PNA IV / Direct Care

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Functional Title: PNA IV / Direct Care
Job Title: Psychiatric Nursing Asst IV
Agency: Health & Human Services Comm
Department: Chld /orAdolPsych Direct Care
Posting Number: 21992
Closing Date: 10/19/2026
Posting Audience: Internal and External
Occupational Category: Healthcare Support
Salary Range: $4,094.50- $5,094.16
Pay Frequency: Monthly
Salary Group: TEXAS-A-16
Shift: Day
Additional Shift: Days (First); Evenings (Second); Nights (Third); Weekends
Telework: Not Eligible for Telework
Travel: Up to 15%
Regular/Temporary: Regular
Full Time/Part Time: Full time
FLSA Exempt/Non-Exempt: Nonexempt
Facility Location: Waco Center for Youth
Job Location City: WACO
Job Location Address: 3501 N 19TH ST
Other Locations:
MOS Codes: 4C0X1,68X,HM

Brief Job Description :

Would you thrive in an environment where you learn and grow personally and professionally all while helping make a positive impact on people’s lives? Do you appreciate being around others like yourself who are dependable, trustworthy, hard workers who believe in the value of teamwork? HSCS is dedicated to building an atmosphere where employees feel valued and supported while providing specialized care for Texans in need. HSCS is comprised of ten psychiatric hospitals, two youth residential treatment facilities, and thirteen state supported living centers. The psychiatric hospitals are a hub of excellence for forensic mental health and complex psychiatric care, with all facilities accredited by The Joint Commission. They provide state-of-the-art treatment that is recovery-oriented and science-based. If providing hope and healing through compassionate, innovative, and individualized care interests you, we welcome your application for the position below.

The Psychiatric Nursing Assistant IV performs advanced (senior-level) rehabilitative patient care services work under the clinical supervision of a registered Nurse (RN) to provide quality psychiatric nursing care in an inpatient setting. Work involves coordinating assignments and specific duties for all PNAs, which includes assisting the patients with activities of daily living, instructing staff on hospital and program procedures and policies, and providing emergency, health, and personal care services to patients; interacting with patients therapeutically; observing, reporting, and documenting, in an electronic record, patient conditions and behaviors; and participating in individualized and unit-based programming. As an integral member of the recovery team or admissions team, provides verbal and supportive documentation concerning individual patient behaviors, including progress or lack thereof, towards individualized goals of the recovery plan. Actively participates in shift reports and recovery team meetings or meetings with admissions staff. Works under limited supervision, with considerable latitude for the use of initiative and independent judgment.

Performs other duties as assigned. Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location.

This position may be eligible to earn additional pay for work performed on evenings, nights and/or weekends.

Essential Job Functions (EJFs):

• Attends work on a regular basis and may be asked to work a specific shift schedule or, at times, even a rotating schedule, extended shift and/or overtime in accordance with agency leave policy and performs other duties as assigned.

• Coordinates assignments and specific duties for PNAs which includes assisting the patient with activities of daily living, hygiene, and eating to promote independence and self-care.

• Takes an active role in the implementation of the individualized recovery plans and offers consistent, ongoing support in assisting patients in reaching their goals. Uses therapeutic, person-centered communication skills in promptly and effectively engaging patients. Accompanies patients to appointments as required.

• Communicates effectively with other team members to promote a positive workplace. Shares information with other PNAs so they understand their role in supporting the patients' treatment.

• Serves as a participant in the recovery team or admissions team. Provides ongoing, collaborative verbal and written communication concerning patients. Instructs other PNAs on how to provide verbal and written communication concerning patients' progress or lack thereof towards their individualized goals. Develops plans for treatment and instructs other PNAs on how to take an active role with patients’ recovery processes.

• Uses basic computer skills and responds to questions from other PNAs on reporting procedures to communicate patient care information clearly and concisely in a timely manner.

• The PNA IV assists the licensed nurse and provides guidance to other PNAs in monitoring patients for medication administration or treatment, including taking and monitoring vital signs and performing other assigned tasks within competency level.

• Proactively promotes safety through continuous environmental awareness and positive engagement of patients to minimize unsafe situations and injuries.

• Promotes classes and programs offered and encourages patient participation. Co-facilitates groups as assigned or requested.

• Models appropriate response in crisis or psychiatric emergency situations using the least restrictive intervention necessary by applying Treatment Intervention Protection Strategies (TIPS), including verbal de-escalation, under the direct supervision of a RN to ensure the health and safety of all persons.

• Performs CPR/Heimlich techniques and use of an Automatic External Defibrillator (AED) correctly and safely according to the specifications of the American Heart Association.

• Instructs other PNAs on how to provide the RN with timely, clinically relevant patient information (such as possible side effects of medication, disease/injury, behavioral escalation, etc.) gained by direct observation/interaction with patients to promote safety. Actively participates in shift change.

• Serves as a preceptor (orientation and ongoing training) for new employees including PNA Is, IIs, and IIIs, and other temporarily assigned personnel to the unit.

• Provides objective and relevant information to the supervising RN on an ongoing basis concerning the work performance of assigned PNAs to support a more comprehensive performance evaluation and to assist in the identification of training and/or other performance improvement opportunities.

• Performs other duties as assigned by the supervisor to ensure efficient operation of the patient care unit. Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location.

Knowledge, Skills, and Abilities (KSAs):

• Knowledge and experience in CAPPS, CARE, Microsoft Word, and Excel.

• Knowledge of patient aggression reduction interventions.

• Knowledge of patient care techniques and of treatment, therapy, developmental, and patient-centered recovery programs.

• Knowledge of effective interpersonal and leadership skills and ability to interact with other team members utilizing effective interpersonal skills.

• Skill in the use of computers and office equipment.

• Ability to prepare and maintain records, files, and reports.

• Ability to serve as a lead worker providing direction to others.

• Ability to read, write, and understand English to effectively communicate and carry out verbal and written instructions.

• Ability to provide patient care, to administer first aid and cardiopulmonary resuscitation, and to conduct TIPS.

• Ability to work with others and accept supervision.

• Ability to train others.

Registrations, Licensure Requirements, or Certifications:

• Must possess a valid Texas driver's license or obtain it no later than 90 days after hire date to drive a state vehicle. Applicants with an out-of-state driver's license must provide an original certified driving record from the state of driving licensure. Eligible driving record required based on HHSC Fleet Management policy. Must be able to drive state vehicles and golf carts.

• CPR certification or the ability to obtain certification for CPR within the first 60 days of employment.

Initial Screening Criteria:

• Four (4) years’ work experience is required.

• At least three (3) years' direct care experience is required.

• At least three (3) years' psychiatric patient experience is preferred.

• At least three (3) years' supervisory experience is preferred.

Additional Information :

Applicants must pass a fingerprint criminal background check, pre-employment drug screen, and registry checks including the Client Abuse/Neglect Reporting System (CANRS), Nurse Aide, Medication Aide, and Employee Misconduct, and List of Excluded Individuals/Entities (LEIE). Males between the ages of 18-25 must be registered with the Selective Service.

All applicants must be at least 18 years of age to be considered for employment at a state-operated facility. Waco and Terrell Center for Youth applicants must be 21 years of age.

Flexibility in work hours may be required for this position. The position may be required to work overtime and/or extended hours.

Compliance with HHSC immunization policy and State Hospital operating procedures related to immunizations is required. According to the Centers for Disease Control and Prevention, healthcare workers are considered to be at significant risk for acquiring or transmitting hepatitis B, measles, mumps, rubella, varicella (chicken pox), tetanus, diphtheria, pertussis (whooping cough), and influenza. All of these diseases are vaccine preventable. As a result, State Hospital policy requires employees be vaccinated according to their level of contact with individuals. In the event you choose to not be immunized for the influenza virus, you may be required to wear a mask and take other protective measures.

Waco Center for Youth is a psychiatric residential treatment facility that serves teenagers ages 13 through 17 with emotional difficulties and/or behavioral problems. Waco Center for Youth bases its treatment philosophy on the belief that both behavior change and an understanding of self and others are equally important in achieving significant long term success in treatment. The mission of Waco Center for Youth is “to give each youth a chance for change” by providing comprehensive psychiatric residential treatment services to emotionally disturbed adolescents of the state of Texas. The facility is operated by the Health and Human Services Commission and is accredited by the Joint Commission on Accreditation of Health Care Facilities.

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Active Duty, Military, Reservists, Guardsmen, and Veterans :

Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.

ADA Accommodations:

In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at View phone number on aiapply.co. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.

Pre-Employment Checks and Work Eligibility:

Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks.

HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form

Telework Disclaimer:

This position may be eligible for telework. Please note, all HHS positions are subject to state and agency telework policies in addition to the discretion of the direct supervisor and business needs.