Public Health Nurse II - Lead Clinic Nurse

Primary Purpose of Position: 

To provide nursing services through the various medical programs within the Department.  Interviews, counsels, assists, and treats patients in prenatal, pediatric, family planning, adult health, and communicable disease clinics.   Inventories, requisitions, and maintains medical supplies for the office.  Position works closely with the Immunization Coordinator to facilitate VFC compliance with state and federal immunization program requirements.   Maintains employee health records for Health Department staff.

B.Work Schedule:  

8:00 AM - 5:00 PM, Monday through Friday.   Occasional extended hours or weekends for community health fairs, flu shots, etc.  Hours may vary depending on the services of the department.

Immunization Lead Nurse for Nashville Clinic

Notifies when State vaccines need to be ordered from the State vaccine from the VFC (Vaccines for Children) program.

Immediately unpacks, checks, and stores vaccine deliveries in the absence of the supervisor.

Ensures proper storage and handling of all vaccines.

Monitors refrigerator and freezer temperatures to ensure temperatures are kept within recommended ranges.

Monitors Digital Data Loggers for proper functioning and replaces them as necessary.

Completes qualifying immunization-related educational contact each calendar year as required by CDC (Centers for Disease Control and Prevention).

Counts vaccine weekly on a rotating basis.

Investigates and ensures correction of vaccine errors found during weekly vaccine inventory count.

Participates in VFC audits.

Completes vaccine adverse event reports using the Vaccine Adverse Event Reports System (VAERS).

Prenatal Program

Completes an initial or interim medical and psychosocial history.

Takes blood pressure and orders appropriate lab tests.

Provides education and counseling regarding medical and psychosocial problems identified.

Provides appropriate education and counseling (ex., nutrition, danger signs of pregnancy).

Dispenses appropriate medications and/or vitamins and iron according to the Department’s Pharmacy Policy and Procedures and Prenatal Policy, Procedures and Standing Orders.

Administers immunizations per standing orders.

Initiates necessary referrals.

Documents findings and all activities in the patient’s medical record according to the Department’s Medical Record Policy.

Family Planning Program

Completes an initial or interim medical and psychosocial history.

Takes blood pressure and orders appropriate lab tests.

Provides education and counseling regarding medical and psychosocial problems identified.

Provides education, counseling, and instructions regarding methods of birth control and method chosen.

Dispenses appropriate medications and/or birth control method according to the Department’s Pharmacy Policy and Procedures and Family Planning Policy, Procedures, and Standing Orders.

Administers immunizations per Standing Orders.

Initiates referrals for abnormal findings and needs identified.

Document’s findings and all activities in the patient’s medical record according to the Department’s Medical Record Policy.

Supplies and Equipment

Responsible for stocking clinic supplies.

Responsible for notifying nursing supervisor of items that need to be ordered for the Nashville office.

Confirms that supplies delivered agree with order submitted.

Stocks and stores supplies according to recommendations.

Monitors expiration dates on drugs and supplies, rotates stock so short dated material is used first.

Monitors emergency equipment (i.e.:  checks oxygen and AED monthly and records).

Spot checks vaccines, supplies and medications.

Cleans and runs autoclave to sterilize equipment.

Child Health Program

Completes child’s initial and or interval medical, psychosocial, developmental, family, and dietary history.

Reviews and dates pre-visit questionnaire (alerts provider of identified concerns).

Performs visual acuity and hearing screening, obtains height and weight, and takes blood pressure on infants and children as outlined in the current Health Check Billing Guide.  Takes temperature, pulse, and respirations on infants and children as needed. 

Provides dental varnishing educational information and applies topical fluoride varnish per Standing Orders of the Child Health Program.

Orders appropriate lab work per Provider instruction and/or Standing Orders. 

Dispenses or administers medications and immunizations according to the Standing Orders of the Child Health Program and the Pharmacy Policy and Procedures. 

Documents findings and all activities in the patient’s medical record according to the Department’s Medical Record Policy.

STD/HIV Program

Completes an initial or interim medical and sexual history.

Orders appropriate lab tests.

Provides education and counseling regarding problems identified.

Dispenses or administers appropriate treatment according to the STD Policy, Procedures, and Standing Orders, and according to the Department’s Pharmacy Policy and Procedures.

Provides pre and post test HIV counseling.

Administers immunizations per Standing Orders.

Initiates referrals for abnormal findings and needs identified.

Documents findings and all activities in the patient’s medical record according to the Department’s Medical Record Policy.

Adult Health Program – Women’s Health Watch

Completes an initial or interim medical and psychosocial history.

Takes blood pressure and orders appropriate lab tests.

Provides education and counseling regarding problems identified (ex., chronic disease and disease prevention).

Dispenses medications according to the Department’s Standing Orders and Pharmacy Policy and Procedures (ex., treatment for vaginitis).

Administers immunizations per Standing Orders.

Initiates referrals for abnormal findings and needs identified.

Sends letters to patients with cholesterol and titers results.   Abnormal cholesterol patients are sent Healthy Eating and Foods to Avoid literature.

Documents findings and all activities in the patient’s medical record according to the Department’s Medical Record Policy. 

Other Duties

Assists with general clinic patients; i.e.:   those presenting for pregnancy tests, TB medications, hepatitis B vaccine, blood pressure checks, B12 injection, etc.

Rotates on the Department’s Quality Assurance Teams.

Helps maintain a safe working environment.

Assists with Red Cross disaster sites as needed.

Other duties as assigned.

Considerable knowledge of and skill in the application of nursing theory, practices, principles, and techniques employed in the field of public health and related programs; general knowledge of and ability to apply the principles and practices of public health; working knowledge of current social and economic problems relating to public health; working knowledge of available resources and organizations.

Ability to deal tactfully with others and to exercise good judgement in appraising situations and making decisions; ability to secure the cooperation of clients, to elicit needed information and to maintain effective working relationships; ability to record accurately services rendered and to interpret and explain records, reports and medical instructions.

Accuracy Required in Work: 

Accuracy and sound judgement are required in all nursing interventions with patients.  Accuracy is required in identifying patient needs through interviewing and data collection.  Interpreting findings, initiating standing orders, medication dispensing, medication administration, reviewing lab work, diagnostic reports, counseling, and initiating referrals all require maximum accuracy.

Consequence of Error: 

Errors could result in inappropriate or inadequate medical services, endangering the health and safety of patients.  Errors may also precipitate malpractice lawsuits and/or enforcement action by the North Carolina Board of Nursing.

Instructions Provided to Employee: 

Receives a three-week minimum orientation.   Attends workshops related to job.   In-house updates at monthly staff meetings or by written memo.  Daily changes related to treatment modalities, supplies, programs, staff are handled by clinical supervisor.

4. Guides, Regulations, Policies and References Used by Employee:

Nash County Health Department Policies, Procedures, and Standing Orders

ACIP Manual

Nash County Personnel Policies

North Carolina Nurse Practice Act

DHHS Program Directives

Federal and State Statutes and Rules

Supervision Received by Employee: 

Works daily with Program Lead Nurses.  Receives formal, written appraisals per the Department’s Policy.  Records are reviewed quarterly by the Department’s Quality Assurance team.   Work in progress is observed by the Clinical Supervisor.

Variety and Purpose of Personal Contacts: 

Works directly with patients of all social, racial, and economic groups on a daily basis.  Works with other staff within the department to assure all needed services are provided for the patient.  Communicates with outside providers to assist patients with their needs and to initiate referrals.  Must always be sensitive to others and be knowledgeable and tactful when assisting patients or when working with the community.

Physical Effort: 

Requires the provision of patient services each day whether through applying direct clinical skills, phone calls, record management, or attending a continuing education workshop.  Occasional stooping, reaching, lifting involved with storage of supplies.

Work Environment and Conditions: 

Employee will be based in one office.  Potential to be exposed to airborne pathogens and bloodborne pathogens.

Machines, Tools, Instruments, Equipment and Materials Used:

Stethoscope, blood pressure cuff, copier, fax, scales, computer/EMR, thermometers, stadiometer and audiometer (OAE and Beltone).

10. Visual Attention, Mental Concentration and Manipulative Skills:

Must be able to identify, organize and complete the work process.  Document on medical records. Administer medications.   Communicate with patients and other professionals.  

Safety for Others: 

Must be knowledgeable of safety polices and procedures of the department.  Must be knowledgeable of local polices, procedures, and standing orders, and have the nursing expertise to provide appropriate medical care.  Must be adequately immunized per Department's policy.   Adheres to Department's Bloodborne Pathogen Policy.

Dynamics of Work: 

Changes in policy occur as state guidelines are updated and their recommendations are incorporated into local policy.  Changes occur daily in response to absences, clinics running behind schedule, or patients who require unforeseen demands.   Changes also occur when recommended by the Department's local medical consultants.

Required Minimum Qualifications: 

Graduation from an accredited school of professional nursing and one year of professional nursing experience.

2. Additional Training/Experience:

HIV Counseling

CPR

Introduction to Disaster

Disaster Health Services I & II

Equivalent Training and Experience: None

License or Certification Required by Statute/Regulation/Agency:

Current license to practice as a Registered Nurse in North Carolina by the North Carolina Board of Nursing.        Valid North Carolina Driver's License.

Salary : $65,231 - $105,048