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Community Health Nurse Specialist

2 months ago

Bronx, New York, United States NYC Health Hospitals Full time
Job Title: Community Health Nurse

NYC Health + Hospitals is seeking a skilled Community Health Nurse to join our team. As a Community Health Nurse, you will play a vital role in providing high-quality care to patients in their homes, communities, and other settings.

Job Summary:

The Community Health Nurse will assess, plan, implement, and evaluate patient care plans, providing direct skilled nursing care and observing and instructing patients in their place of residence. The ideal candidate will have a strong background in nursing, excellent communication skills, and the ability to work independently in a fast-paced environment.

Responsibilities:
  1. Provides individualized skilled nursing care to patients requiring part-time intermittent professional nursing service through the use of the nursing process.
  2. Assesses patient needs and develops a plan of treatment and care with ongoing evaluation of patient/family needs for other services.
  3. Provides professional nursing services as outlined in the patient's plan of treatment and authorized by the patient's physician, and provides emergency treatment as needed.
  4. Records physical, social, psychosocial, and environmental needs of the patient.
  5. Provides ongoing monitoring of the patient in the home care setting and escalates any clinical changes to the physician or non-physician provider as needed.
  6. Utilizes input from the patient, caregiver, MD, and peers to devise a nursing care plan that is feasible within the physical, financial, and emotional resources of the patient/caregiver and the Department of Health.
  7. Evaluates patient response to plan of care as necessary, consistent with physician's orders.
  8. Reviews and revises plan of care as necessary, consistent with physician's orders.
  9. Plans activities necessary for effectuating the timely discharge/transfer of the patient and notifies all appropriate parties, including the patient's physician.
  10. Authorizes and coordinates all services, including nursing, rehab, respiratory therapy, nutritional services, equipment, professional, and non-professional staffing, and support services.
  11. Collaborates with Accountable Care Managers and other disciplines regarding the patient's progress, plan of care, and discharge plans.
  12. Demonstrates a professional attitude and ethical conduct in compliance with departmental standards.
  13. Involves the patient and caregiver actively in goal setting.
  14. Establishes and maintains a cooperative, effective working relationship with the staff, MDs, Case Managers, and other hospital personnel, outside vendors, agencies, and the community.
  15. Attends weekly to bi-monthly team meetings and participates in case conferences and case load reviews on a weekly to bi-weekly basis.
  16. Completes physician orders in a timely manner.
  17. Completes admission paperwork, including physician and nursing POCs, within 48 hours of visit encounter.
  18. Reviews clinical records to ensure compliance with departmental and regulatory standards.
  19. Obtains written orders for all verbal orders returned.
  20. Writes clean and concise progress notes that reflect the implementation of the plan of care and the patient's response to that plan of care.
  21. Maintains up-to-date patient files with complete records, including care plans and re-certifications, reports of all services rendered, progress notes, and discharge summaries.
  22. Competent in knowledge of patient teaching plans and interventions.
  23. Competent in knowledge of safe administration and teaching.
  24. Demonstrates safety and accuracy in performing treatments and procedures according to the Home Care Department standards of care/practice.
  25. Competent to complete thorough and accurate nursing assessments.
  26. Demonstrate competence in skilled nursing interventions.
  27. Competent in knowledge of documentation requirements for Home Care.
  28. Participates in case conferences and/or Interdisciplinary Team conferences as needed and as designated by the Clinical Manager.
  29. Works with other members of the Interdisciplinary Team (IDT) to develop appropriate interventions in order to achieve clinical and functional goals.
  30. Participates in the agency's Quality Assurance Performance Improvement/PIP as assigned.
  31. Supervises and monitors the care given by home health aides and ensures proper.
  32. Participates in an interdisciplinary health care team in determining and implementing a comprehensive plan of care.
  33. Participates in the coordination of other professional and para-professional services in the home and provides supervision as needed.
  34. Provides patient/family/significant other/patient-identified representatives with teaching and involves them in assessment activities.
  35. Maintains current, complete, and appropriate documentation in the patient care record. May be required to use computer systems in carrying out these functions.
  36. Duties include but may not be limited to wound care, including NPWT/VAC, Peg/Trach Care Management, Foley insertion and catheter care management, JP/PleuRx Drain care, administering injections.
  37. Provides teaching on disease and medication management.
  38. Obtains photographs for consultation by wound specialists.
  39. Ability to apply evidence-based practices to the home care setting.
  40. And other duties as ordered/prescribed.

Minimum Qualifications:

  1. A valid New York State license and current registration to practice as a Registered Professional Nurse in New York State.
  2. Holds, or obtains through facility orientation, a valid and current certification in Basic Life Support (BLS) through the American Heart Association (AHA).
  3. One (1) year of experience as a registered nurse.
  4. Ability to travel regularly to patient/client assignments across New York City via public transportation and/or private vehicle.
  5. Demonstrated commitment to continued professional development.

Department Preferences:

  1. CERTIFICATION(S)/LICENSE(S): Licensed and currently registered to practice as a professional nurse in New York State; and Current certification in Basic Life Support procedures including
  2. CPREDUCATIONAL LEVEL: Baccalaureate Degree in Nursing from an approved program preferred
  3. YEARS OF EXPERIENCE: Minimum two (2) years of full-time nursing experience At least 2 years of experience in Homecare, Long-term Care, or Hospital setting
  4. KNOWLEDGEABLE IN: Demonstrated knowledge regarding Federal, State and local regulations and JCAHO standards for Home Care. Excellent verbal, written, organizational and analytical skills. Demonstrated competence as a registered nurse in patient assessments and critical thinking skills Previous experience using various computer software applications: i.e., Word, Excel, Access, etc.
  5. EQUIPMENT/MACHINES OPERATED: Smart phone * Laptop Computer * Scale * Nursing BagCOMPUTER PROGRAMS/SOFTWARE OPERATED: EPIC H2O Hyperspace EPIC H2O Remote Client Microsoft Office (Word, Excel, PowerPoint, Visio, OneNote)