LPN/RN Acute, (AM) Crisis Center

Overview

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The Behavioral Health Crisis Center is strategically placed in Mobile County with easy access for the area with the highest need and the most frequent use, the midtown/downtown area of Mobile. This Crisis Center operates a 24/7/365 with a full complement of staff to provide crisis de-escalation and resolution no matter the time or the day.

A study of mental health related law enforcement calls shows that, as one of Alabama’s largest cities, Mobile has the highest demand for police and EMS within the I-65/I-165 corridor. Stationing the Diversion Center in this area will allow expeditious access from Baldwin, Washington, Clarke, Monroe, Conecuh, and Escambia Counties, which will also utilize the Diversion Center. Mobile Metro Jail is the second largest jail in Alabama. The annual number of individuals booked into the jail is just under 20,000. Since the Stepping Up Initiative began last year, all inmates are screened for mental illness and substance use disorders. Last year 6,828 individuals screened positive for serious mental illness. This is a serious over-representation of mentally ill individuals per capita when compared to statistics for the general population. Most individuals with mental illness or substance use disorders are arrested for petty crimes. These individuals could be diverted from arrest with the addition of more Mobile Crisis response and a Behavioral Health Crisis Center. Based on data collected from Crisis Response Team calls, Access to Care, law enforcement, local emergency departments, and a Community Health Needs Assessments, the size and structure of the Crisis Center must consist of a large living room model staffed by peer specialists, an 18 recliner temporary observation unit, and a 6 bed extended observation unit.

Responsibilities

Clinical responsibilities

• Completes timely admissions according to diversion center policy and procedure while ensuring customer service as a priority for staff and consumers in relations to admissions flow, referral source contact, consumer care and support.
• Ensures needs are met for the consumer, the referral source, the physicians, and the facility.
• Evaluates needs and reports pertinent information gathered from admission to physician, nurses, and social workers as needed.
• Completes the discharge process for consumers according to policy and procedure for nurses on units.
• Plans, conducts and documents patient education provided to consumers, both individually and in group settings.
• Provides education to the consumer and family concerning treatment plans, compliance with medications and its side effects, disease management and other applicable topics.
• Completes medical and dietary consultations as needed.
• Communicates effectively with the physician and outside agencies as applicable regarding the consumer’s physical and mental condition
• Initiates and implements the multidisciplinary treatment plan, coordinates with the multidisciplinary team and participates in the plan’s continued development.
• Provides emergency care as needed (CPR, Mindset, PRN medications), according to AltaPointe policies and procedures.
• Assists consumers with personal care issues (bathing, toileting and other personal hygiene routines).
• Demonstrates willingness to work on any unit based on facility needs and as directed by the Nurse Manager.
• Demonstrates the ability to recognize the elements of a crisis state and knows how to deescalate or resolve the situation.
• Assists with seclusions and restraints per AltaPointe policy and procedure.
• Actively assists with hospital cost containment by accepting responsibility for time management and use of unit supplies.
• Effectively demonstrates the application of adult and child competencies.
• Adheres to professional code of ethics.
• Serves as Charge Nurse as needed, overseeing routine task assignments of RNs, LPNs, Mental Health Technicians, MA’s and behavioral staff.
• Initiates and administers IV fluids in accordance with the provider’s order, facility policies and applicable nursing standards.

Supervision and consultation

• Seeks clinical supervision and consultation needed.
• Accepts and employs suggestions for improvement.
• Actively works to enhance clinical skills.

Clinical record keeping

• Documents in a timely fashion per AltaPointe policy.
• Documents in a clear, concise manner types of consumer problems, treatment goals and services provided.
• Documentation shows that forms, notes, logs, and other applicable written information are completed promptly, accurately and updated when appropriate.
• Documents legibly.

Courteous and respectful attitudes towards consumers, visitors and co-workers:

• Treats consumers with care, dignity and compassion.
• Respects consumers’ privacy and confidentiality.
• Is pleasant and cooperative with others.
• Assists consumers and visitors as needed.
• Personal values don’t inhibit ability to relate and care for others.
• Is sensitive to the consumers’ needs, expectations and individual differences.
• Is gentle and calm with consumers and families.

Administrative and other related duties as assigned

• Actively participates in Performance Improvement activities.
• Actively participates in AltaPointe committees as required.
• Completes assigned tasks in a timely manner.
• Accesses appropriate community resources according to consumers’ needs.
• Follows AltaPointe Policy & Procedures.
• Maintains current state license and requirements for renewals, and attends required in-services and workshops.

Physical Requirements of the Job

• There is frequent standing, sitting, and walking which are in bursts of 5 to 10 minutes. However, there are times when this can be extended to pacing with the consumer (time could be undetermined), and at times sitting and standing can be extended with the employee having the ability to change positions as permitted by the observance and behavior of the consumer at that time.
• There is occasional forward bending from the hips while kneeling to reach to the side.
• There is an occasional need to be able to assume a full squat/lunge from a standing position.
• There is an occasional need to maintain back extension while being on stomach with one’s own body weight on hips and legs. This position is maintained for several minutes.
• Occasionally, be able to put one’s own body weight on one knee and one elbow on the same side of one’s body.
• Occasionally, be able to kneel and reach to same side toward the floor.
• Lift up to 10 pounds from the floor to various levels, including from the floor to overhead occasionally during shift.
• Have the ability to lift up to 50 pounds to assist in activities of daily living, as required. Be able to lift up to 50 pounds from floor to waist.
• Strong grasp is needed to use keys to open doors throughout the facility, and to maintain constant contact with a consumer during a restraint procedure or with other hold techniques.
• Pushing/pulling force up to 25 pounds occasionally during shift.
• There are times that require the employee to be able to ambulate as quickly as possible to assist coworkers with a consumer in a restraint procedure. (Example: jog/run up to 0.1 mi).
• At times therapy may be inside or outside the facility; therefore, some activities will dictate physical requirements for playing or games.

Qualifications

Current LPN or RN license to practice in the State of Alabama.

Knowledge in adult specialty outlined below to be attained within six months of employment:

• Knowledge of psychiatric disorders in the adult and child populations
• Knowledge of general and psychiatric nursing care
• Knowledge of growth and development of individuals as related to all intellectual, emotional, spiritual, and physical aspects of their development
• Knowledge of substance use disorders and treatment
• Knowledge of intellectual and developmental disabilities
• Basic knowledge of medical terminology in psychiatric care
• Familiarity of psycho-pharmacy and the use of psychotropic medications with the adult populations
• Knowledge of behavior management, crisis intervention, and interventions common to acute psychotic consumers as well as to non-violent crisis intervention practice
• Knowledge of instruction, teaching tools, educational methods appropriate for adult populations
• Knowledge of family dynamics
• Knowledge of effects and treatment of physical/sexual/emotional abuse and neglect issues
• Knowledge of cultural diversity