Public Health Nurse I (Clinic Nurse)

Nash County Health Department Nursing Services

A. Primary Purpose of Position: 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. B. Work Schedule: 8:00 AM - 5:00 PM, Monday through Friday. Occasional extended hours or weekends for community health fairs, communicable disease outbreaks, flu shots, etc. Hours may vary depending on the services of the department.

20% Women's Preventive Health Program Completes an initial or interim medical and psychosocial history. Takes blood pressure and orders appropriate lab tests per Provider instruction and/or standing order. 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 Procedures and Family Planning Policy, 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. 20% Adult Health Program Completes an initial or interim medical and psychosocial history. Takes blood pressure and orders appropriate lab tests per Provider instruction and/or standing order. 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 (ex., treatment for vaginitis). 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. Job Description: PHN I II. A. (Con't) DESCRIPTION OF RESPONSIBILITIES AND DUTIES: 20% STD/HIV Program Completes an initial or interim medical and sexual history. Orders appropriate lab tests per Provider instruction and/or standing order. 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. Provides pre and post test HIV counseling. 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. 20% Child Health Program Performs visual acuity and hearing screening and takes blood pressure on children three years and older. Completes initial or interim medical, psychosocial, and developmental history. Ensures completion of pre-visit questionnaire. Applies topical fluoride varnish and provides educational information. Orders appropriate lab work per Provider instruction and/or standing order. Dispenses or administers medications and immunizations according to the Standing Orders of the Child Health Program and the Pharmacy Policy and Procedures. Documents findings and all activities in the patient's medical record according to the Department's Medical Record Policy. Job Description: PHN I II. A. (Con't) DESCRIPTION OF RESPONSIBILITIES AND DUTIES: 15% Prenatal Program Completes an initial or interim medical and psychosocial history. Takes blood pressure and orders appropriate lab tests per Provider instruction and/or standing order. Provides education and counseling regarding medical and psychosocial problems identified. Provides appropriate education and counseling (ex., nutrition, danger signs of pregnancy). Dispenses appropriate medications and/or vitamins and iron according to the Department's Pharmacy Policy and Procedures and Prenatal Policy, Procedures and Standing Orders. Initiates necessary referrals. Documents findings and all activities in the patient's medical record according to the Department's Medical Record Policy. 5% Other Duties Other duties as assigned. Assists with general clinic patients; i.e.: those presenting for pregnancy tests, TB medications, hepatitis B vaccine, blood pressure checks, B12 injection, 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. Preparedness/Disaster shelter and duties. Participates in Quality Assurance/Quality Improvement tasks.

Job Description: PHN I II. B. OTHER POSITION CHARACTERISTICS: 1. Accuracy Required in Work: Accuracy and sound judgement are required in all nursing interventions with patients. Accuracy is required in identifying patient needs through interviewing and data collection. Interpreting findings, initiating standing orders, counseling, and initiating referrals all require maximum accuracy. 2. Consequence of Error: Errors could result in inappropriate or inadequate medical services, endangering the health and safety of patients. Errors may also precipitate malpractice lawsuits and/or enforcement action by the North Carolina Board of Nursing. 3. Instructions Provided to Employee: Receives orientation up to maximum of 12 weeks. Supervisor may extend as needed. Attends workshops related to job. In-house updates at monthly staff meetings or by written memo. Daily changes related to treatment modalities, supplies, programs, staff are handled by clinical supervisor. 4. Guides, Regulations, Policies and References Used by Employee: • Local Health Department Policies, Procedures, and Standing Orders • ACIP Manual • Local Personnel Policies • North Carolina Nursing Practice Act • DHHS Program Directives • Federal and State Statutes and Rules 5. Supervision Received by Employee: Works daily with Program Lead Nurses. Receives formal, written appraisals per the Department's Policy. Records are reviewed quarterly by the Department's Quality Assurance team. Work in progress is observed by the Clinical Supervisor. 6. Variety and Purpose of Personal Contacts: Works directly with patients of all social, racial, and economic groups. Works with other staff within the department to assure all needed services are provided for the patient. Communicates with outside providers to assist patients with their needs and to initiate referrals. Must always demonstrate professional knowledge, tactfulness and sensitivity when assisting patients or working with the community. 7. Physical Effort: Requires the provision of patient services each day whether through applying direct clinical skills, phone calls, record management, or attending a continuing education workshop. Occasional stooping, reaching, lifting and pulling may be required. 8. Work Environment and Conditions: Potential to be exposed to airborne pathogens and bloodborne pathogens. 9. Machines, Tools, Instruments, Equipment and Materials Used: Stethoscope, blood pressure cuff, copier, fax, scales, computer/EMR, thermometers, titmus machine, audiometer. 10. Visual Attention, Mental Concentration and Manipulative Skills: Must be able to organize, identify, and complete the work process. Document in medical records. Administer medications. Communicate with patients and other professionals. Job Description: PHN I 11. Safety for Others: Must be knowledgeable of safety polices and procedures of the department. Must be knowledgeable of local polices, procedures, and standing orders, and have the nursing expertise to provide appropriate medical care. Must be adequately immunized per Department's policy. Adheres to Department's Bloodborne Pathogen Policy. 12. Dynamics of Work: Changes in policy occur as state guidelines are updated and their recommendations are incorporated into local policy. Changes occur daily in response to absences, clinics running behind schedule, or patients who require unforeseen demands. Changes also occur when recommended by the Department's local medical consultants.

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; general knowledge of and ability to apply the principles and practices of public health; working knowledge of current social and economic problems relating to public health; working knowledge of available resources and organizations. Ability to deal tactfully with others and to exercise good judgement in appraising situations and making decisions; 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.

1. Required Minimum Training: Graduation from a four-year college or university with a B.S. Degree in Nursing which includes a Public Health Nursing rotation; or graduation from an accredited school of professional nursing and one year of professional nursing experience; or an equivalent combination of education and experience. 2. Additional Training/Experience: • HIV Counseling • CPR • Introduction to Disaster • Incident Command System • Introduction to Public Health Nursing (if no B. S. Degree in Nursing) 3. Equivalent Training and Experience: None C. License or Certification Required by Statute or Regulation: Current license to practice as a Registered Nurse in North Carolina by the North Carolina Board of Nursing. Valid North Carolina Driver's License.