Registered Nurse (RN - Specialty Clinics)

STATEMENT OF PURPOSE

Coordinates comprehensive nursing care for patients of all ages utilizing the nursing process, including assessment, planning, intervention, and evaluation. Directs patient and family education and ensures continuity of care within the clinic setting. Collaborates with providers, Specialty Clinic Director, and interdisciplinary team members to maintain high standards of professional nursing practice, regulatory compliance, quality outcomes, and efficient clinic operations.

Full-time, benefited position working 80 hours per two week pay period. Days of work are Monday - Friday from 7:30am - 4:30pm with no nights, weekends or holidays   

JOB FUNCTIONS

Quality

• Maintains standards of nursing care and implements hospital and Clinical Services policies and procedures.
• Provides direct and indirect patient care for pediatric, adult, and geriatric patients using the nursing process (assessment, planning, intervention, evaluation).
• Develops and modifies individualized plans of care based on patient condition and outcomes.
• Collects and documents patient data including chief complaint, medication and allergy history, and vital signs; communicates findings to the physician.
• Updates patient medical records in the computerized charting system.
• Assists physician with patient preparation for procedures; maintains sterile field for surgical and office procedures.
• Decontaminates equipment, instruments, and rooms between patients.
• Prepares medications as directed by the physician for administration.
• Completes lab and x-ray order entry and escorts patients to appropriate departments.
• Changes dressings and authorizes drug refills as directed by the physician.
• Maintains clinical competency through annual evaluations, continuing education, and required re-certifications.
• Follows disaster procedures, standard precautions, aseptic techniques, infection control and isolation guidelines; investigates and reports incidents per risk management policy.

Service

• Performs telephone triage nursing; assesses patient needs and determines appropriate level of care (emergent care, appointment scheduling, home care guidance, or additional resources).
• Manages provider in-basket communications for specialty clinics.
• Schedules appointments, return visits, referrals, and surgeries.
• Provides required surgical information to patients; obtains insurance pre-authorization; coordinates pre-op physicals and post-op follow-up calls.
• Coordinates supplies, scheduling, and patient registration for satellite clinics; assists with patient care as needed.
• Explains treatment procedures and provides patient education related to examinations and treatments.
• Assists patients with mobility, positioning, and clothing removal/replacement based on age and ability.
• Obtains appropriate information for prescription refills and phone messages.
• Obtains medical charts from Health Information Services.
• Specific to Phone Nurse: Serves as triage nurse for all Specialty Clinic departments with a working knowledge of each service area.
• Performs other related duties as assigned or requested.

People

• Communicates effectively with physicians, providers, and interdisciplinary team members regarding patient care needs.
• Supports a collaborative clinic environment to ensure smooth office and clinical operations.
• Routinely performs administrative and clinical tasks to keep the office functioning efficiently.
• Demonstrates knowledge of physician preferences and procedural workflows to support team efficiency.

Finance

• Schedules surgeries and obtains insurance pre-authorizations to support reimbursement.
• Maintains understanding of billing charges related to services provided.
• Orders specialized non-stock and stock items; maintains appropriate inventory levels.
• Maintains supplies, equipment, and materials for the practice to ensure cost-effective operations.

Growth

• Expands clinical knowledge across Specialty Clinic departments, particularly in triage functions.
• Participates in ongoing education and competency development to enhance clinical expertise.
• Supports satellite clinic operations and specialty service expansion.

Specific to Podiatry/Orthopedics:

• Coordinate ordering and dispensing orthotics through appointments and mailing of supplies
• Refurbish orthotics and cut shoe inserts according to physicians order
• Performs fitting and application of specialized patient appliances, such as Cam walkers, splints, etc.
• Assist in castings. Remove casts. Check instruments for wear and order new when needed.
• Assures medical equipment (Doppler and rechargeable grinder) is recharged
• Prepare charts for day-make up new charts
• Specific to Joint Navigation: Joint Navigator guides and coordinates patients through the entire continuum: preoperative, surgical and postoperative care. The Joint Navigator will collaborate with the medical staff to provide individualized care to the patient and perform all duties involved in the management of the daily operations of the joint replacement program. Organize and coordinate orthopedic joint education class working collaboratively with providers and nutritional services for optimal education.

Specific to OB/GYN:

• Attends physician during physical examination and procedures.
• Interviews Obstetric patients, assisting physician with completion of prenatal visit documentation utilizing nationally recognized ACOG prenatal form.
• Assists with monitoring of established patient’s preventive screening such as routine mammogram and Pap smears.
• Administers medications parenterally, orally or via inhalation as ordered by the physician.
• Availability for extensive training required for involved nursing procedures.

Specific to Urology:

• Assist physician during clinic procedures.
• Demonstrates critical thinking skills required for assessment and completion of nurse visit procedures.
• Demonstrates skill in use of equipment relevant to position, verbalize knowledge of appropriate safety procedure requirements.
• Diagnoses equipment problems; fixes or seeks out someone to fix
• Competent in equipment set up and handling required for procedures as well as appropriate transfer of equipment for sterilization.
• Competent in handling and administration of medication within the JRMC Clinic in correlation to safety regulations. 
• Availability for extensive training required for involved nursing procedures. 

Specific to Wound Care:

• Assess, determine classification, and measure wounds accurately and in accordance with policy.
• Assess compliance to the Clinical Pathway and communicate to the Physician Formulate desired outcomes specific to patient’s problems and Wound Clinic protocols.
• Implement wound care and HBO protocols as clinically indicated.
• Complete new patient review form and participate in weekly meeting.
• Accurately complete the superbill and ensure that all orders and charges are initiated accurately.
• In collaboration with the Physician and other Wound Clinic employees, revise the plan of care and continuously reassess and evaluate until desired outcome is obtained.
• Complete the 4-week reviews in the Multi-Disciplinary Plan of Care and communicate findings with Physician. Revise Plan of Care as indicated and consistent with Healogics Clinical Pathway.

Specific to Holistic Pain Management:

• Assist APP during clinic procedures and interventions.
• Demonstrates critical thinking skills required for assessment and completion of pain management nurse visits and procedures.
• Demonstrates competency in the use, setup, and troubleshooting of equipment relevant to pain procedures while adhering to safety standards.
• Competent in procedure room setup, sterile technique, and handling of equipment and instruments requiring sterilization.
• Competent in handling and administration of medications within the JRMC Clinic in accordance with safety regulations.
• Provides pre- and post-procedure patient education and discharge instructions.
• Accurately completes documentation, orders, and charges related to pain management services.
• Availability for extensive training required for involved nursing procedures.

Specific to Oncology:

• Competent in handling and administration of medication within the JRMC Clinic in correlation to safety regulations. 
• Demonstrates skill in accessing, preparing and using information as relevant to position.
• In correlation with the patient, develops a plan of care based on nursing assessment and diagnosis that prescribes interventions to attain expected outcomes. This includes identifying the holistic needs of the patient, treatment decisions and priorities. Identifies community resources needed for continued care and make referrals.
• Implements the plan of care and the nursing interventions for the patient by writing nursing orders, giving direct care, assisting with care, determining the responsibilities that can properly and safely be assigned or delegated, providing an environment conducive to safety and health, communicating interventions and responses to other members of the health care team and executing the regimen prescribed by a licensed practitioner.
• Evaluates the responses to nursing interventions by documenting and communicating evaluation data to appropriate members of the health care team, utilizing data as a basis for reassessing client health status, measuring outcomes and goal attainment, modifying nursing diagnoses, revising strategies of care and prescribing changes in nursing interventions. 
• Availability for extensive training required for involved nursing procedures. 

Specific to ENT:

• Assist physician during clinic procedures.
• Demonstrates critical thinking skills required for assessment and completion of nurse visit procedures.
• Demonstrates skill in use of equipment relevant to position, verbalize knowledge of appropriate safety procedure requirements.
• Diagnoses equipment problems; fixes or seeks out someone to fix
• Competent in equipment set up and handling required for procedures as well as appropriate transfer of equipment for sterilization.
• Competent in handling and administration of medication within the JRMC Clinic in correlation to safety regulations. 

QUALIFICATIONS/REQUIREMENTS FOR THIS POSITION:

1. Preparation & Training - Work requires a professional level of knowledge acquired by completing an accredited RN nursing education program. Must hold an unencumbered RN licensure from the ND State Board of Nursing for the current year. Position requires completion of BLS CPR. Position is required to attend Non-Violent Crisis Intervention (NCI) training in the appropriate timeframe according to department orientation checklist.
2. Work Experience - Previous work experience in a clinic. Preference for a minimum of six months experience in a related position in a health facility or clinic. Time to reach competency on the job: Three weeks to three months. 
3. Attendance - Punctual and regular attendance is an essential responsibility of each employee at JRMC. Employee is expected to report to work as scheduled, on time and prepared to start working. Employee is also expected to remain at work for their entire work schedule.
4. Analytical Ability - Required to gather and interpret data in situations such as clinical observations, contributing to care plan, interpreting routine data and carrying out physician directed assignments. Must be able to determine priorities within area of assignment. Must have the ability to access, manipulate, organize and relay information in meaningful ways using email, word processing, spreadsheets, presentation software, and database management.
5. Independent Judgement - Independent nursing judgment is often required by the professional RN based on established policies and procedures. Substandard performance in nursing skills or judgments may adversely affect patient care, patient welfare, and hospital goodwill.
6. Contact with Others - High degree of duties involve contact with others; imperative that this person maintain good relationships with co workers, patients’ families, and visitors; must be tactful and maintain telephone courtesy; must be able to exchange information on a factual basis, dispatch verbal or written messages as directed on a timely basis and perform other activities which require courtesy and tact. Must have excellent and clear communication skills, ability to adapt to quick change, and be well organized.
7. Supervising the Work of Others - Required to plan, assign work to and check the work of others. Responsible for own work. Little or no responsibility for the work of others.
8. Responsibility for Welfare of Others - High frequency with which work performed by the staff RN may result in very serious physical or emotional harm to others. It is the responsibility of the professional RN to continuously uphold the highest degree of performance within currently defined and acceptable nursing practice standards. High degree of contact with other employees that may result in minor discomfort and delay to patients and co-workers. Activities during the day impact the welfare of patients and employees. Responsible for maintaining absolute confidentiality of information; may be required to assist a team member if needed.
9. Mental/Visual Effort - Must be able to speak and write the English language in an understandable and legible manner. Must demonstrate physical and emotional ability to meet agreed upon work schedule and performance standards required by the position. Ability to adapt to change. Work regularly requires the employee to exert a high level of mental/visual effort. Visual acuity necessary for performing clerical duties and working with medical devices and equipment. Color perception necessary for interpreting testing procedures involving color comparisons.
10. Working Conditions - OSHA job classification: This position is defined as a Category I in which the employee does have exposure to bloodborne pathogens. Position requires exposure to patients with infectious diseases and odor. Must practice aseptic techniques and observe Standard Precautions. Participates in and complies with Hospital Safety Management program. Position is subject to frequent interruptions. Work may be beyond normal working hours and/or temporarily in other positions when necessary. Risk of exposure to elements and hazards related to travel and work in satellite clinics. Must hold a current, unencumbered North Dakota driver's license. Working areas are clean and vented, but on occasion the position requires tasks that will expose individual to grinder dust.
11. Physical & Sensory Effort - Frequent standing or walking. Lifts, positions, pushes and/or transfers patients and/or equipment. Frequent reaching, stooping, bending, kneeling and crouching. Needs finger dexterity when handling equipment and performing nursing related functions.
12. Promotion - No formal line of promotion
13. Background - A comprehensive background check and drug screening will be conducted as a condition of employment for this role. 
14. Drug Screen - A urine drug screening is required for all positions and must be completed within 30 days of the date of hire.
15. Physical Requirement - These are physical requirements of the position that may be performed as part of daily duties. Inability to meet one or more of these physical requirements will not automatically disqualify a candidate or employee from the position. Upon request for reasonable accommodation, JRMC may be able to adjust or excuse one or more of these requirements, depending on the requirement, the essential functions to which it relates and the proposed accommodation.

Employee Requirements

• Visual Observation - Continuously
• Standing - Continuously
• Walking - Continuously
• Sitting - Continuously
• Hands and Finger Dexterity - Continuously
• Reaching with Hands and Arms - Continuously
• Climbing - Never
• Stooping/Kneeling/Crouching/Crawling - Frequently
• Hearing/Listening - Continuously
• Tasting or Smelling - Occasionally
• Working Inside - Continuously
• Working Outside - Never
• Working in Extreme Heat - Never
• Working in Extreme Cold - Never
• Working with Hazardous Materials - Occasionally
• Noise - Continuously
• Working in Dirt/Dust - Rarely
• Driving - Rarely

Lifting / Carrying / Pushing / Pulling: 

• Up to 10 pounds - Continuously
• Up to 25 pounds - Continuously
• Up to 50 pounds - Continuously
• Up to 75 pounds - Occasionally
• Up to 100 pounds - Occasionally
• Over 100 pounds - Occasionally