Registered Nurse Withdrawal Management

POSITION SUMMARY

The Withdrawal Management Nurse provides nursing support, assessment and care for the dual diagnosis and withdrawal management programs at Adult and Youth and is the first line support for patients, staff, Nurse Practitioners and the Medical Director on service specific clinical issues.

ESSENTIAL JOB FUNCTIONS

Clinical Coordination:

Cares for patients in the withdrawal management program according to staffing ratios determined by the Oregon Administrative Rules.

• Collaborates and communicates issues/concerns with the treatment team on clinical and non-clinical issues.
• Supports admission & medical staff in screenings for potential admissions for medical appropriateness.
• Reviews newly admitted patients’ medical histories and obtains additional medical information as necessary.
• Reviews risk assessments and provides further evaluation and referral as needed.
• Completes comprehensive nursing assessment as medically indicated on newly admitted patients.
• Provide on-going, accurate assessment, including:  obtaining & monitoring vital signs, drawing blood, urinalysis, performing CIWA-Ar & COWS scales, and performing other physical and social assessments as appropriate and necessary.
• Screens ongoing patients' medical symptoms or concerns to determine level of medical intervention needed.
• Provides nursing interventions as appropriate with available facilities, following medical policies, procedure & protocols safely & accurately.
• Review medication and orders and enter prescription orders safely and accurately.
• Administers medications as indicated by LMP ordered protocols and orders in a safe manner.
• Evaluate diagnostic tests to identify and assess patient's condition and notify provider of any abnormalities.
• Maintain up to date documentation in patient’s hard chart. 
• Maintain accurate controlled medication storage, disposal and count as indicated by policy.
• Educates patients on general health guidelines and preventative measures to improve over-all health and decrease risk factors, including continuum of care in A&D treatment and withdrawal symptoms.
• Arrange or assist patients in following through with referrals to other appropriate resources to meet medical needs and exchange relevant information with the agency or professional to whom the referral is being made.
• Collaborate with outside providers and facilities as needed in order to optimize continuum of care.
• Documents assessment, planning, implementation and evaluation in the patient record.
• Documentation is thorough, timely and in accordance with industry standards. Documentation reflects objective/subjective data, nursing interventions and patient's response to treatment. Notes provider orders accurately and in a timely manner.
• Provides care based on the best evidence available.  Interacts and participates in the education and orientation of medical support staff, withdrawal management nurses, patients and staff.  Promotes/supports growth of others through precepting and mentoring when appropriate.
• Role model healthy styles of communication and behavior, by using non-violent communication, verbal de-escalation, and demonstrating appropriate physical and emotional boundaries. Maintain professional boundaries with the patients at all times.
• Regularly attend medical withdrawal management staff meetings.
• Adhere to all state and federal privacy regulations, including HIPAA and 42 CFR Part 2, and to Fora policies and agreements regarding confidentiality, privacy, and security. Support compliance with all privacy and security requirements pursuant to community partners’ and outside providers’ patient confidentiality agreements, including privacy and security requirements for EMR access.
• Perform related tasks as assigned.

ADDITIONAL JOB RESPONSIBILITIES

• Maintain and strengthen good working relationships with members of the clinical teams.
• Coordinate admission of residential and detoxification patients with admissions and milieu staff.
• Request and obtain medical records to ensure that Fora receives the necessary paperwork to provide a proper continuum of care.
• Collaborate with the pharmacy and laboratory to ensure accurate orders and adequate supplies to perform nursing duties.
• Works with the patient, medical and clinical staff to ensure transition is safe and supported to another level of care.
• Perform related tasks as assigned.

QUALIFICATIONS

EDUCATION AND EXPERIENCE REQUIRED

• Current Oregon Registered Nurse or Licensed Practical Nurse license.
• Current BLS CPR & 1^st Aid Certification
• 2 plus years in behavioral health care and one plus years direct patient care. 

• Have basic knowledge of substance use disorders.
• Recognize the importance of family, social networks, and community systems in the treatment and recovery process.
• Demonstrate an understanding of and compliance with best treatment practices related to matters of self-awareness, diversity and ethics.
• Recognize the importance of individual differences which influence patient behavior and will develop and use strategies to maintain one’s physical and mental health.
• Proficient in the competency and standards developed for the Lead Nurse. 
• Understand the regulations that govern nursing care and abide by those regulations.
• Knowledge of nursing theory and practice.
• Knowledge of chemical dependency and treatment methods.
• Application of knowledge in nutrition, sanitation, and personal hygiene.
• Ability to follow verbal and written directions and to apply techniques for specific needs.
• Knowledge of community resources.
• Knowledge of de-escalation methods or ability to be trained in de-escalation methods.
• Ability to work in an environment where people may be hostile or abusive.
• Ability to manage time and meet deadlines.
• Ability to maintain accurate records and necessary paperwork that meets industry standards.
• Ability to learn and apply training instruction.
• Knowledge of medical assessment of patients in addictions treatment.
• Proficient in Microsoft Office applications.
• Communicate information effectively in writing and verbally.
• Strong organization and attention to detail skills.
• Maintain confidentiality of sensitive information and documents.
• Initiative and problem solving skills.
• Social perceptiveness and service orientation.
• Team development skills.

OTHER REQUIREMENTS

• Verification of Sobriety, per Oregon Administrative Rules (OAR) standards
• DHS Background Check Approval
• Successful completion of Drug Test upon hire
• Documentation of Tuberculian test and/or evaluation with negative results or evidence of non-communicability

WORKING CONDITIONS

• This position generally works in an indoor office environment with periodic travel between sites or to special events.
• Possible exposure to communicable diseases which can encompass a variety of illnesses and infections, including tuberculosis, Hepatitis A, B, and C, and HIV.
• Possible exposure to upset, angry, severely traumatized or emotionally disturbed adults, adolescents, and families. 
• Position might require overtime, but not consistently.  Adjustment of work schedule may be required.
• Shift work may include day, swing and graveyard hours. Shifts may also be scheduled on weekends and holidays.
• Exposure to potentially hazardous cleaning chemicals, body fluids, sharps equipment and medication; personal protective equipment provided.

HOURS AND PAY

This is an on call position earning $52.33-56.12 per hour (depending upon experience). This position is non-exempt and eligible for overtime compensation. On call employees are not eligible for benefits.

Day and overnight shifts available working 12 hour shifts 7am to 7:30pm or 7pm to 7:30am

LOCATION

This position is an on-site position at our SE Cherry Blossom location in Portland, Oregon.