RN - Ambulatory BFCC / Pediatric Specialty Clinics

Job Title

Assumes responsibility and accountability for patient screenings; triage; pain management; falls prevention, nutritional and psychosocial, discharge planning and other interventions to restore, maintain or promote patients' physical health. Utilizes the nursing process in the provision of direct patient care. Assists all patients, families/significant others through the healthcare system by acting as a patient advocate and navigator. Responsible and accountable for prescribing, delegating, and coordinating all care provided to assigned patients. Executes medical plan of care, at the direction of the treating clinician, in accordance with licensure of a Registered Professional Nurse. Utilizes nursing diagnoses to treat human responses to actual and potential health problems through such services as case finding, health teaching, health counseling, and provision of care supportive or to restorative of life and well-being. Supervises patient care provided by Licensed Practical Nurses (LPN), Medical Office Assistants (MOAs), Nursing Attendants (NAs), technicians, and supplemental staff. Supports patients' self-management of disease and behavior modification interventions. Coordinates continuity of patient care with external healthcare organizations and facilities, including the process from admission to discharge and referrals from the primary care provider to the specialty care provider. Promotes clear communication amongst a care team and treating clinicians by ensuring awareness regarding a patient's plan of care. Participates on a team for data collection, health outcomes reporting, clinical audits, and programmatic evaluation related to Patient-Centered Medical Home and ambulatory care initiatives. Assists in the prior authorization process for clinical and pharmacy related orders. Demonstrates the ability to function as part of an interdisciplinary health care team.

Responsibilities

Assesses the immediate and continuing care needs of the patient/families/significant other.

Develops comprehensive and current plans of care which include physical needs, patient teaching, discharge planning and psychosocial/spiritual needs.

Provides direct patient care based on assessed needs and the medical regimen. Oversees and ensures the provision of all aspects of care for the patient. Supervises the care provided by other nursing personnel including Licensed Practical Nurses (LPN), Medical Office Assistants (MOAs) and Nursing Attendants (NAs), as defined in the scope of practice.

Participates in Quality Improvement activities related to patient care delivery and the development of nursing/hospital/ambulatory care standards.

Recalls patients for abnormal results and/or follow-ups as requested by Provider. Documents all attempts via telephone and correspondence.

Establishes priorities for care in collaboration with the multidisciplinary team and initiates follow-up, as indicated, to ensure timely provision of patient care and therapeutic modalities.

Observes, evaluates, documents, and communicates to relevant team members the patient's response to illness and/or therapeutic modalities as related to diagnosis. Ensures timely reassessment of patient responses to treatment and when significant changes occur in patient condition and/or diagnosis.

Participates in Patient Centered Medical Home Model including conducting daily briefings and huddles, as required.

Provides Patient and Family education, as needed.

Daily, weekly and monthly checks of all logs including refrigerators, medications, testing equipment as per established protocols.

Coordinates the overall plan of care to ensure implementation of nursing interventions and consistency with medical regimen.

Assures the plan of care integrates age-specific care needs (e.g. pediatrics, geriatrics) as defined in the unit scope of care.

Accepts responsibility and accountability for nursing interventions and outcomes based on professional clinical judgments.

Demonstrated ability to communicate effectively, manage stressful situations appropriately and facilitate interpersonal relationships with other disciplines.

Ensures that patients receive timely and appropriate care within the delivery system and assists with facilitating internal and external referrals.

Communicates with pharmacies as well as insurance companies related to patient treatment plans and approvals of medications and/or procedures/Diagnostic Imaging.

Collaborates with medical providers in identifying patient's educational needs and provides resources to meet these needs.

Performs vital signs: T-P-R, O2 Sat, as required and weight, height and blood pressure, as needed.

Performs diagnostic testing: EKG, point of care testing, as needed.

Administration of medications and immunizations at the direction of the physician.

Orders all vaccines, including Vaccines for Children Program and documenting pediatric immunizations in City wide Immunization Registry.

Collects various screening information including: Falls, Nutritional, Psychosocial and Pain Assessments, as required and documents findings.

Assumes role of patient advocate and conforms to policies and regulations governing patient rights, confidentiality and the HIPAA Privacy & Security Rules.

Participates in Performance Improvement/Quality Assurance activities and demonstrates initiative in identifying and communicating performance improvement/quality assurance problems and issues.

Participates in appropriate professional and community organization activities.

Obtaining prior authorizations for (this list is not all inclusive): MRI, CAT Scans, EMG, Video Ambulatory and Ambulatory EEGs, medications, diagnostic testing and procedures, as applicable to insurance carriers. Includes review of Provider documentation to ensure tests/procedures are included for insurance purposes.

Ensure lab testing has been ordered as per specialty clinic guidelines, i.e., every visit or every quarter including Genetic testing, Specialized Hematology, Renal and Gastroenterology services

Schedule external appointments for (this list is not all inclusive): Early Intervention; PT/OT; Neurosurgery; Pediatric services: Orthopedics, Eye, Genetics and Psychiatry, as applicable.

Establish routine communication with foster care agencies/Nursing staff; ACS; School Nursing, Psychiatry and Social Work staff, internal and external resources.

Completion of school, foster care agency and early intervention forms are completed in a timely manner.

All other duties as assigned.

Qualifications

Internal & 1199 SEIU:

• Graduate of accredited nursing program(s).
• Bachelor's Degree in Nursing preferred.
• Minimum three (3) years' experience in outpatient clinics with adult population and one (1) year with pediatric populations.
• Phlebotomy experience preferred.

Non 1199 SEIU Candidates:

• Bachelor's Degree in Nursing (BSN) required.
• Master's Degree in Nursing, preferred.
• Minimum three (3) years' experience in outpatient clinics with adult population and one (1) year with pediatric populations.
• Will Accept Associate's Degree with minimum five (5) years of clinical experience in outpatient clinics.
• Phlebotomy experience preferred.

New Graduates:

• Bachelor's Degree in Nursing (BSN) required.
• All required certifications within six (6) months of hire.
• Phlebotomy experience preferred.

Knowledge and Skills:

• Demonstrates a commitment to continuing professional growth and development.
• Critical thinking, math, and computer skills Excel & Word.
• Works as a team player.
• Demonstrates respect and professionalism in all interactions.
• Excellent oral and communication skills.
• Decision making and problem solving.
• Able to see, hear, read and write English.
• Ability to fully utilize BHMC's electronic record systems, equipment and healthcare and billing systems relevant to this position.

Licenses, Certifications:

• Current NY State RN License required.
• Basic Life Support (BLS) required.
• Advanced Cardiovascular Life Support (ACLS) required.
• Pediatric Advanced Life Support (PALS) required.
• Certified Pediatric Nurse (CPN) preferred.
• Medical Surgical Certification required.

Physical Requirements:

• Physically demanding, high-stress environment requiring prolonged periods of standing, reaching, walking throughout the working day.
• Position will be required to stoop, bend, lift, and carry items weighing up to 35 pounds for routine performance of essential functions.
• An individual in this position may be exposed to: Adverse indoor environmental conditions, Blood borne pathogens, Blood and body fluids, Physical hazards (e.g., needle pricks, etc.), communicable diseases, chemical hazards, radiation, and repetitive motions.
• Full range of body motion, able to lift up to 100 pounds, if necessary, to assist lifting and moving patients.
• Manual and finger dexterity, as well as hand and eye coordination.
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