Nurse- Community-Primary Care | PD BWH

Primary Care Registered Nurse

BWH BROOKSIDE COMMUNITY HEALTH | PER DIEM | ONSITE | ROTATING SHIFT Jamaica Plain, Boston MA

The primary responsibility of the staff RN is to provide excellent care to patients and families. The role requires the provision of care that is comprehensive, compassionate delivered to patients of all ages, working with a diverse, medically and socially vulnerable population. Role responsibilities within this setting are defined below. Responsibilities include but not limited to:

• Medication and immunization administration for patients of all ages including pediatric (from birth).
• Telephone Triage of patients, both Adult, Pediatric, Adolescents and OB/GYN.
• Emergency department discharge follow up and assessment.
• Performing nurse-only visits by patients including patient education.
• Other duties as assigned.

ABOUT BROOKSIDE COMMUNITY HEALTH CENTER: Brookside is a licensed Community Health Center of Brigham and Women's Hospital and provides multi-disciplinary, comprehensive care with services in a range of medical areas including: Adult, Family and Pediatric Primary Care, OB/GYN, Family Planning, Dental/Oral Surgery, Nutrition/WIC, Behavioral Health and Specialty Medicine (Cardiology, Pulmonology and Nephrology). Brookside also has a Laboratory onsite, Financial Counseling and Community Resource Specialists. Each year, more than 11,000 patients from Jamaica Plain, the city of Boston and surrounding areas use these services, producing more than 69,000 visits to Brookside each year. Most of Brooksides patient population are Spanish-speaking and socioeconomically underserved. The health center's services, guided by equity, are provided by a bilingual English/Spanish medical and professional staff. Brookside is a teaching site for Harvard Medical School, Mass General Institute of Health Professionals School of Nursing, Harvard Dental School, Boston University Dental School, as well as other Boston area health care professional programs.

GENERAL SUMMARY: The Primary Care Registered Nurse is an important member of the primary care multi-disciplinary healthcare team. Patients/families and the health care team work best as partners with shared goals for attaining optimal health and wellness. The RN is integral to providing the support and care necessary to achieving such goals.

CLINICAL PRACTICEOrganization of Patient Care Accountable for assessing, planning, implementing and evaluating a plan of care for a specific patient assignment. Sets priorities when organizing care for patients with varying acuity. Maintain continuity through clear and concise (verbal and written) communication. Demonstrates appropriate knowledge of growth and development of the adult and geriatric patient. In areas, such as the NICU and Obstetrics the principals of growth and development are applicable to the neonate.

Quality of Care Documents patient care in a manner that is clear, complete, concise and in compliance with nursing documentation standards. Develops a comprehensive plan of care based on data from an initial assessment of patient and family, information from other members of the health care team, intra-agency referral and previous medical records. Develops a comprehensive educational plan for the patient and family, utilizing appropriate resources and documents according to the department's documentation standards. Develops a comprehensive discharge plan utilizing appropriate resources and referrals including community resources. Evaluates the effectiveness of the plan of care, and documents progress in meeting stated goals. Revises plan of care as needed to achieve desired outcomes. Participates actively in the unit-based and organizational quality management and/or quality improvement programs. Provides a safe environment for patients, staff, family and visitors. Administers medication safely according to established policies and procedures. Performs nursing procedures safely and efficiently. Uses equipment safely and efficiently. Demonstrates awareness of potential/actual risks of infection and modes of transmission. Utilizes universal precautions in nursing practice.

Coordination/Collaboration Interacts with patients, families, and colleagues in a professional manner. Collaborates with other discipline(s). Develops, utilizes and evaluates unit-specific standards of care. Upholds the A.N.A. code of ethics and acts as a role model to other staff members. Participates in determining and implementing goals and objectives for the unit. Participates in determining goals and objectives in the periodic review and evaluation. Serves on unit-based and organizational committees and disseminates information to peers.

Education Assumes responsibility for personal and professional growth through identification of own learning needs. Shares knowledge and experience with colleagues. Participates in unit-based and organizational educational programs. Seeks and accepts guidance for additional learning needs.

Research Utilizes nursing research findings in clinical practice. Contributes to nursing and/or medical research endeavors by supporting investigators.

Budget Utilizes time and materials in an effective and economical manner. Provides suggestions which support the delivery of cost-effective health care. Assesses patient's acuity accurately when making decisions regarding staffing, transfers and assignments. Demonstrates awareness of the need to manage within established budgetary boundaries.

Personnel Participates in the orientation of new staff members, students and others as appropriate. Provides input into the clinical evaluation of other staff, as appropriate. Assumes responsibility for the unit in the absence of leadership personnel. Adheres to hospital and nursing policies and aids in their interpretation to others. Recommends change in policies and procedures through appropriate channels. Participates in the cooperative effort and peer support required for the smooth running of the unit, e.g., flexibility in relation to patient assignments, shift assignment, or work schedule.

PRINCIPAL DUTIES AND RESPONSIBILITIES: Patient Care Organization May perform all duties as described in the Brigham and Womens Registered Nurse Job Description to meet direct care requirements of the role. Functions effectively and safely within the scope of practice of the Registered Nurse: recognizing limitations of the role and knowing when to seek assistance/guidance of the LIP. Willing to work within scope to strengthen the practice and provide patient centered care. Provide culturally sensitive, patient-centered care of the highest quality to patients of all races, ethnicities, backgrounds and income levels. Triages all urgent calls and assist with walk-ins or patients that become acutely ill during the office visit. Sets priorities when organizing care based upon the acuity of urgent calls. Is aware of clinic flow and re-arranges provider schedules to accommodate the urgent care needs Assesses the care needs of patients with routine and chronic illness. Develops, implements and re-evaluates an individualized nursing plan of care (PoC) Within a multi-disciplinary team, assists patients with pre-existing conditions to achieve lifestyles changes that promote a healthy mindbodyspirit. Uses a variety of modalities to engage patients including nurse visits, telephonic and electronic communication (Gateway/ Telehealth) Operating from a Human Caring framework, implements a wide range of interventions/skills including coaching, education, counseling, motivational interviewing, referral and advocacy to services and resources as appropriate to promote health and wellness Evaluation and documentation of disease management impact; works closely with clinical team and family to promote self-management and ensure a cycle of continuous refinement of PoC which includes education for the patient and family, utilizing appropriate resources. Demonstrates awareness of community resources and assists staff, patients, and families to effectively utilize them. Ensures coordination of care across the care continuum including; home care, outpatient clinics, emergency/urgent care and hospital settings using clear, concise communication and documentation in the EHR. Knowledge base should include basic health teaching, family planning education, how to care for common pediatric and adult illnesses. Facilitates the advanced care planning process, assisting patients and families to consider options and goals for future healthcare decisions. Documents advanced care goals in the EHR. Works with Population Health Coordinator and Primary Care Providers to develop and implement interventions targeted at patients not meeting metrics (e.g. HgbAlc control, Blood pressure control, etc).

Team Based Care Willing to educate and mentor clinical support staff as needed. Able to delegate safely and effectively to support staff tasks that are within scope of practice. Provide care management and coordination across the primary care team for aging, chronically ill, those with increasingly complex health needs; strategically providing care with team members functioning at the top of their license/ responsibilities. Evaluates effectiveness of care given by multi-disciplinary care team, identifies problems and Guides members toward solutions promoting health. Facilitates the improvement of patients ability to self-manage prevention and behavioral health issues and placing emphasis on transitional care, prevention, and wellness. Communicates effectively and clearly with members of the care team regarding patient status and needs. Backs up floor nurse as needed for required medication and vaccine administration.

BWH Professional Practice Model Qualities Nurses as Authentic Leaders: Serves as a resource person to other members of the team around the care needs of patients and provides support to other members of the clinical and administrative team in an accessible, open manner. Is an active participant in cared delivery and shared decision making. True Collaboration: Engages with enthusiasm in process improvement activities, piloting of new workflows, willing to embrace change and thrive in an environment of continuous process improvement. Open to feedback and ongoing learning. As part of this process, the RN is able to demonstrate skilled respectful and effective communication. Meaningful Recognition: Is committed to enhancing their individual professional growth and development by participating in activities that foster a commitment to achieve and sustain quality and safety outcomes for patients. This