4C02

PAY RANGE: EP22

COMMUNITY HEALTH REGISTERED NURSE

(General)

(Bilingual)

GENERAL DEFINITION

This is general duty nursing work in the care, treatment and teaching of patients and groups of patients. An employee in this class provides direct patient care and required medical services in accordance with Standing Medical Orders. Work includes motivating and counseling patients in proper health care practices and serving as patient advocate. Employees may work in specialized assignments, such as coordinating the delivery of managed health care services and reviewing and evaluating the quality and level of services; or specialized nursing work in the care and treatment of patients with a specific disease or condition.  Work is performed under the supervision of a nursing superior. Work may require some physical effort.

ALLOCATING FACTORS: (The following conditions must be met for a position to be allocated to this class.)

• Position must provide direct patient care and required medical services in accordance with Standing Medical Orders, or coordinate delivery of managed health care services.
• Position must motivate and counsel patients in proper health care practices and serve as patient advocate.

TYPICAL EXAMPLES OF WORK (ILLUSTRATIVE ONLY)

Provides direct patient care; takes patient history and vital signs, including temperature, pulse, blood pressure, respiration, weight and height; may perform EKG, venipuncture, vision, hearing and fingersticks; assesses and records patient needs and problems; triages patients entering health centers; manages medical care of patients; serves as advocate for patients; explains medical service availability and requirements; refers patients for appropriate treatment.

Carries out assigned care and treatment functions as defined by standing medical orders or program protocols; assists physicians as required in treatments and examinations; explains physician instructions to patients; develops, implements and evaluates a nursing plan; collaborates with physicians and other team members to develop patient management plans and service goals, and to provide coordinated service.

Instructs and counsels patients and families, and reinforces the physician's regimen of care; instructs groups of patients on such subjects as prenatal care and control of diabetes; schedules patients for follow-up instruction.

Administers medications and immunizations; dispenses over-the-counter medications in team and triage areas, and performs treatments, screening and diagnostic procedures according to physician orders or appropriate standing orders; obtains specimens for laboratory analysis or instructs patients in proper methods to obtain specimens.

Conducts nursing services as primary provider according to standing orders for such services as administration of immunizations and well-child examinations; screens patients without appointments based on program policies and protocols and refers to appropriate staff; implements protocols for patients who fail to keep appointments; documents nursing services and nursing care plans, and completes required forms.

Specialized Nursing Assignments - Performs the above services for patients with a specific disease, condition or need or in various program areas, such as infectious disease, tuberculosis, immunization, acute communicable disease, emergency preparedness and bioterrorism; may plan, review and coordinate the provision of medical, nursing, therapy, and related care and rehabilitative services for patients in a residential home facility; may report to an administrative supervisor and receive technical direction from a nursing or medical superior; conducts physical examinations, determines medical and personal histories of patients, and provides treatment and management determined by the condition and needs of the patient; plans, develops and conducts educational programs for departmental nurses, health care professionals and community groups in the area of  specialized treatment; responds to inquiries from hospitals, physicians, nurses and the general public regarding specialized services.

          Managed Care  Assignment  - Coordinates the provision of health care services associated with a variety of managed health care plans; functions as liaison between the City, health care providers and health maintenance organizations; ensures that appropriate documentation, diagnostic test results and other patient information are forwarded to health care providers as required; responds to requests for information from hospitals, health facility staff, and patients; evaluates the provision of patient services in accordance with program policy; monitors and reviews provision of patient services; evaluates and ensures the application of health care principles and practices and applicable professional standards; makes recommendations to improve standards of care and the quantity and quality of patient services; coordinates the provision of medical services for municipal employees who have received service-connected injuries.

Performs related work as required.

REQUIRED KNOWLEDGE, SKILLS AND ABILITIES

KNOWLEDGE OF:

· current nursing theory, principles, practices and techniques

· literature and current developments in the field of nursing

· the resources available to persons in need of related health and social services

· educational methods as they apply to health care and disease prevention

· symptoms, diagnoses and treatment in the area of  specialized treatment if required by assignment

· current trends, practices, and developments in the area of  specialized treatment if required by assignment

· the principles and practices of managed health care if required by assignment

· utilization review methods and techniques as they relate to patient care and treatment if required by assignment

· current principles, practices, methods, literature, and new developments in the field of occupational health if required by assignment

· laws and regulations governing provision of nursing services in a residential facility if required by assignment.

ABILITY TO:

· provide direct patient care and required medical services in accordance with Standing Medical Orders

· instruct patients and family in the principles of health care, home nursing and prevention of disease

· maintain an empathetic attitude towards and harmonious relationships with patients and the public

· learn health problems and treatment requirements unique to specified areas of the city

· perform general and condition specific physical examinations

· evaluate health histories and results of examinations

· instruct and counsel patients, particularly in the area of  specialized treatment

· coordinate the provision of health care services associated with a variety of managed health care plans if required by assignment

· evaluate and resolve problems related to the administration of managed health care services if required by assignment

· understand and follow oral and written instructions

· maintain adequate records of nursing services

· establish and maintain effective working relationships with associates

· use computers and computer software packages if required by assignment.

MINIMUM ACCEPTABLE TRAINING AND EXPERIENCE (The following statement represents the minimum training and experience standards which will be used to admit or reject applicants for tests. Applications submitted by candidates for this class will be reviewed based on training and experience requirements as approved on 4/07.)

EDUCATION

Graduation from an accredited School of Nursing.

Completion of a comprehensive training program for the prevention of sexually transmitted diseases mandated by the Center for Disease Control if required by assignment

Diabetes Nursing Assignment Only - Completion of a bachelor's degree program at an accredited college or university with major course work in nursing, nursing education or a closely related area

AND
BILINGUAL SPECIALTY

Sufficient training and/or experience to be able to understand and speak fluently and clearly in English and a designated non-English language.

PHYSICAL AND MEDICAL REQUIREMENTS

Ability to physically perform the duties and to work in the environmental conditions required of a position in this class.

LICENSES, REGISTRATIONS AND/OR CERTIFICATES

Eligibility for a license as a Registered Nurse issued by the Pennsylvania State Board of Nurse Examiners at the time of application and possession of such licensure at the time of appointment and during tenure of employment.

Class Established: 6/89

Spec. Revision:

CSC: 6/89

Ad Board: 9/89

CSC: 9/98

Ad Board: 1/99

Change in pay rate:

CSC: 1/03

Ad Board: 7/1/03

Spec. Revision and Consolidation with 4C04, 4C11, 4C16, 4C32, 4C49

CSC: 2/07

Ad Board: 4/07

Change in Pay Rate:

CSC – 9/13

Ad. Board – 11/13

Latest Spec. Revision:

CSC: 10/15

Ad. Board: 10/15

Change in pay rate:

CSC – 10/23

Ad. Board – 11/23

JL