LVN - CRISIS CARE

GENERAL SUMMARY

Extended Observation Unit (EOU) Licensed Vocational Nurses (LVNs) are responsible for triaging MEDCOM phone calls and assuring patients are appropriate for the unit and coordinating with leadership. The LVN provides professional nursing services for consumers, assists with laboratory, EKGs and other medical treatments, psychosocial, and assists the Registered Nurse (RN) in creating assignments for unlicensed staff. LVN's at the Josephine Recovery Center (JRC) are responsible for providing professional nursing services for consumers, including medication administration and injections. The LVN will assists the RN in making assignments to unlicensed staff. Both EOU and JRC Licensed Vocational Nurses maintain pharmaceutical oversight of medication samples, and complete associated documentation for the consumer and program, and must be capable of providing psychiatric emergency services. New nurses will be assigned a home station where the majority of their time will be spent. However, they will be cross trained to float between the 24/7 operation sites to include Detox, Crisis Center and the Crisis Step Down Unit JRC. The Crisis EOU and JRC are 24/7 facilities requiring 24/7 nursing coverage.

ESSENTIAL DUTIES & RESPONSIBILITIES

Essential functions are the basic job duties that an employee must be able to perform, with or without reasonable accommodation. The list of essential functions, as outlined herein, is intended to be representative of the tasks performed within this classification. The omission of a function does not preclude management from assigning essential duties not listed herein if such duties relate to the position.

• Administers emergency medications on combative consumers using Nonviolent Crisis Intervention (NCI) techniques.
• Administers injections, draws labs, and completes applications for clients as needed.
• Aids in the Utilization Management function as needed by collecting, reviewing, and authorizing Medicaid and non-Medicaid covered emergency Mental Health hospitalization for consumers throughout the Center's system.
• Assists the RN in making assignments to unlicensed observation staff of various skill levels, instructing and supervising staff as needed.
• Assists with laboratory collection, EKGs, and other medical treatments/interventions and documenting initial health history on new patients.
• Collaborates and communicates with law enforcement, outpatient clinic, hospitals, and other providers to assure appropriate consumer care.
• Collaborates with Metropolitan Area hospitals for admission or discharges, as needed.
• Collaborates with SAPD, Bexar County Courthouse, BCSO, and other Law Enforcement agencies to assure appropriate consumer care.
• Completes daily reports containing status of current consumers on unit to Crisis Providers.
• Completes patient monitoring and documents findings every 2 hours (required).
• Conforms to the Texas Nurse II Practice Act and the Board's rules and regulations as well as all Federal, State, and local laws, rules, or regulations affecting the LVN's current area of nursing practice.
• Contacts all Behavioral Health (BH) medical facilities to arrange placement for OPC, ED, medical clearance.
• Coordinates medication distribution with the Center's pharmacy contract; ensures medications, controlled substances and consumer medications are appropriately stocked and maintained.
• Coordinates with case managers to create consumer plan of care as needed.
• Coordinates with patient clinics for admission to the EOU or JRC.
• Educates consumers on health-related topics and responds to questions or concerns.
• Examines patients and prepares them for visit with prescriber as needed.
• Maintains a 24-hour line of sight monitoring.
• Maintains pharmaceutical oversight of medication samples for specified units participating in the program through assigned unit level staff.
• Monitoring of OOWS/CIWA Consumers for Withdraw Symptoms.
• Obtains and transcribes verbal orders to administer medication as dictated by Providers.
• Obtains collateral from outpatient clinics prior to admission.
• Participates in multi-disciplinary quality assurance program to evaluate and ensure staff proficiency, quality of patient care, error reporting, environmental safety, and comprehensive documentation.
• Provide professional goal-directed nursing care to individuals by performing nursing assessments regarding the health status of the client, completing nursing diagnosis, developing a plan of care in conjunction with the case managers, evaluating consumer's responses to nursing interventions.
• Provides comprehensive nursing care for acutely and/or critically ill patients whose conditions warrant expert and complicated treatment.
• Performs other related duties as required.

MINIMUM ENTRANCE QUALIFICATIONS

Education and Experience

• High School Diploma or GED is required.
• One (1) to two (2) years of nursing experience in an acute fast-paced environment which includes one (1) year in a psychiatric or behavioral health setting.

Licenses or Certifications

• Current Texas LVN licensure

Other Requirements

• Crisis Care Center and JRC Units: Incumbent will act as a rover across both units. Schedule will include day and night shifts providing appropriate coverage at all times.
• Crisis Care Units work 12-hour shifts.
• Must maintain a valid driver's license and automobile insurance coverage, be able to travel as needed, and be able to meet on a consistent basis the driving record requirements of the Company's auto insurance carrier if you drive your vehicle during company business.
• Must maintain required credentials and mandatory training requirements to ensure compliance with all State regulations and CHCS policies.
• Must be able to meet the physical requirements to complete Nonviolent Crisis Intervention (NCI) and CPR training including lifting up to 12 lbs. and supporting up to 55 lbs.; bending, stooping and getting on and off the floor without assistance.
• Nonviolent Crisis Intervention (NCI) is a proven safe and harm-free method of behavior modification. All consumer-facing employees of CHCS must take NCI courses facilitated by the CHCS Training team within the first 45 days of employment.
• NCI is intended to support human service professionals in giving aggressive, disruptive, or out-of-control people the best care and welfare possible, even in the most violent situation.
• NCI training provides staff with the skills to safely recognize and respond to everyday crisis situations that may involve more challenging behaviors. It focuses on prevention and offers proven strategies for safely defusing anxious, hostile or violent behavior at the earliest possible stage.

PREFERRED QUALIFICATIONS

• Associate's Degree in Nursing is preferred.
• Bilingual (English/Spanish) preferred. Language Proficiency Pay (LPP) payments are subject to successful testing, certification by CHCS Payroll, and availability of funding. Funding may be renewed in subsequent fiscal years but is not guaranteed.

SUPERVISION

• Job has no responsibility for the direction or supervision of others.

COMPETENCIES FOR SUCCESSFUL PERFORMANCE OF JOB DUTIES

Knowledge of:

• Applicable software applications (including Microsoft Office)
• CHCS nursing requirements and standards of practice
• Community and center resources to tailor discharge planning
• Federal, State, and local laws, rules, or regulations affecting the current area of nursing practice.
• Legal requirements for EDs, MHWs, 4 hour letters and OPC process
• MEDCOM diversion process and communication expectations
• Medical diagnosis and applicable medications
• Mental health nursing practices
• Phlebotomy procedures

Skilled in:

• Critical decision making to differentiate between psychiatric, substance induced and medical needs and making arrangements to facilitate transfers as needed.
• De-escalation and conflict resolution
• Monitoring patients for adverse reactions to medications
• Organization and time management

Ability to:

• Accurately organize and maintain paper documents and electronic files.
• Coordinate telemedicine visits with outside agencies.
• Effectively communicate, both verbally and in writing.
• Establish and maintain effective working relationships.
• Maintain accurate and complete records.
• Maintain the confidentiality of information and professional boundaries.
• Meet schedules and deadlines of the work.
• Monitor patients for adverse reactions to medications.
• Obtain and transcribe verbal orders.
• Perform a variety of duties, often changing from one task to another of a different nature.
• Perform basic mathematical functions such as addition, subtraction, multiplication, division, percentages, and ratios.
• Respond to patient needs.
• Understand and carry out oral and written directions.
• Verify active order for labs and injections and confirm labs ordered.
• Work via tele-court with the Judge to facilitate the probable cause hearings associated with the OPC .

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.

• Must be able to meet the physical requirements to complete Nonviolent Crisis Intervention (NCI) and CPR training including lifting up to 12 lbs. and supporting up to 55 lbs.; bending, stooping and getting on and off the floor without assistance.
• Must have adequate mobility that requires frequent walking, standing, bending, stooping, kneeling, reaching (vertical and horizontal), using fingers, hands, feet, legs and torso in various care. The employee must be able to regularly lift and/or move up to 40 pounds and occasionally must lift and/or move up to 50 pounds. The employee must be able to occasionally transfer a consumer.

601 N Frio Bldg 1 3/4 rotation 7:00am-7:00pm

Code : 4369-5

HOURLY RATE RANGE: $23.99-$26.00