Staff Nurse - Ambulatory Care
: Job Details :

Job DescriptionMarketing StatementNYC Health + Hospitals/Gotham Health is one of the largest Federally Qualified Health Center (FQHC) in the country, providing coordinated world-class primary and specialty care with dignity and respect for all New Yorkers, without exception. At Gotham Health, we practice a person-centered caring culture that values delivering compassionate, quality healthcare in partnership with our patients, community organizations, and staff. Gotham Health is focused on high-quality, affordable care to everyone regardless of ability to pay or immigration status. Gotham Health serves the community through a two-pronged approach: providing treatment to those who need it while at the same time emphasizing prevention. We strive to deliver services in a way that maximizes each patient's opportunity to achieve successful health outcomes, we believe in every person's right to participate in their care plans, we facilitate partnerships with other community resources to meet the needs of our patients beyond healthcare, and we celebrate and recognize the compassionate care of our committed staff. Join our team if you want to be part of our Gotham Health Family, a person-centered, fully integrated, and innovative ambulatory care network that enables all New Yorkers to live their healthiest lives.Job DescriptionPURPOSE OF POSITIONThe Registered Nurse will provide professional nursing care including diagnosing and treating human responses to actual and potential health problems through case finding, health teaching, counseling and the provision of care supportive of or restorative to life and well-being in accordance with their scope of practice.Summary Of Duties And ResponsibilitiesAssessment

• Completes patient assessment according to established guidelines.
• Identifies patient problems and barriers to providing optimal care (e.g., language, culture, and behavioral health issues) and incorporates patient's perception of illness.
• Prioritizes the data and information collected based on the patient's condition and preferences, situation, and/or anticipated needs.

Diagnosis

• Formulates nursing diagnosis based on identification data.
• Identifies the nursing diagnosis, actual or potential based on the analysis of assessment data and information, current ambulatory care RN knowledge, and evidence-based practice.

Outcomes Identification

• Involves the patient, family, and health care team in establishing goals/outcomes that are realistic/measurable/mutually set and expected.
• Defines expected outcomes in terms of the patient values, preferences, spiritual, emotional, cultural and ethical considerations, age-related issues, and situational environment.
• Specifies a time estimate for attainment of measurable expected outcomes.

Planning

• As a member of the health care team, participates in pre-visit planning, daily clinical huddles, and other activities to meet Patient Centered Medical Home Standards.
• Identifies Care Gaps and works with the team to close gaps through proactive outreach, patient education, referrals, and needed services.
• Develops an individualized ambulatory nursing plan for patients seeking care for health promotion, health maintenance, or health-related situational problems.
• Considers patient or population needs in terms of age, gender, race, cultural values and practices, ethical and legal considerations, physiological, psychological, and environmental factors, and the anticipated risks and benefits of interventions for individualized plan development.
• Incorporates a timeline for ambulatory care nursing plan implementation and goal achievement, reevaluation or reassessment, follow-up care, and care coordination as appropriate.
• Provides a plan of care that is clear and understandable to patient, family, and/or caregivers.

Implementation

• Develops and implements an individualized teaching plan based on the patient's preferences, resources, motivation, and anticipated needs.
• Utilizes evidence-based, ambulatory care-specific interventions to achieve agreed upon outcomes during clinical visits, nurse visits, telephone encounters, and electronic communications.
• Provides culturally sensitive care to patients and families in collaboration with other health team members.
• Assists with diagnostic tests and procedures within scope of practice and facility policy.
• Communicates and documents pertinent information to the health care team.
• Adheres to standard work flows and completes EPIC work queues as identified.

Coordination of Care

• Applies effective teamwork and collaboration skills to overcome identified barriers to produce quality and effective patient outcomes.
• Utilizes an interprofessional approach to engage patient, caregivers, and providers in implementing and coordinating the plan of care across care settings.
• Manages high-risk individuals and/or population(s) with the aim of preventing or delaying adverse

outcomes, utilizing population health database, as needed.

• Communicates the relevant information to patient, caregivers, and interprofessional health care team across the continuum.
• Participates in coordination of care activities through Accountable Care Organizations (ACO) and in the development and implementation of other patient care/health care delivery initiatives.

Health Teaching and Promotion

• Assesses a group or patient's learning needs, abilities, readiness, preferences, and barriers to learning.
• Utilizes health teaching and health-promotion strategies which support the patient's learning needs, values, preferred language, socioeconomic status, cultural, and spiritual preferences.
• Documents learner assessment, comprehension, and effectiveness of educational strategies, as well as modifications to plan of care.
• Participates in outreach and preventative care education.

Evaluation

• Participates in the development and maintenance of a system of evaluation of nursing care, practices and procedures, including evaluation of nursing personnel.
• Reviews effectiveness of plan, evaluates interventions and expected outcomes.
• Evaluates the quality of care provided to patients.

Documentation

• Records activities, documents assessments, plan of care, interventions, evaluations, and reevaluation of patient status, and contact notes as appropriate in the Electronic Medical Record.
• Utilizes appropriate downtime documentation procedure when the electronic system is down.
• Updates care plan according to policy.

Education/Self Development

• Pursues educational and professional experiences that expand ambulatory care nursing knowledge, skills, and competencies.
• Participates in Nursing Shared Governance and other patient care committees and/or projects within the institution.
• Demonstrates and awareness of current departmental standards/regulatory /accreditation requirements for nursing.
• Maintains current state professional nurse (RN) license and certifications.
• Mentors and supports new nurses to the ambulatory care nursing setting, incorporating them into interprofessional activities and ongoing continuing education.

Research and Evidence-Based Practice

• Reviews and evaluates current literature for research and evidence relevant to ambulatory care nursing practice.
• Utilizes current research findings and other evidence to expand professional knowledge, enhance role performance, and increase knowledge of ambulatory care nursing professional issues.

Performance Improvement

• Monitors/evaluates assures compliance with quality improvement standards.
• Participates in Quality Assurance/Quality Improvement data collection and Performance Improvement projects (Nursing, departmental, service based).

Communication

• Communicates pertinent information to health team members in a timely manner.
• Initiates appropriate referrals to health care providers and other resources.
• Demonstrates positive verbal and non-verbal communication skills.
• Addresses patients/visitors in a professional manner; functions as patient advocate.

Leadership

• Delegates assignments for nursing personnel based on patient acuity and employee skill level of competency.
• Coordinates unit routines and provides guidance/supervision to assigned nursing staff; leads by professional example.
• Investigates, reports/corrects significant conditions which may affect safety of patient/staff/visitors.
• Actively participates in patient safety huddles and debriefings.
• Operates equipment/performs work related duties in a safe manner.
• Reports equipment malfunctions/requests repairs as necessary.
• Ensures emergency equipment/supplies are available and working properly.
• Demonstrates knowledge of infection control procedures.
• Follows procedures and practices for identification of patients.
• Adheres to policy for facility fire/safety/understands role in fire drills; Internal/external disaster plans.
• Recognizes/responds to emergencies appropriately.
• Orients new personnel to unit policies, procedures, and practices.

Environment and Safety

• Administers medications and treatments in accordance with hospital policies and procedures.
• Follow up abnormal labs and recall patient as per provider's instructions.
• Performs POC (Point of Care) testing, as necessary including Rapid HIV, blood glucose, INR, rapid

strep, pregnancy and urinalysis and records results in the Electronic Medical Record.

• Performs HIV counseling and testing to patients as needed.
• Complies with VFC (Vaccine for Children) guidelines for storage and handling of vaccines.
• Ensures control and thermometer log are completed.

Personnel Responsibilities

• Reports on time and ready to work at start of the shift, complies with time and leave policies.
• Observes facility policies governing conduct at work such as telephone usage.
• Accepts reassignment to other units and schedules when necessary.
• Accepts reassignment for RN functions and responsibilities as needed and/or assigned.
• Observes facility uniform/dress code.
• Wears identification name badge while on facility premises.
• Conduct one's self in a professional and respectful manner while on duty.
• Customer service behavior and attitude.
• Knowledgeable and upholds to the Gotham Health Standards of Behavior.
• Completes annual mandates and annual in-services.
• Conforms to policies governing patient rights and confidentiality of patient information.
• Performs other duties as may be requested by Nursing Administration.
• Work/or maintain EPIC work ques.
• Adherence to wearing allocated uniforms.
• Evenings/or weekend assignments as needed.
• Follow standardized work for Treat to Target.

Minimum Qualifications

• A valid New York State license and current registration to practice as a Registered Professional Nurse in New York State; and
• Holds, or obtains through facility orientation, a valid and current certification in Basic Life Support (BLS) through the American Heart Association (AHA).

Special NoteFor assignments in Post-Acute Care ONLY, individuals meeting the following criteria may also be considered for appointment: Graduation from a nursing education program registered by the New York State Education Department (NYSED) as licensure qualifying for Registered Professional Nurse (RN) and has applied for licensure as an RN. These unlicensed individuals may be employed to practice under the immediate and personal supervision of a NYS licensed, currently registered, RN for up to 90 days immediately following graduation pending receipt of a limited permit, which selected candidates must apply for and receive within the same 90-day period. Once a limited permit is received, individuals can practice nursing, under the immediate and personal supervision of a NYS licensed, currently registered, RN at a NYC Health + Hospitals health care setting for up to one (1) year from the date of issuance of the limited permit. In addition, must hold or obtain through facility orientation, a valid and current certification in Basic Life Support (BLS) through the American Heart Association (AHA).Department PreferencesCertification(s)/License(s)QUALIFICATIONS FOR THE JOB:

• NYS RN License
• Certification in Ambulatory Nursing preferred

Educational Level

• BSN degree from an accredited school
• Certification in Ambulatory Care preferred

Knowledgeable In

• Ambulatory and/or primary care nursing
• Spanish or a second language preferred
• Microsoft suite

Supervision Of Staff

• PCA, PHA, LPN

Equipment/Machines Operated

• Manual and Automatic B/P machine
• Oxygen tanks
• Nebulizer
• POCT equipment
• AED
• EKG
• Computer
• Copier/fax
• Spirometer

COMPUTER PROGRAMS/SOFTWARE OPERATED

• Computer literacy essential
• Word programs
• Electronic Medical Record
• Referral System
• Scheduling System

Years Of Experience

• 2 years or more in primary care
• 1-year ambulatory nursing preferred

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