Public Health Nurse II (Clinical & CAP)

Nash County Health Department Nursing Services

To provide nursing services to all Nash County Health Department patients following agency policies, procedures and standing orders. Health department programs include Maternal Health, Family Planning, Women's Health, Adult Health, Child Health, Immunization, STD/HIV, Tuberculosis and Communicable Disease.

To provide the nursing portion of the annual multidisciplinary assessments for target patients as required per the most current NC Medicaid Community Alternatives Program for Disabled Adults and Children (CAP/DA and CAP/C) Clinical Coverage policies.

Community Alternative Program for Disabled Adults {CAP/DA) -A Medicaid Home and Community-Based Services (HCBS) Waiver authorized under section191S(c) of the Social Security Act and complies with 42 CFR § 440.180, Home and community-based waiver services. This waiver program provides a cost-effective alternative to institutionalization for a beneficiary, in a specified target population, who is at risk for institutionalization if specialized waiver services were not available. These services allow this targeted individual to remain in or return to a home and community-based setting.

Community Alternative Program for Children (CAP/C) - A Medicaid Home and Community­ based Services (HCBS) program authorized under section1915(c) of the Social Security Act and complies with 42 CFR § 440.180, Home and Community-based Waiver Services. This waiver program provides a cost-effective alternative to institutionalization for a Medicaid beneficiary who is medically fragile and at risk for institutionalization if home- and community­ based services approved in the CAP/C waiver were not available. These services allow the beneficiary to remain in or return to a home and community-based setting. This waiver supplements, rather than replaces, the formal and informal services and supports already available to an approved Medicaid beneficiary.

Work Schedule:

8:00 a.m. - 5:00 p.m. Monday through Friday. Some duties require working occasional weekends and overnight travel. Employee may have to work emergency shelter or special clinics as necessary. Hours vary depending on the services of the department and the needs of patient.

Essential Duties and Tasks

40%CAP Public Health Nurse

Performs nursing assessments on patient at time of annual reassessments.

Expected total CAP/DA and CAP/C visits to be between 5-20 patients per month but may vary depending on available slots and changes in patient status.

Reviews patient's current medications.

Enters data into EHR (eCap).

Documents date RN assessment completed in CAP/DA – CAP/C spreadsheet as notification to patient's CAP Case Manager that visit has been completed.

10%Women's Health Program

Completes an initial or interim medical and psychosocial history. Takes blood pressure and orders appropriate lab tests.

Provides education and counseling regarding medical and psychosocial problems identified.

Provides education, counseling, and instructions regarding methods of birth control and method chosen.

Dispenses appropriate medications and/or birth control method according to the Department's Pharmacy Policy and Procedure and Family Planning Policy and Procedures and Standing Orders.

Updates immunizations per Standing Orders.

Initiates referrals for abnormal findings and needs identified.

Documents findings and all activities in the patient's medical record according to the Department's Medical Record Policy.

10%Prenatal Program

Completes an initial or interim medical and psychosocial history.

Takes blood pressure and orders appropriate lab test per standing orders and guidance from clinician. Provides education and counseling regarding medical and psychosocial problems identified.

Provides appropriate education and counseling. Assists physician with exam.

Dispenses appropriate medications and/or vitamins and iron according to the Department's Pharmacy Policy and Procedures and Maternity Policy and Procedures.

Initiates referrals for abnormal findings and needs identified.

Documents findings and all activities in the patient's medical record according to the Department's Medical Record Policy and Procedures.

10%STD/HIV Program

Completes an initial or interim medical and sexual history. Orders appropriate lab tests.

Provides education and counseling regarding problems identified.

Dispenses or administers appropriate treatment according to the STD Policy, Procedures, and Standing Orders, and according to the Department's Pharmacy Policy and Procedures.

Updates immunizations per Standing Orders. Provides pre and post-test HIV counseling.

Initiates referrals for abnormal findings and needs identified.

Documents findings and all activities in the patient's medical record according to the Department's Medical Record Policy.

Fills in as necessary to receive referrals from other health care facilities. Contacts patients needing medical treatment.

10%Child Health

Completes an initial or interim medical, psychosocial, and developmental history.

Performs visual acuity and hearing screening and takes blood pressure on children four years and older. Orders appropriate lab work.

Counsels parent regarding nutrition, growth and development, medical concerns, immunizations, care of the newborn and older child, etc.

Dispenses or administers medications and immunizations according to the Standing Orders of the Child Health Program and the Pharmacy Policy and Procedures.

Issues prescription according to the Standing Orders of the Child Health Program. Initiates referrals for abnormal findings and needs identified.

Documents findings and all activities in the patient's medical record according to the Department's Medical Record Policy.

10%Adult Health Program

Completes an initial or interim medical and psychosocial history. Takes blood pressure and orders appropriate lab tests.

Provides education and counseling regarding problems identified (ex., chronic disease and disease prevention).

Dispenses medications according to the Department's Standing Orders and Pharmacy Policy and Procedures.

Updates immunizations per Standing Orders. Initiates referrals.

Documents findings and all activities in the patient's medical record according to the Department's Medical Record Policy.

5%Communicable Disease/COVID-19/Community Health

Administers immunizations per Standing Orders. Provides education and counseling.

Documents findings in the patient's medical record according to the Department's Medical Record Policy.

Participates in disaster services as required.

Assists with department wide community activities, i.e.: community flu/pneumonia programs, COVID-19 vaccine and//or testing clinics, health fairs, etc.

Assists other Department staff with school activities; i.e.: immunizations, communicable disease services, etc.

Assist with Red Cross disaster sites/shelters as needed Participates in disaster services as required.

5%Other Duties

Assists with general clinic patients; i.e.: those presenting for pregnancy tests, TB medications, hepatitis B vaccine, blood pressure checks, B12 injections, etc.

Maintains required personnel records (ex., time, travel, and telephone logs).

Attends staff training and other continuing education programs and monthly staff meetings. Helps maintain a safe working environment.

Performs other duties as assigned by the supervisor or health director.

Knowledges, Skills and Abilities

A considerable knowledge of and skill in the application of nursing theory, practices, principles, and techniques employed in the field of public health and related programs is required and have the ability to apply these principles and practices of public health.

This position requires strong assessment skills and qualifications to perform adult and pediatric physical assessments. Ability to secure the cooperation of clients, to elicit needed information and to maintain effective working relationships; ability to record accurately services rendered and to interpret and explain records, reports, and medical instructions. Requires knowledge of available resources and appropriate referral methods. Requires the ability to plan and coordinate work with others, to deal tactfully with others, and to exercise good judgement in appraising situations and making decisions. Requires working knowledge of current social and economic problems relating to public health.

Accuracy Required in Work:

Accuracy is required when determining eligibility for case management services. Accuracy and sound judgement are required in all nursing interventions with patients. Accuracy is required in identifying patient needs through interview and for performing medical and psychosocial assessments, and for documentation, and referral process, as well as following agency policies and procedures.

Consequence of Error:

Errors could result in inappropriate or inadequate health services endangering the health and safety of patients. Errors may also precipitate malpractice lawsuits and/or disciplinary action