Ambulatory Care Nurse

We have an exciting opportunity to join our team as a Ambulatory Care Nurse - **Rego Park**.

In this role, the successful candidate will support the coordination, integration, communication, implementation and evaluation of nursing practice and clinical policies and procedures. In this role, the Ambulatory Care Nurse will participate in site and organizational quality and performance improvement activities, collect patient healthcare data systematically using appropriate assessment techniques and instruments, and collaborate with licensed providers to develop patient centered plans of care that prescribe interventions to attain expected outcomes. The Ambulatory Care Nurse provides comprehensive care in support of all patients manifested requirements through: administration of treatments and medication, acting as a sentinel for untoward events or symptoms, disease prevention guidance, rehabilitation care, public health care, and supportive care for symptom relief including health teaching and health counseling.

Job Responsibilities:

Specific activities include, but are not limited to:

• Performs physical examinations and diagnostic tests

• Collects patient health history

• Records information in electronic health record

• Provides information, counsel, and education to patients and families regarding test results and treatment plans as directed

• Administers medications (including vaccination, IV therapy, oxygen administration), provides comprehensive wound care, and performs phone and in-person patient triage for clinical concerns.

• Assesses and monitors patient responses to various treatments, procedures, and anesthesia.

• Assesses and interprets patient information, making treatment decisions as appropriate

• Consults with clinical supervisors and licensed providers to determine best treatment plans for patients

• Directs, supervises, and delegates to licensed practical nurses, medical assistants and technicians as needed to support patient flow and efficiency

• Performs other duties as needed

Clinical Responsibilities

• Supports the coordination, integration, communication, implementation and performance evaluation of nursing practice and clinical policies and procedures

• Ensures clinical compliance with Patient Safety initiatives and reporting

• Supports key quality initiatives ( MIPS, Care gap management) to impact clinical outcome measures.

• Demonstrates knowledge of the NYULH Service Standards and incorporates into the performance of responsibilities.

• Participates in designated activities related to NYULH clinical standards and regulations of relevant outside agencies.

• Supports the missions, philosophy, standards, goals and objectives of NYULH, Departments of Nursing, and FPG

• Participates in coordination of on-site activities to provide patient care in a healing, humane and caring environment.

• Collaborates with members of the interdisciplinary team and promotes collegial relationships.

• Serves as a support and resource for nursing, other clinical staff and providers

• Participates in clinical inquiry and activities to foster evidence-based practice.

• Embraces fundamental values and obligations beyond that of a private citizen including ethical obligations and a recognition of patients' rights to confidentiality. (NYSED, 2009)

• Provides emergency care in accordance with organizational policy

• Functions as a respectful member of the health care team.
• Delegates and oversees specific nursing interventions to implement patient care plans to members of the health care team as deemed appropriate by job description and license/certification.

Professional

• Engages in self-assessment and participates in activities to promote own professional growth and development

• Seeks, acquires and maintains current nursing knowledge and competence to fulfill responsibilities as FGP Ambulatory Nurse.

• Procures and applies new knowledge related to medical treatment and technology

• Utilizes resources to meet individual learning needs and promote professional development in clinical practice.

• Maintains awareness of current patient centered, evidence-based practice and considers applicable research data to patient care delivery

• Acts as a mentor to peers and colleagues

• Fulfills obligation to identify and report professional misconduct appropriately

Implementation / Provision of Care

• Executes medical regimens as prescribed by licensed providers: (physicians, dentists, nurse practitioners, certified midwife, physician assistants, podiatrists)

• Assessment: Assess patients, identify unmet patient needs and plan comprehensive care to meet those needs in relation to the patient's illness, condition or disability.

• Case-finding: Identify unidentified co-morbidities or emergent complications and report to the provider so that an intervention may be ordered.

• Co-ordination: Integrate care with other health care providers such as respiratory therapists, physical therapists, social workers, physicians, nurse practitioners, dieticians, navigators, and discharge planners.

• Provision of direct care services: Provides physical care in the entire patient's manifested requirements including but not limited to administration of treatments and medication, acting as a sentinel for untoward events or symptoms, disease prevention guidance, rehabilitation care, public health care, and supportive care for symptom relief including health teaching and health counseling.

TASK/PROCEDURE

• Collects and documents patient clinical historical and assessment data.

• Performs onsite testing, POC lab testing, EKG, specimen collection (including phlebotomy), auditory & visual test, psychiatric & physical risk screening, fetal monitoring (ante partum) and non-stress test, spirometry, allergy skin testing, bladder, tb skin testing and result evaluation.

• Performs medical and nursing treatments in accordance with plan of care, provider orders, and NYSBON scope of practice.

• Perform procedures, hot & cold applications, placement/ removal of orthopedic appliances, casts, splints, suture and staple removal, urinary bladder irrigation w/ and w/o chemotherapy, insertion/removal/catheter care of urinary catheter, ear irrigation.

• Applies and removes dressings, and performs wound care 

• Assists with Minor and Major Procedures

• Performs patient monitoring including pre, intra, post procedure, testing, medication administration, medical/surgical treatment and/or sedation

• Provides medication administration: (IM, PO, SQ, ID, IV topical, inhalation, ocular, vaginal, rectal) as per provider orders or protocols to patients in practice, following nursing rights of medication administration and organizational policies. This includes oxygen therapy.

• Facilitates medication refills by reviewing clinical information and preparing order for provider (prospective) authorization in EMR.

• Administers IV therapy: including blood, blood products, IV fluids, chemotherapy (with proper certification), IV medications via peripheral or central venous devices.

• Starts and discontinues peripheral IV lines.

• Maintains peripheral and central IV lines and manages complications with appropriate certification

Communication and Message Management

• Ensures clinical in-baskets are managed and encounters closed in a timely manner.

• Receives, documents, and reports critical lab values as indicated

• Relays normal and abnormal clinical results, follow up, and explanation to patients, as directed by provider. 

• Performs preliminary review of results for prioritization of urgent findings, then notifies provider for final verification.

• Performs in person and phone triage for patient clinical concerns with appropriate escalation; provides clinical advice as within RN scope and/or direction from provider.

• Performs Care/Case management of a defined population via multi-disciplinary plan to coordinate/facilitate patient care as needed.

Health Promotion & Education

• Identifies, through case-finding and critical analysis, patient, family and/or community deviations from health and wellbeing; advocates for, initiates and/or recommends appropriate actions including the establishment of safe environments.

• Collects patient healthcare data systematically and continuously, using appropriate assessment techniques and instruments.

• Analyzes assessment data to determine health status and nursing diagnoses

• Reports deviations requiring medical diagnosis and/or treatment to provider.

• Escalates urgent/emergent deviations to medical provider and/or emergency care.

• Identifies expected outcomes and anticipates unexpected or adverse outcomes as individualized to the patient.

• Considers needs and behaviors of specific patient age and cultural groups in all patient care activities.

• Assesses patient's ability to adapt to new situations and circumstances created by changes in health status and/or environment.

• Identifies barriers to optimal care, physical, cognitive, language, literacy, socioeconomic, cultural, and or behavioral

• Assesses & identifies learning needs; documents and updates accordingly.

• Develops patient centered plans of care that prescribe interventions to attain expected outcomes, and partners with patients to set individualized goals

• Educates patients and families to facilitate and promote healthy adjustment to new or changed health patterns.

• Implements interventions identified in the plan of care.

• Evaluates patient progress toward attainment of expected outcomes.

Patient Experience

Serves as NYU Langone Health Faculty Group Practice Brand Ambassador by upholding the NYULH Mission, vision and values and promoting excellence in the patient experience, during every encounter.

• Drives consistency in every patient and colleague encounter by embodying the core principles of our FGP Service Strategy CARES (Connect, Align, Respond, Ensure, and Sign-Off)

• Greets patients warmly and professionally, stating name and role, and clearly communicates each step of the care/interaction as appropriate

• Works collaboratively with colleagues and site management to ensure a positive experience and timely resolution for all patient interactions and inquiries whether in person, by phone or via electronic messaging.

• Proactively anticipates patient needs, and participates in service recovery by applying the LEARN model (Listen, Empathize, Apologize, Resolve, Notify), and escalates to leadership as appropriate.

• Shares ideas or any observed areas of opportunity, to improve patient experience and patient access, with appropriate leadership. ( ways to optimize provider schedules, how to minimize delays, increase employee engagement, etc.)

• Partners with Patient Access Center and Central Billing Office team members to support collaboration and promote a positive patient experience.

• Takes a proactive approach in ensuring that practice staff are fully versed in the Access Agreement gold standard principles.

Minimum Qualifications:
To qualify you must have a A Baccalaureate degree in Nursing is highly preferred; a Diploma or Associates Degree in Nursing requires a minimum of one year experience in conjunction with plans to earn a baccalaureate degree required. Current Registered Professional Nurse in New York licensure is required. BCL is also required. Emergency room or critical care nursing experience and membership in pertinent professional organizations preferred. Membership in pertinent professional organization preferred. Fluent written and spoken English language skills necessary. Physical stamina, manual dexterity, visual and aural acuity to perform responsibilities needed also required..

Required Licenses: Registered Nurse License-NYS, Basic Life Support Cert

Preferred Qualifications:
ACLS certification.

Qualified candidates must be able to effectively communicate with all levels of the organization.

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