Registered Nurse (RN) - Day Shift, ORCA POD

Schedule: Monday–Friday, business hours (typically 9am–5pm with 30 minute lunch); some flexibility required for outreach events, field engagement, and collaboration with community partners.

Insurance Benefits: Dental, Life, Long-term Disability, Medical (no premiums/payroll deductions for employee coverage)

Other Benefits: Employee Assistance Program (EAP), Flexible Spending Account (FSA), ORCA card subsidy, Paid Time Off (34 days per year), Retirement Plan

Union Representation: This position is a part of a union and is represented by SEIU Healthcare 1199NW.

Supervised by: ORCA POD RN Supervisor

A cover letter is required as part of your application to be considered for this role.

About the Opioid Recovery & Care Access (ORCA) program

DESC’s ORCA program provides compassionate, low-barrier, and evidence-based care to individuals who are recovering from opioid overdose and those seeking treatment for opioid use disorder (OUD). The ORCA Center, our brick-and-mortar location, provides post-overdose subacute stabilization services and provides walk-in access to medications for opioid use disorder (MOUD). The ORCA Patient Outreach Division (POD) delivers field-based MOUD care – meeting people where they literally are in the community.

ORCA Center

The ORCA Center is open 24 hours per day, 7 days per week, including holidays. It is staffed by a multidisciplinary team, including providers, nurses, medical assistants, peers, and milieu specialists. The ORCA Center offers four overlapping types of services:

• Care to individuals in stable condition who have experienced an opioid overdose, brought to the ORCA Center by first responders or transferred from local emergency departments.
• Rapid initiation of medications for opioid use disorder (MOUD), including buprenorphine (sublingual and long-acting injectable) and methadone (under the “72-hour rule”, or CFR Title 21 §1306.07 (b)), for people with OUD, regardless of whether an opioid overdose has recently occurred.
• Harm reduction counseling and OUD-related physical and behavioral health services.
• Follow-up care for individuals who have started MOUD to ensure support in MOUD continuation.

ORCA POD

ORCA POD is ORCA’s field-based care team, bringing MOUD induction, stabilization, and maintenance services as well as education and other supports directly to patients in the community. ORCA POD operates during business hours (Monday through Friday, 9 a.m. to 5 p.m.). ORCA POD is a multidisciplinary team, including providers, nurses, and peers, operating across several geographic areas throughout the greater Seattle region including:

• Permanent Supportive Housing (PSH) sites
• Emergency shelters
• Encampments or unsanctioned sites
• High-need geographic zones identified in collaboration with DESC and community partners
• Areas without easy access to low-barrier MOUD services

JOB OVERVIEW:

The Registered Nurse (RN) provides and coordinates care for individuals suffering from opioid use disorder in DESC’s low-barrier buprenorphine program. The RN acts as a member of an interdisciplinary team to provide buprenorphine services to our community’s most vulnerable population, many of which are experiencing homelessness, mental illness and a range of comorbidities. This position provides the opportunity to participate in community engagement in shelters, encampments and permanent supportive housing. The RN will provide client-centered care through the lens of harm reduction and trauma-informed care. Work is done under the supervision of the Nursing Supervisor and Nurse Manager at DESC’s Downtown Behavioral Health Clinic.

MAJOR DUTIES AND RESPONSIBILITIES:

• Provide low-barrier, outreach-based OUD treatment focused on a population of clients who have difficulty accessing traditional buprenorphine services. Integrate care with a multidisciplinary team of psychiatric providers, nurses, substance use professionals, peer support specialists, mental health case managers and primary care providers.
• Assess and monitor patients in induction, stabilization, and maintenance phases of treatment with clients wanting buprenorphine or intramuscular naltrexone, using an approach that is patient-centered and includes harm reduction strategies and motivational interviewing in a non-traditional setting.
• Provide counseling and education about treatment options to clients and work together with them to set and monitor goals.
• Follow state and federal guidelines, as well as program-specific policies and procedures for patients with OUD in collaboration with prescribing providers and dispensing pharmacies.
• Provide screening, counseling and care coordination for both HIV and Hepatitis C.
• Use critical thinking, clinical judgment, patience and flexibility in frequent contacts with clients.
• Have strong communication and customer service skills.
• Demonstrate leadership ability as well as using interdisciplinary team concepts.
• Provide ongoing assessment of mental status and the positive impact and side effects of treatment.
• Assess clients for a range of health care needs and facilitate linkage and on-going connection to relevant urgent, primary and specialty health services to ensure continuity of care. Advocate for patients’ access to a variety of community resources and services.
• Collaborate closely with other DESC services, particularly DESC housing teams and substance use disorder professionals (SUDPs) on the SUD team.
• Consult and collaborate with community providers to ensure continuity of care and that patients’ needs are being met, and rights maintained.
• Provide nursing services and basic wound care.
• Serve as an educational resource and provide consultation for DESC staff.
• Participate in psychiatric consultation, supervision, program meetings and in-service trainings.
• Comply with the agency’s clinical accountability policies and procedures; maintain current and complete clinical records; participate in quality assurance reviews.
• Participate in verbal de-escalation and crisis interventions in emergent situations and be willing and able to assist other staff as needed to maintain a safe and secure environment.
• Other duties as assigned.

MINIMUM QUALIFICATIONS:

• Registered Nurse licensed in the State of Washington OR Registered Nurse licensed under Nurse Licensure Compact (NLC) and will apply for Washington State endorsement within 60 days of hire.
• Knowledge of psychiatric medications, side effects and methods of administration.
• Desire to serve people with complex needs who are or have been experiencing homelessness and are living with serious and persistent mental illness, substance use disorder, and other complex medical conditions.
• Able to work effectively with clients displaying a wide range of challenging behaviors .
• Adaptable to changing priorities, processes, or workflows as the program grows and evolves.
• Able to give and receive constructive feedback.
• Familiar with trauma-informed care, harm reduction, and equity and social justice principles.
• Possess cultural humility and able to work effectively with individuals of diverse backgrounds and identities.
• Willing to travel across the greater Seattle area.

PREFERRED QUALIFICATIONS:

• Bachelor of Nursing degree.
• Nursing certifications
• Knowledge and skill in working with co-occurring mental health and substance use disorders; with people with a history of homelessness; and crisis intervention and stabilization experience.
• Familiarity with Recovery Principles, Crisis Intervention and Stabilization, Integrated Treatment of Co-occurring Disorders, Intensive Case Management, Illness Management, and relevant Evidenced based/Emerging best practices.
• Bilingual in Spanish/English.
• Ability to drive an agency or personal vehicle to conduct agency related business, which requires a current Washington State driver's license and insurable driving record.

Strong applicants are able to demonstrate the ability to be positive in their empathetic responses to all persons; understand the value of meaningful and deep client engagement; and value a non-judgmental response to sensitive issues. Candidates should be able to accept feedback and work in a highly collaborative and sometimes stressful environment.

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee will be required sit for long periods of time, communicate with other persons by talking and hearing, required to lift and carry items weighing up to 25 pounds and to operate computer hardware systems. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

EQUAL OPPORTUNITY EMPLOYER:

DESC is committed to diversity in the workplace and promotes equal employment opportunities for all staff members and applicants. The Agency will not discriminate against any employee or applicant for employment on the basis of race, creed, color, sex, gender, sexual orientation, age, national origin, caste, marital status, or the presence of any sensory, mental or physical disability in any employment practice, unless based on a bona fide occupational qualification. Minorities and veterans are encouraged to apply.