Per Diem Registered Nurse (RN) - CSC & ORCA Center

Registered Nurse Position at DESC

Locations:

• DESC's Crisis Solutions Center, 1600 S Lane St, Seattle, WA 98144
• DESC's Opioid Recovery and Care Access Center, 515 3rd Ave, Seattle, WA 98104

Shift:

• CSC: Day Shift (6:30am 7pm), Night Shift (6:30pm - 7am)
• ORCA Center: Day shift (7am 7:30pm), Night shift (7pm 7:30am)

Shift Differential: $3.25 per hour Night Shift differential, paid in addition to hourly wage

Other Benefits: 403(b), EAP (Employee Assistance Program), Sick & Safe Time

Union Representation: This position is a part of a union and is represented by SEIU Healthcare 1199NW.

About DESC:

Recognized nationally as an innovator and leader in developing solutions to homelessness, DESC is a social services organization, supportive housing operator, and licensed behavioral health treatment provider focused on meeting the needs of people experiencing long-term homelessness and living with complex behavioral health and other medical conditions. Approximately 3,000 people are actively receiving services from DESC at any given point in time. Our vision is a community where all people are shown compassion, treated with dignity, and everyone has a safe, stable, and affordable place to call home.

DESC operates five shelter/emergency housing programs, 19 permanent supportive housing facilities with over 1,750 units, several hundred additional scattered site apartments, and a range of behavioral health services including outpatient mental health and substance use disorder treatment, residential crisis stabilization, street outreach, mobile crisis response, and treatment for opioid use disorder.

Job Definition:

CSC: The RN is a member of a multi-disciplinary team responsible for providing on-going case management services to homeless and formerly homeless, mentally ill adults. The Registered Nurse works primarily with clients in need of psychiatric and other medical attention. This position will share responsibility for coordinating the medication services for the team.

ORCA Center: The Registered Nurse (RN) acts as a member of a multi-disciplinary team responsible for providing nursing services to adults who have experienced an opioid overdose and/or those with a diagnosis of Opioid Use Disorder. DESC's ORCA Center provides 24-hour, low-barrier, enhanced supportive services. Here, the RN will provide in-the-moment, low-threshold medical access to clients who may not otherwise present to more traditional clinics. Work is done under the supervision of the ORCA Nurse Supervisor, Senior Nurse Manager, Director of Nursing, and Medical Director.

Major Duties and Responsibilities:

• Under the guidance and direction of the Nursing Supervisor, coordinate medical aspects of care, including monitoring and administration of medications in a manner that meets the unique needs of clients.
• Provide education to clients regarding their treatment, medical and mental health condition.
• Develop and engage clients in health promotion activities such as health and wellness clinics, smoking cessation efforts, and client education programs for disease prevention.
• On-going assessment of mental status and the positive impact and side effects of current treatment.
• Provide specialized training and consultation to other staff members on medical/mental health issues relating to clients and their care.
• Participate in psychiatric consultation, supervision, program meetings and in-service trainings; participate in clinical reviews and case conferences for team clients.
• Comply with the agency's clinical accountability policies and procedures; maintain current and complete clinical records; participate in quality assurance reviews.
• Comply with applicable program research and evaluation procedures.
• Participate in verbal de-escalation and physical interventions in emergent situations and be willing and able to assist other staff as needed to maintain a safe and secure environment.
• Other duties as assigned.

Medical care (ORCA):

• Care to individuals in stable condition who have experienced an opioid overdose, brought to the ORCA Center by first responders or transferred from local emergency departments
• Provide clinical assessments, RN case management, medical monitoring, wound care and other treatments, intervention in medical emergencies, and linkages to behavioral health treatment and primary care.
• Rapid initiation of medications for opioid use disorder (MOUD), including buprenorphine (sublingual and long-acting injectable) and methadone (under the "72 hour rule", or Code of Federal regulations Title 21 1306.07 (b)), for people with OUD, regardless of whether an opioid overdose has recently occurred.
• Follow-up care, at the ORCA Center or at times field-based, with individuals who have started MOUD to ensure support in MOUD continuation.
• Harm reduction counseling and OUD-related physical and behavioral health services, such as hepatitis C testing and treatment and HIV pre-exposure prophylaxis.
• Provide / coordinate chronic disease management; educate client re: self-care and medication management.
• Administer oral medication, injections, and provide wound care within scope of practice and plan of care or as prescribed by eligible provider.
• Oversee on-site medication monitoring services.
• Teach clients about safer substance use, overdose prevention and overdose reversal.

Clinical and Social Support:

• Participate as a member of a multi-disciplinary team providing some components of on-going case management services to homeless and formerly homeless adults.
• Assess clients for range of health care needs and facilitate linkage and on-going connection to relevant urgent, primary and specialty health services.
• Advocate for clients' access to community resources and services, especially primary health care services, ensuring that clients' needs are met and rights maintained; consult and collaborate with community providers to ensure continuity of care.
• Participate in the planning, organizing and facilitating of group treatment services for consumers served by the mental health program.
• Coordinate services closely with mental health program supervisors and case management staff.
• Build trusting relationships with clients who may be wary and difficult to engage by employing a warm and accepting approach that includes trauma informed care, harm reduction and motivational interviewing. Demonstrate a commitment to this approach through language and behavior.

Other:

• Participate in psychiatric consultation, supervision, program meetings and in-service trainings; participate in clinical reviews and case conferences for clients on caseload.
• Comply with the agency's clinical and general policies and procedures; maintain current and complete clinical records; participate in quality assurance review activity as requested.
• Comply with applicable program research and evaluation procedures.
• Other duties as assigned.

Requirements

Minimum Qualifications:

• Registered Nurse, licensed in the State of Washington, in good standing. If licensed under the Nurse Licensure Compact Multistate License (NLC MSL), compliance with RCW 71.12.740 and NLC MSL Rule 402.2 is a condition of employment.
• Knowledge of psychiatric medications, side effects and methods of administration.
• Interest or experience in working with adults who are experiencing or who have experienced homelessness and are disabled by mental illness and/or co-occurring substance abuse disorders.
• Flexibility, willingness to adapt to changing circumstances, accept new responsibilities and work cooperatively with team members to accomplish goals of program.
• Able to prioritize multiple responsibilities, work independently and exercise professional judgment.
• Interest in or experience working with participants who are difficult to engage and refer to traditional programs.
• Experience or training in addiction medicine and harm reduction.
• Ability to communicate and work effectively with staff from various backgrounds.
• Ability to work effectively with clients displaying a wide range of unpleasant and/or bizarre behavior.
• Ability to relate to a wide range of people, demonstrate highly developed communication skills, and have a desire to serve people with Opioid Use Disorder.
• Familiarity with trauma-informed care, harm reduction principles, and equity frameworks.
• Subscribe to the philosophy of cooperation and continuity across programs and of consideration and respect for clients.
• Skills and competence to establish supportive trusting relationships with persons