Senior Community Health Nurse

Under the general supervision of the Director of Quality Management, the Sr. Community Health Nurse provides comprehensive home visit nursing services using a referral based process. The incumbent works in collaboration with the care coordination and case management multi-disciplinary team in addressing the needs of referred patients and families. Works with community partners to address social determinants of health factors that are impacting the health needs of referred patients and families. The work includes assessment and nursing diagnosis as well as counseling and prevention services. Functions autonomously and routinely interacts with other area resources and at times will need to facilitate response in order to access services for patient(s). Uphold the principles of WIHCC’s Vision, Mission, and Value Statements. Maintains confidentiality of all privileged information at all times.

This list of duties and responsibilities is illustrative only of the tasks performed by this position and is not all-inclusive.

Essential Duties & Responsibilities:

• Maintains regular attendance and punctuality.
• Integrates ethical provisions and leadership in all areas of public/community health nursing practice.
• Advocates protecting the health, safety, and rights of the individual, family, community, and population.
• Acts independently and within the professional nursing standards and the nursing standards and the nursing scope of practice, and established “Physician Standing Orders,” to engage, identify, and address the health needs of the referred individuals and families across the age spectrum for home visit nursing care services.
• Implements a patient centered-home visit nursing care services within the standards of care and the nursing scope of practice.
• Implements critical-thinking strategies in the field and evaluates the severity of health care related matters encountered in the communities.
• Directs patient care based on assessment skills when determining trip to the local field clinics or when to require implementation of Emergency Medical Services (EMS) system.
• Coordinates and participates in the planning, implementing, and addressing psychosocial issues and concerns in patient care.
• Collaborates with the Care Coordination and Case Management team  in the planning, implementation, and evaluation of a comprehensive plan of care using evidence based nursing practices to meet the health care needs of clients.
• Provides education, coordinates, and case manages referred patients living with chronic disease illnesses via home visit program.
• Provides home care self-management education to clients.
• Assists with maintaining the Standards of Care guidance for the various chronic disease illnesses and home visit policies and procedures. 
• Provides/Facilitates/Coordinates Self-Management Education classes in the communities.
• Identifies and prioritizes care to clients with high-risk conditions.
• Documents patient encounters via Electronic Health Record using the community health nursing template that incorporates patient self-assessment and goal setting information.   
• Provides primary, secondary, and tertiary prevention activities in the community i.e. health fairs.
• Considers factors related to safety, effectiveness, cost, and impact on practice on the populations in the planning and delivery of nursing care, policies, and services.
• Assists the Director of Quality Management, Care Coordination, and Case Management teams to develop, implement/monitor, and evaluate/revise program policies and procedures, protocols, and standing orders.
• Assists the Director of Quality Management, care coordination, and case management teams to develop short and long-term program goals and objectives.  Interprets data to identify trends and deviations from needs assessment to target high priority or “at risk” areas in the communities.
• Participates in quality assurance activities to improve access to care and services for patients living with chronic disease illnesses and clinical outcomes. 
• Maintains proficiency and knowledge in trends affecting nursing issues such as treatments, concepts, skills, and nursing theories through continuing education, workshops, staff meetings, and Improving Organizational Performance team committees.
• Requires completion of tasks or duties assigned by a supervisor.
• Upholds all principles of confidentiality and patient care to the fullest extent.
• Adheres to all professional and ethical behavior standards of the healthcare industry.
• Adheres to WIHCCs Personnel Policies and Procedures, departmental policies, rules, and regulations.
• Interacts in an honest, trustworthy and dependable manner with patients, employees, visitors, and vendors.
• Possesses cultural awareness and sensitivity.
• Maintains compliance with all Human Resources requirements.
• Performs other duties as assigned.

Minimum Qualifications:

Bachelor of Science degree in Nursing or entry of Masters of Nursing degree and minimum of two years’ experience in Nursing or Public/Community Health Nursing required. Must be licensed as Registered Nurse in the state of Arizona (excludes USPHS commissioned officers). Current CPR and BLS certification required. A certification in Public/ Community Health Nursing preferred. Previous Public Health Nursing experience preferred.  Bilingual skills in English and Navajo language preferred.  Must maintain a valid unrestricted and insurable driver’s license. Must successfully pass a background investigation and maintain suitable requirements for a Child Care position. This position is considered as a Child Care position, which requires a satisfactory background check investigation and is subject to the requirements of the Indian Child Protection and Family Violence Prevention Act, as amended (henceforth referred as the ICPFVP Act).

Knowledge, Skills, Ability:

• Knowledge and ability to apply principles, concepts and theories, core functions and essential services of Public/Community Health Nursing to provide nursing care services in homes and community settings.
• Knowledge and ability to incorporate the Patient Centered Medical Home aims into the community health home program.

• Knowledge of adult learning and health education techniques and principles including: reproductive health education, related services information, option counseling and emergency contraception services.
• Knowledge of anatomy, physiology, pathophysiology, epidemiology, physical assessment and basic pharmacology.
• Knowledge of human systems (wellness, illness, growth and development, basic nutrition, human behavior, psychosocial development, family and community systems).
• Knowledge of prescribed treatments and medical interventions; ability to effectively monitor and document the patient’s treatment progress and response; ability to refer to appropriate providers as indicated.
• Knowledge of health care technology, equipment, supplies and materials needed for medical treatment.
• Knowledge of Electronic Health Record documentation, medical record forms, State and Federal Laws that govern release of information, and patient consent.
• Knowledge of and awareness of cultural and language differences. 
• Knowledge of communicable disease outbreak, medical emergencies, and other unforeseen causes.
• Knowledge of emergency preparedness, at home, work and in the community.
• Knowledge of incident command structure and its use in the community; public health nurse is a first responder.
• Knowledge of current recommendations of the Advisory Committee on Immunization Practices (ACIP) and/or the Arizona State Immunization Information System (ASIIS) for vaccination of infants, children, and adults.
• Knowledge of relevant OSHA Standards.
• Knowledge of the National Incident Management System (NIMS)/Incident Command System (ICS) 100, 200 and 700.
• Knowledge of strong work ethics in the workplace.
• Knowledge of basic application of confidentiality.
• Knowledge of basic computer skills, e.g. Outlook, Word, Excel, PowerPoint.
• Ability to demonstrate knowledge of ACIP and ASIIS guidelines to determine which immunizations are needed for an individual based on individual demographics and medical history.
• Ability to meet attendance, overtime (if necessary), and other reliability requirements of the job.
• Ability to travel and make home visits including in inclement weather.
• Ability to demonstrate professional conduct and upholds the nursing practice standards of care set forth by the State Board of Nursing. 
• Ability to work collaboratively with Team Leader to provide patient care services.
• Ability to be dependable in attendance and job performance.
• Ability to work in unstable family settings and high risk neighborhoods.
• Ability to accept and learn from feedback.
• Ability to communicate effectively both verbally and in writing.
• Ability to provide exemplary customer service at all times.
• Ability to interact positively with others and possess great interpersonal skills.
• Ability to multitask and perform well under pressure.
• Ability to have self-confidence.
• Ability to be a great team player.
• Ability to accept and learn from supervisor/peer critique.
• Ability to be flexible and adaptable to the changing needs of the organization.

Physical Demands:

While performing the duties of this job, the employee regularly is required to walk; sit; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. The employee frequently is required to stand; climb or balance; and stoop, kneel, crouch, or crawl. The employee frequently is required to taste or smell. The employee must occasionally lift and/or move up to 50 pounds.   

Work Environment:

Work is performed in an office or home setting with a moderate noise level. Work environment may involve exposure to physical risks, such as blood borne pathogens and operating dangerous equipment or working with chemicals. Evening and/or weekend work may be required. Extended hours and irregular shifts will be required.

As required by P.L. 93-638, absolute preference will be given to qualified Navajo applicants.  If there is no qualified Navajo applicant, preference will be given to qualified American Indian applicants.