Public Health Nurse 2 - Clinical Preventive Services

This recruitment has been reopened for additional applicants. If you have already applied for recruitment #511-2024-1, you do not need to reapply. 

Marion County Health and Human services is seeking a qualified RN to provide TB case management and Public Health Clinic services. If you have a passion for Public Health and want to support the promotion and provision of vaccines, promote STI screening and treatment, and help treat Tuberculosis and prevent new cases, then this job is for you!

GENERAL STATEMENT OF DUTIES 
Provide comprehensive nursing assessments, develop intervention strategies, and provide nursing services to individuals, families, groups, and communities; provide case management for high-risk clients.
 
SUPERVISION RECEIVED 
Work under the general supervision of a manager or supervisor, who assigns work, establishes goals and reviews results obtained; may perform nursing duties as set forth in the medical standing orders established for a specialty area.
 
SUPERVISION EXERCISED 
Supervision of other employees is not a responsibility of positions in this class.The nurse in this position provides Tuberculosis Case Management and Public Health Clinic Services. Demonstrates flexibility in adapting as program and/or service needs change.

Tuberculosis (TB) Program Services
Works to prevent and control the spread of tuberculosis. Related duties include but are not limited to:

• Participates in TB surveillance and service activities including, but not limited to reportable TB and outbreak response.
• Participates in weekly case review and documents summary of case review to maintain a basic knowledge of all clients on caseload.
• Identifies needs and makes appropriate timely referrals.
• Develops and implements comprehensive plans of nursing care including:
  • Makes/plans home visits for TB program Directly Observed Therapy (DOT).
  • Routine medication assessment, refill, and monitoring.
  • TB screening
  • Collects sputum specimens, draws blood, and administers tests and vaccinations per the patient treatment plan.
  • Contact investigation and follow-up.
  • Educates, counsels and coaches’ clients regarding disease processes, risk behavior, healthy lifestyles, prophylaxis, medication management and treatment goals.
  • Evaluates and revises treatment goals with clients to assure effective plans.
  • Coordinates and consults on plan of care with MCHHS Health Officer and outside providers/agencies.
  • Evaluation and appropriate follow-up of x-ray/lab/sputum.
  • Drives to client home or other sites to provide services, attend off-site meetings, pick up specimens or conduct field investigation of communicable disease.
  • Maintains open communication with and provides nurse guidance and oversight to Public Health Workers providing TB and sexually transmitted infections services.
  • Utilizes computer and internet to access information and document activities.
  • Performs accurate and timely documentation in ORPHEUS database.
  • Performs accurate and timely documentation in electronic medical record.
  • Provides services to non-English speaking clients via telephonic or in-person interpreter.

General Public Health Clinic Responsibilities

• Provides direct service to clients, including administration of injections.
• Follows the policies and procedures specific to the services provided.
• Provides health information and education relevant to the services sought by the individual, per policy. 
• Provide timely, accurate & complete documentation and billing of services. 
• Obtains and transports supplies from refrigerator/freezer, overhead cabinets, and other storage areas.
• Greets client in waiting area, escorts to clinic service area and back to front desk.
• Documents services provided accurately and completely at the time of service.
• Checks and records refrigerator and freezer temperatures each AM and PM and informs Supervisor and/or Coordinator of temperature falling outside the range.
• Participates in returning client calls, signing off on returned labs, follow-up of positive labs, weekly chart audits, drug counts, etc.
• Drives to community sites to provide services and attend meetings and training.

Immunizations to Infants, Children and Adults:  

• Administer vaccines as forecasted unless medically contraindicated.
• Provides immunizations in Marion County clinics and special off-site clinics.  
• Assures documentation of services to meet state and local standards.   

Sexually Transmitted Infections Clinic Services  
Complete the intake, screening, nursing history, and assessment of clients, per MCHHS standing orders.
Assure and provide appropriate treatment for clients, to include:

• Administration of medications and immunizations
• Provision of current and appropriate medication information verbally and in writing.
• Initiate a plan with client for follow up and treatment.
• Triage walk-in clients and those phoning in with questions or requests for exams.
• Provide accurate and timely documentation in electronic medical record.
• Reviews lab results and processes appropriately.
• Phone in prescriptions as ordered by the Health Officer.

Infection Prevention Services to MCHHS employees:

• Conduct Immunity Assessment, TB screening, and provide immunizations to employees per policy.
• Draw blood for post vaccine titer per policy.
• Provide post occupational exposure follow-up for BBP and other communicable diseases as appropriate.
• Provide timely, accurate & complete documentation of services in confidential digital & paper files.
• Maintain PPD, fit test solution and vaccine medication inventory for employees.  
• Ensure OSHA requirements for HBV vaccine are met in concert with Immunization Coordinator.
• Ensure employees who fail to comply with needed services are referred to their supervisor and Clinic supervisor within 1 month of being overdue in concert with Immunization Coordinator.  

Share in General Program Duties with the Clinical Preventive Services (CPS) Team: 
Participates and/or provides leadership to a variety of activities not limited to the following:

• Develop and/or contribute to Team meeting agenda, policies and procedures and other documents.
• Review and provide feedback to Health Officer regarding standing orders.
• Provide services to and communication with community partners, e.g., homeless shelters, school nurses and information and technical assistance to healthcare providers.
• Communicate client and program issues to the Clinic Coordinator and/or Program Manager.
• Participate in planning, implementation, and evaluation of CPS program activities.
• Participates in and may provide evaluation and monitoring of CPS program services and activities including quality improvement initiatives and program performance management measurement and tracking.

Other duties as assigned by your supervisor.  May include but is not limited to response to public health emergencies to provide essential MCHD nursing or non-nursing services, including mass clinics to provide immunization/medication, or outreach responses, or other functions.

Response Level 2: In the event of an emergency, employee makes a reasonable effort to report to work. Employee may be required to perform duties outside of their regularly assigned duties. Employee may be requested to work an extended or flexible schedule. Staff at this response level must complete Incident Command System 100 and 700 on-line or in-person training. 

May flex schedule to provide services outside of normal Monday–Friday, 800 am–5:00 pm hours.

May work late clinic; occasional after hours or weekends to meet business need. 

EXPERIENCE AND TRAINING

1. Associate degree, or diploma, in nursing and two years of experience as a nurse in a public health, social services, or community health setting; OR
2. Bachelor's degree in nursing; OR
3. Any satisfactory combination of work, education, training, or experience relevant to the position, as determined by Marion County. 

SPECIAL REQUIREMENTS

• Possession of a current license to practice as a registered nurse in the State of Oregon at the time of appointment.
• Must have a current CPR certificate.
• Must possess a current driver's license in the applicant's state of residence and an acceptable driving history.  Marion County will obtain a copy of the driving record for all qualified applicants from Driver and Motor Vehicle Services and review the driving record according to the Marion County policy and procedure for Driving on County Business.  The policy can be found at:  http://apps.co.marion.or.us/APAP/.
• The finalist for this position will be required to pass a criminal history background check; however, conviction of a crime may not necessarily disqualify an individual for this position.
• This is a safety sensitive/special needs position. Final candidates selected for this position will be required to pass a pre-employment drug screen, including testing for marijuana. The Marion County Drug and Alcohol Use and Testing Policy can be found at: http://apps.co.marion.or.us/APAP/policy.aspx?p=policy&pid=518.
• This position may be subject to the following:  Must not be excluded from participation in the federal health care programs (Medicaid, Medicare and other federally funded programs that provide health benefits); AND must not be excluded from participating in federal procurement (Federal Acquisition Regulation) and non-procurement activities (Executive Order No. 12549).
• This is a full-time position that is eligible for overtime.
• This position is represented by a union.
• Typical work schedule:  Monday through Friday, 8:00 am - 5:00 pm, with flexibility to meet the needs of the department or program.

Knowledge of 

• the practice of public health nursing and the use of community resources.
• public health sciences and services.

Skills and abilities 

• in interdisciplinary teamwork.
• make nursing assessments which include environments and systems, in addition to individuals, families and groups.
• accept and abide by supervision received.
• recognize the needs and concerns of people and to maintain constructive and therapeutic relationships.
• provide skilled nursing care.

PHYSICAL REQUIREMENTS
Operates a motor vehicle; sees using depth perception; stands; sits; moves about the work area; bends forward; climbs 1 floor of stairs; reaches overhead; lifts, pushes, pulls, carries and moves carts weighing up to 20 lbs. such as home visit bag and/or equipment to and from car and from clients house; frequently carries items weighing between 1-2 pounds; operates a keyboard; speaks with a clear and audible voice; reads a 12-pt. font and 6-pt. medication vials; able to take blood pressure; administer PPD's and draw blood; hears a normal speech level; and uses a stethoscope.  Works in areas that may be exposed to heat, cold, dust, smoke, humidity, noise, and chemicals.  Works in areas that may be wet or uneven.  Job involves driving to homes to visit clients, so employee is exposed to potential weather extremes when between the automobile and the office or home. Noise:  May be exposed to screeching or crying infants or children in homes. Chemicals:  May be exposed to disinfecting towelettes when cleaning toys and supplies. Uneven area: may encounter uneven surfaces at community sites.