties and responsibilities of a particular job assignment.

Triage Duties
• Works with the Nurse Manager, Director of Nursing (DON), Medical Director, medical providers, and support staff to ensure there is an integrated healthcare delivery system at HICHC that is efficient, effective, and timely with appropriate response to patient and community needs.
• In consultation with Nurse Manager and DON, plans and oversees health service delivery, makes assignments, supervises and evaluates quality of care delivered; provides leadership for quality improvement efforts in primary care delivery.
• Screens and responds to patient phone calls and walk in patients, directing to Primary Care Provider as needed. Assigns a triage priority based on observations and available information. Initiates appropriate follow up.
• Accurately documents the encounter with the patient in the EHR system. Documents all medical questions and messages for providers and labels them properly using our clinical guidelines/protocols.
• In conjunction with nurse manager, procurement and facilities to ensure the safety and functionality of clinical systems by coordinating maintenance and repair of all medical and nursing equipment.
• In conjunction with the Director of Clinical Operations and Nurse Manager, maintains compliance with State licensure by enforcing Quality Assurance protocol adherence in the laboratory, medical supply, and nursing/patient care areas of the clinic.
• In conjunction with the Nurse Manager ensures compliance with vaccine program requirements including training, documentation, vaccine supply storage and handling as well as safe, effective vaccine administration by clinical staff.
• Completes other projects and duties as assigned and attends all required meetings.

Clinical Nursing Duties
• Follows Nursing Practice Standards to evaluate patient needs and formulate and implement an appropriate nursing care plan to include physiological, psychosocial, and environmental factors. Revises plan of care based on ongoing assessments as needed with any new data or changes in patient condition.
• Documents nursing assessment and patient care provided, including nursing intervention, patient response to care provided, patient needs, problems, capabilities, limitations, and progress toward goals. Documentation includes evidence of appropriate patient, family, and significant other teaching, and the understanding of these instructions is noted in record.
• Communicates with the medical provider regarding patient needs, nursing assessments, interventions, and patient education in a timely manner.
• Educates patients by disseminating patient information and literature relating to health education programs including but not limited to discharge planning, family planning, pre-natal care, and health promotion/disease prevention for all age categories.
• Performs direct patient care, utilizing established procedures, policies, and standards as evidenced by client/staff feedback and physician observation.

o Assesses patient, collects and documents the patient’s current health status and medical history. Make accurate initial and ongoing nursing assessments and respond appropriately. This may occur in person at scheduled appointments, walk-in visits and via telephone triage calls.

o Observes and documents patient's response to pertinent medications and interventions.

o Demonstrates ability and appropriate technical skills when administering medications, IV’s, medical/nursing treatments and procedures in accordance with medical provider's orders, standing operating procedures and HICHC policies.

o Demonstrates necessary skills and knowledge to provide care for patients of all ages according to policy and procedure and primary care nursing competencies.

o Demonstrates ability to handle emergencies in a prompt, precise, professional manner per nursing training and HICHC protocol.

o Performs personal patient care in a manner to provide comfort and well-being to the patient, acknowledging physiological and psychological needs.
• Provides support for clinical activities by acknowledging, adhering to, and implementing organizational, nursing and medical policies and standard operating procedures.
• Performs clinical case management as needed by contacting, teaching, and following protocol for patients with abnormal laboratory or imaging results or by providing assistance with maintaining sufficient medication or medical supplies.

III. POSITION SPECIFICATIONS

Requirements of Position

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the education, experience, knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and Experience
• High School graduate or GED certificate and completion of an accredited RN program.
• Degree in Nursing (RN) required.
• Preferred experience in a community health center and working within a managed care environment.
• Must possess sufficient prior work experience in progressively responsible positions during which the skills and abilities to perform all the essential functions have been amply demonstrated at a consistently competent level.

Licenses and Certifications
• Current RN Nursing license for the State of Hawai'i is required, and documentation of education, experience and licensure is required and must be maintained; incumbent must be insurable under the policies and requirements of HICHC.
• Current BLS certification is required and must be maintained.

Knowledge, Skills and Abilities

The Triage Nurse must be familiar with the community health care field and must have a sound understanding of and ability to apply leadership and management principles and methods. Additional knowledge and skills important to this position include but are not limited to:
• Demonstrates knowledge of the principles of growth and development over the life span and incorporate them in their plan of care and health education.
• Supervisory skills and knowledge of clinical management techniques regarding various clinical functions (i.e. JCAHO, OSHA, lab, pharmacy, and infection control) and familiarity with state and federal laws and regulations f or the operation of nursing services is essential.
• Interpersonal relations and customer service skills; facilitating interdepartmental, inter-clinical operations.
• Knowledge of the applicable administrative standards, rules and regulations.
• Good organizational and self-management skills, including time management, document handling and management, etc.
• Working knowledge of computer systems including but not limited to word processing, spreadsheet, database, and electronic communication software applications.

Language Skills
• Ability to read and interpret documents such as patient records, operating and maintenance instructions, procedure manuals, etc.
• Ability to write at an above average level of competence, including internal reports and memoranda.
• Ability to communicate with diverse groups of people to include staff and providers and patients.
• Ability to communicate effectively with patients and their families to make their visit a pleasant experience.
• Sensitivity to the multicultural nature of the service area population and may be required to communicate in another language.

Physical Requirements
• Ability to stand and walk for extensive periods of time.
• Manual and finger dexterity and eye-hand coordination to provide nursing care and operating equipment.
• Ability to lift up to 50 pounds.
• Ability to stoop, squat, or bend frequently.
• Corrected vision and hearing within normal range to observe and communicate with patients and professional staff.
• Exposure to patient elements including communicable disease and bloodborne pathogens.
• Exposure to toxic substances, ionizing radiation, medicinal preparations, and other common hazards of a healthcare clinic.

Personal Characteristics

Personal characteristics include: being a team player, self-starter working well with minimal supervision, high integrity, good personal habits, regular work attendance, courteous and friendly, able to work well with diverse groups of people, organization of multiple tasks and projects, and gain and maintain respect of others, both inside and outside HICHC and the communities it serves.

Confidential and Sensitive Information

Because the employee has access to personal and professional data regarding individual employees and their families, personal data regarding individual patients and the families, and/or sensitive company financial data, an essential job result is the maintenance of a high level of confidentiality of the information processed by the employee. Violation of this confidence may result in disciplinary action, including termination of employment.

IV. PHYSICAL CHARACTERISTICS/WORKING CONDITIONS

General Remarks: The work environment described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential tasks and functions.

Environment: The noise level in the work environment is usually moderate. There are no known environmental hazards on the premises. Work environment is often stressful. Work is mostly inside, and normal office worker safety precautions and practices are required. Incumbent will be exposed to patients' conditions and some-unpleasant sights, smells and contagious diseases including virus, disease

and infection from patients and specimens in working environment. All employees are offered the opportunity to receive the Hepatitis B vaccination series.

OSHA: This position performs tasks that involve exposure to blood, body fluids, or tissues; normal medical safety precautions and practices are required

Work Hours: This position is exempt under the provisions of the Fair labor Standards Act (FLSA) and is not subject to the policies and procedures pertaining to overtime hours and premium pay. The foregoing position description is not all-inclusive of the duties that may be assigned to the employee. In order to ensure maximum flexibility and efficiency and to encourage cross training, employees will be assigned additional duties as deemed necessary or desirable by HICHC.

Mental Demands: Duties require attention to detail, alertness, problem solving, tolerance to stress and exercising sound judgment. Duties require high tolerance and adequate coping skills for dealing with loss, grief and bereavement. Good stress reduction and management skills are essential.

V. REMARKS

The foregoing position description is not all-inclusive of the duties that may be assigned to the employee. To ensure maximum flexibility and efficiency and to encourage cross training, employees will be assigned additional duties as deemed necessary or desirable by HICHC.