Navajo Preference Employment Act In accordance with Navajo Nation and federal law, TCRHCC has implemented an Affirmative Action Plan pursuant to the Navajo Preference in Employment Act. Pursuant to this Plan and corresponding TCRHCC Policy, applicants who meet the necessary qualifications for this position and (1) are enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe will be given preference in hiring and employment for this position, (2) are legally married to enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe and meet residency requirements will be given secondary preference, and (3) are enrolled members of other federally-recognized American Indian Tribes will be given tertiary preference. Overview POSITION SUMMARY This position will provide services in the Ambulatory Care Department as assigned. The incumbent will work under the supervision of a Licensed Independent Practitioner (e.g. physician, dentist, and nurse practitioner). Medical assistants perform a broad range of administrative and clinical duties to facilitate the work of the Licensed Independent Practitioner (LIP). Certified Medical Assistant will be responsible for gathering necessary vital signs from patients, prepare and send laboratory specimens for routine tests, sets up and cleans examination room, maintains supply stock in between exams, and record data under direct supervision of the provider or LIP. Qualifications NECESSARY QUALIFICATIONS Education: High School Diploma or GED Certification: Must be a Certified Medical Assistant from one of the following accrediting bodies: American Association of Medical Assistants (AAMA), American Medical Technologists (AMT), National Center for Competency Testing (NCCT), or National Health Center Association (NHA) Approved medical assistance training program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP); the Accrediting Bureau of Health Education Schools (ABHES); a medical assisting program accredited by any accrediting agency recognized by the USD of Education or a training program the meets or exceeds and verifies the entry-level competencies of a medical assistant prescribed under R4-16-402(A).) Must have and maintain a current Basic Life Support (BLS) certification by the American Heart Association (AHA) Experience: Demonstrated satisfactory performance during clinical experiences as a part of an accredited program as evidenced by positive references from clinical instructors Other Skills and Abilities: A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers. All employment references must address and indicate success in each one of the following areas: Successful and positive working relationships; seen as a team player Possession of high ethical standards and no history of ethics complaints Reliable and dependable; reports to work as scheduled without excessive absences Ability to read, analyze and interpret the most complex documents and respond effectively to the most sensitive inquiries or complaints Excellent customer service skills and telephone etiquette Proficient in the use of Microsoft Suite applications and EMR system. Knowledge of infection control procedures, Personal Protective Equipment (PPE) and safety precautions Completion of and, above-satisfactory scores on all job interviews, demonstrating to the satisfaction of the interviewees and TCRHCC that the applicant can perform the essential functions of the job Successful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of TCRHCC a record of satisfactory performance and that the applicant can perform the essential functions of the job Successful completion of fingerprint clearance requirements, physical examinations, and other screenings indicating that the applicant is qualified to be employed by TCRHCC and demonstrating to the satisfaction of TCRHCC that the applicant can perform the essential functions of the job Submission of all required employment-related documents, applications, resumes, references, and other required information free of false, misleading, or incomplete information, as determined by TCRHCC. MENTAL AND PHYSICAL EFFORT The physical and mental demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical: Work requires prolong periods of standing, walking, sitting, bending, talking or hearing and reaching with hands and arms. This position requires extended use of hands to finger, handling and feeling as well as intermittent pushing/pulling, stooping, kneeling, crouching, or crawling. Agility and ability to lift up to 25 pounds of heavy and/or disabled patients for an extended period of time. Must also be able to hear alarms on equipment, client calls and instructions from physician and or department staff. Must have close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus. This position also requires prolonged repetitive motion of both feet, both hands, grasping with simple/light and firm/heavy as well as fine dexterity. Mental: Must be able to prioritize and use good judgment; must be able to coordinate a variety of issues while being frequently interrupted. Environment: This job may have intermittent exposure to outdoor weather conditions and exposure to infectious diseases. The typical noise level for this position is moderate. Responsibilities ESSENTIAL FUNCTIONS Assists with direct patient care procedures and related tasks; checks patients in, assists in obtaining patient histories, takes vital signs, prepares records and assists with medical examinations. Responsible for obtaining and recording (into the electronic health record) patient information as assigned per policy (i.e., vital signs, height, weight, etc.). Provides care to assigned patients under the direction of a LIP in accordance with established policy. Provides basic care to patients with a variety of conditions, illnesses and/or injuries (i.e. apply and remove dressings, slings, braces, apply heat and cold packs; assist patient in ambulation, transferring, positioning, etc.). Assist the LIP in examination of patients by explaining procedures, positioning, draping and assembling instruments and supplies. Performs the following procedures, after approved specific formal training and completion of required competencies. Any required specific training and competency testing required for the procedures in an ambulatory setting will be completed in addition to standard outpatient service training: Performs waived testing (e.g., glucometer testing, rapid strep testing and colorimetric urinalysis) and records the results in compliance with regulations/standards. Complies with the laboratory requirements (i.e., CLIA, Joint Commission) for quality control of waived testing for accuracy and record keeping. Obtains bacteriologic specimens such as clean-catch urine specimens and topical cultures. Assists with incision and drainage procedures. Performs less complex dressings and treatments without assistance. Assist with cleaning, irrigating, and dressing complex wounds. Prepare and administer medication as directed by the LIP. Administer injections – IM (intermuscular), SQ (Subcutaneous), and ID (Intradermal). Instruct patients in proper collection of urine samples. Prepares samples for analysis (e.g., labels specimen tubes). Routes requisition forms to consultative services, dietary, laboratory and radiology. Shares the responsibility for reporting observations by observing the patient’s conditions and reactions, and by keeping the provider informed of changes in clinical condition. Schedules and monitors patient appointments; may coordinate routine office like activities and administrative functions with supplemental staff of the clinic. Shares the responsibility of maintenance of clinical records. Utilize established software to data enter immunizations, follow-up on laboratory and radiological exams, or other computer functions as required by mobile clinical services or outpatient department. Educates and advises patients on specified medical issues within established parameters. Practices safety, environmental, and/or infection control methods. Prepares any patient related documentation for the provider or patient. Maintains a courteous and professional manner in contact with patients, family, and other clients. Assists in answering telephones and supplying routine information per policy. Performs general non-direct patient care duties at the site-based clinics including cleaning, arranging, and restocking supply cabinets from supplies; cleaning and sorting supplies, instruments and equipment; calling attention to deficiencies in supplies and equipment; cleaning refrigerators and assisting with maintenance of temperature logs; and maintains a clean and safe patient environment. Participates in performance improvement activities and data management responsibilities. Fosters a collaborative environment, using a team approach to share ideas and to promote safe, patient centered care. May be required to work additional hours to maintain patient care. Floats to other clinics to meet patient care needs during staffing shortages. Ensure proper PPE is worn at all times while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates) Completes all electronic health record entries accurately and timely pertinent to patient care role. Participates in departmental workflow and or testing teams as related to electronic health record or other project initiatives. Performs miscellaneous job-related duties as assigned.
Navajo Preference Employment Act In accordance with Navajo Nation and federal law, TCRHCC has implemented an Affirmative Action Plan pursuant to the Navajo Preference in Employment Act. Pursuant to this Plan and corresponding TCRHCC Policy, applicants who meet the necessary qualifications for this position and (1) are enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe will be given preference in hiring and employment for this position, (2) are legally married to enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe and meet residency requirements will be given secondary preference, and (3) are enrolled members of other federally-recognized American Indian Tribes will be given tertiary preference. Overview POSITION SUMMARY The Ambulatory Care Nurse in collaboration with other health care professionals, address patient wellness, acute illness, chronic disease, disability, and other outpatient needs. The nurse will perform a problem focused assessment of the patient’s primary concerns in the clinical or telemedicine setting. Integrate into the practice the finding of quality of care and performance improvement initiatives. Ambulatory Care Nurse performs a variety of nursing care procedures requiring nursing competency and assessment for specific patient conditions and treatments, with the ability to complete electronic health data entry tasks. The Ambulatory Care Nurse will carry out physician’s orders, adhere to high, quality standards of care, follow nursing policies and procedures and TCRHCC hospital policies. Qualifications NECESSARY QUALIFICATIONS Education: Associate’s or Bachelor’s Degree in Nursing License/Certification: Must have a valid, current, full and unrestricted Professional Nursing License to practice nursing in any state of the United States of America, The Commonwealth of Puerto Rico, or a territory of the United States Must maintain a current valid certification of the following throughout employment: Basic Life Support (BLS) from the American Heart Association Experience: Must have one (1) consecutive year of nursing experience in outpatient and/or acute healthcare setting Other Skills and Abilities: A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers. All employment references must address and indicate success in each one of the following areas: Positive working relationships with others Ability to prioritize competing responsibilities while under pressure. Ability to communicate and interact effectively with patients and co-workers. Ability to work independently; reports to work as scheduled without excessive absences. Ability to work in a computerized environmental setting; computer skills required. Knowledge of normal growth, development, and life cycle changes. This also includes knowledge of the physical, psychosocial, and behavioral characteristics of the age specific group for which care is provided. Knowledge of disease entities to recognize complications and therapeutic interventions required. Knowledge of pharmaceuticals to recognize the desired effects, side effects and complications on their use, with emphasis on vasopressors and emergency medications titration of these medications. Knowledge of infection control procedures, Personal Protective Equipment (PPE) and safety precautions. Completion of and, above-satisfactory scores on all job interviews, demonstrating to the satisfaction of the interviewees and TCRHCC that the applicant can perform the essential functions of the job Successful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of TCRHCC a record of satisfactory performance and that the applicant can perform the essential functions of the job. Successful completion of fingerprint clearance requirements, physical examinations, and other screenings indicating that the applicant is qualified to be employed by TCRHCC and demonstrating to the satisfaction of TCRHCC that the applicant can perform the essential functions of the job. Submission of all required employment-related documents, application, resumes, references, and other required information free of false, misleading or incomplete information, as determined by TCRHCC. MENTAL AND PHYSICAL EFFORT The physical and mental demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical: Work requires prolonged periods of standing; walking; talking or hearing; sitting watching, observing, concentrating on computer monitors and equipment; use of hands to finger, handle, feel; bending, stooping, kneeling, crouching; reaching with hands and arms; and, taste or smell. Agility and the ability to lift, pull and bend are required to move patients to and from beds, wheelchairs, stretchers, et cetera, and in moving equipment and medical supplies. Must be able to lift up to 50 lbs frequently through entire shift. Most be able to move, pull/push, lift, maneuver more than 100 lbs. when caring for patients and must be able to use proper body mechanics and lifting equipment when available. Must be able to discern when working with over a hundred pounds when, how, and who to ask for assistance to protect and prevent self-injury. Must have the ability to hear and recognize alarms on equipment; client calls; instructions from physicians/department staff; and, hear overhead pages through loudspeaker. This position requires vision required to see close; distant; colored; peripheral; and depth perception. Must be able to adjust visual focus as needed. to ask for assistance. This position requires the ability to perform repetitive motion actions in both hands including prolonged grasping of simple/light action; intermittent grasping of firm/heavy action; and prolonged ability of fine dexterity. Mental: Contacts often require tact and sensitivity as those related to stressful situation such as death, dying, and catastrophic illnesses. Must be able to prioritize and use good judgment. Must be able to coordinate a variety of issues while being frequently interrupted. Must be able to work with the attitude of team building with other staff; collaborate with multiple departments and job positions. Must be willing to assist when able and as needed with other team players. Environmental: Will be working occasionally around fumes or airborne particles; toxic or caustic chemicals; and, risk of electric shock. Typical environmental noise level is moderate. As with any area of a Health care setting, must be able to work around and with infectious diseases. Responsibilities ESSENTIAL FUNCTIONS The Ambulatory Care Nurse is fully accountable in all ambulatory care settings for all nursing services and associated patient outcomes provided under their direction. Responsible for the initial and long-term assessment of patients in an outpatient setting and instructing on wellness/prevention methods to illness and support of patients. Responsible for working in outpatient settings and able to respond to high volumes of patients in a short-term time spans. Provides age specific care in a compassionate, caring, culturally and ethically sensitive manner. Utilize competent, evidence-based ambulatory care nursing intervention during clinic visits, telephone or telemedicine and electronic health communication encounters. Interviewing patients and family members; consults and coordinates with providers and other members of the health care team to assess, plan, implement, and evaluate patient care plans carries out treatments and procedures per scope of practice. Provides counseling and education to patients and families or surrogates on preventive, curative and rehabilitative measures related to their health care needs. Serve as patient advocate by supporting the basic rights, values and beliefs of the patient. Maintain accurate health records by documenting observations, nursing interventions and therapeutic measures administered in an accurate, efficient, and timely manner. Recognizing and respond to adverse patient signs and symptoms promptly, especially in emergency situations including the execution of life saving procedures. Participating in the development, implementation and evaluation of standards of care, quality assurance and infection control activities. Contribute to positive working relationships within the Outpatient Department (OPD) team and other supplemental departments in the hospital. Delivers clinical nurse patient care with adherence to the PCMH model and in conjunction with ambulatory nurse strategy and competencies. Monitoring and initiating corrective action to maintain the environment of care including equipment and material resources. Accepts responsibility, when delegated by the Program Director or designee, as team leader to providing direction to ancillary nursing and other personnel. Serve as charge nurse for a group of patients or staff when assigned. Participates in orientating new employees. Fosters a collaborative environment, using a team approach, in which ideas are shared and valued to promote safe, patient centered care. Maintains professional knowledge and proficiency in nursing through continuing education, staff meetings, workshops and serving on nursing committees. Floats to other Outpatient Department’s clinical areas to meet patient care needs during staffing shortages. Ensure proper PPE is worn at all times while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates. Completes all electronic health record entries accurately and timely pertinent to patient care role. Participates in departmental workflow and or testing teams as related to electronic health record or other project initiatives Performing other duties as assigned.
Navajo Preference Employment Act In accordance with Navajo Nation and federal law, TCRHCC has implemented an Affirmative Action Plan pursuant to the Navajo Preference in Employment Act. Pursuant to this Plan and corresponding TCRHCC Policy, applicants who meet the necessary qualifications for this position and (1) are enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe will be given preference in hiring and employment for this position, (2) are legally married to enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe and meet residency requirements will be given secondary preference, and (3) are enrolled members of other federally-recognized American Indian Tribes will be given tertiary preference. Overview POSITION SUMMARY This position serves as a Physician Assistant (PA) or Nurse Practitioner (NP), which involves performance of medical care services for patients of all ages in the Emergency Department. Interviews, assesses, and evaluates patients to determine their physical condition and type of medical services needed, and orders initial diagnostic studies appropriate for the patient’s medical condition. Qualifications NECESSARY QUALIFICATIONS Education: Master of Science in Nursing or Doctor of Nursing Practice OR Master’s degree in Physician Assistant studies Experience: Nurse Practitione r Must have a minimum of 2 years of Acute Care Nursing (RN) experience. Physician Assistant Completed clinical rotation in a high-acuity Emergency Department under direct supervision of board-certified Emergency Medicine Physicians and PA’s. Licensure/Certification: Must possess a valid, current, full and unrestricted license to practice as a nurse practitioner or Physician Assitant in any state within the United States, District of Columbia, or the Commonwealth of Puerto Rico Must possess a certificate from the NCCPA (National Commission for Certified Physician Assistants) or the American Association of Nurse Practitioners. Credentialing: Must be credentialed and privileged to serve on the Medical Staff Other Skills and Abilities: A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers. All employment references must address and indicate success in each one of the following areas: Positive working relationships with others; has the ability to work effectively in a culturally diverse environment Possession of high ethical standards and no history of complaints Reliable and dependable; reports to work as scheduled without excessive absences Must possess excellent communication and interpersonal skills to optimize the care of patients Excellent clinical skills and judgment Is seen as a staff member who is trustworthy and willing to share information Is a mentor to colleagues and other organizational staff Responds effectively to sensitive inquiries or complaints Completion of and above-satisfactory scores on all job interviews, demonstrating to the satisfaction of the interviewees and TCRHCC that the applicant can perform the essential functions of the job Successful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of TCRHCC a record of satisfactory performance and that the applicant can perform the essential functions of the job Successful completion of fingerprint clearance requirements, physical examinations, and other screenings indicating that the applicant is qualified to be employed by TCRHCC and demonstrating to the satisfaction of TCRHCC that the applicant can perform the essential functions of the job Submission of all required employment-related documents, applications, resumes, references, and other required information free of false, misleading or incomplete information, as determined by TCRHCC MENTAL AND PHYSICAL EFFORT The physical and mental demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical: Must have ability of prolonged walking and maintaining balance, ability to frequently stand, bend, kneel, crouch, maintain balance, reach, and occasionally sit, drive, and climb. Frequent ability to lift, push, and pull up to 34lbs is required, must also be able to occasionally lift, push, and pull over 100lbs as needed. Sensory requirements for position include prolonged ability of far, near, color vision, depth perception, seeing fine details, hearing normal speech, hearing overhead pages, and telephone use. Must have both hand manipulation of continuous simple and firm grasping, fine manipulation and frequent use of keyboards. Mental: Must be able to perform evenings, nights, and weekends on a regular basis and handle the stresses of rural medicine with critically ill patients; must have high degree of judgment and leadership in coordinating emergency services. Must have ability to cope with high level of stress, make decisions under high pressure, concentrate, handle a high degree of flexibility handle multiple priorities in stressful situation, work alone, demonstrate high degree of patience, adapt to shift work, work in areas that are close and crowded, and frequently cope with anger/fear/hostility of others in a calm way, as well as occasionally managing altercations. Must accept a flexible schedule to meet unit needs. Environmental: May be exposed to infectious diseases for a prolonged amount of time, frequent exposure to loud noises, and occasional exposure to chemical agents, and hazardous or moving equipment. Responsibilities ESSENTIAL FUNCTIONS Provides comprehensive diagnostic, preventative, and therapeutic health care services to patients. Documents visits in the medical records of patients including updating problem lists. Secures a health and developmental history from the patient or parent, records findings and contributes in making critical evaluations. Performs or requests special screening and developmental tests and laboratory tests and reviews and interprets obvious results. Provides emergency services or crisis intervention in the absence of the physician. Review and evaluates the nursing and medical aspects of care, plans periodically, recognizing when there is a need for reassessment by the physician or other health professionals. Gives direct physical and psychological care in emergencies and in the presence of illness or disability in order to maintain life, provide comfort, reduce distress and enhance coping ability. Identifies and manages a full range of complex to general illnesses. Comfortable handling of basic trauma, suturing, fracture reduction, chest pain & abdominal pain work up. Performs a basic physical assessment using techniques of observation, inspection, auscultation, percussion, palpation and diagnostic instruments. Discriminates between normal and abnormal findings to recognize early stages of serious physical, emotional, and mental problems. Consults and collaborates with other health care professionals to establish health care plans and to review patient progress and response to therapy, including the use of written referrals to Community Health Nurses, specialty clinics, schools, etc. Adheres to medical regimens to stabilize chronically ill persons and adjusts regimens within established protocols. Makes decisions concerning medical care needs of patients consulting with physicians as appropriate. Works collaboratively with the physician in management of selected complex medical problems. Makes referrals for home visits when indicted to implement a care plan based on family needs. Provides health care and preventive services to healthy individuals including immunizations, guidance in nutrition, common illnesses, accidents, child growth and development, substance abuse, exercise, and depression screening. Teaches patients and family member(s) ways to maintain or improve their health status. Carries out treatments and procedures, administers medications; observes and documents changes in patient’s condition, reactions to medications and treatments. Responsible for prescribing medications including computation of doses. Participates in planning, instituting, evaluating, and revision program plan, assist in determining conditions, resources, and policies essential to delivery of health care services. Participates in a teaching capacity in the development of other health care workers. Participates in performance improvement initiatives which may involve chart reviews, studies relevant to health care and nursing needs of patients. Keeps abreast of the latest medical knowledge via CME as required by respective licensing agency. Handwriting must be legible and must be willing to use an Electronic Health Record. Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates) Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee, and external customer satisfaction. Responsible for electronic health records data entry pertinent to patient service role. Performs other duties as assigned.
Navajo Preference Employment Act In accordance with Navajo Nation and federal law, TCRHCC has implemented an Affirmative Action Plan pursuant to the Navajo Preference in Employment Act. Pursuant to this Plan and corresponding TCRHCC Policy, applicants who meet the necessary qualifications for this position and (1) are enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe will be given preference in hiring and employment for this position, (2) are legally married to enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe and meet residency requirements will be given secondary preference, and (3) are enrolled members of other federally-recognized American Indian Tribes will be given tertiary preference. Overview POSITION SUMMARY The purpose and overall goal of Pre-Anesthesia Screening (PAS) is to gather the clinical information necessary for the safe and effective administration of anesthesia through a process that is convenient for patients and physicians and results in efficient surgical throughput. The Nurse Practitioner of the Pre-Op clinic has overall supervision of the pre-operative clinic provided in the Surgery area, in addition to the flow of the pre-surgical testing and pre anesthesia clearance for patients to gain admittance to the operating room. The Nurse practitioner of the Pre-op clinic will provide input and assist with major decision making processes in regards to cardiac, pulmonary, and overall general health clearance for optimizing the health of patients who will undergo future surgery. They will play a major role in collaboration with the CRNA team and Internal Medicine department to decide if a patient is physically fit to undergo surgery and to decide if the patient’s laboratory markers deem them to be safe candidates for the administration of general anesthesia. Through the development of algorithms and checklists by the CRNA and surgical/Internal medicine team the NP of the Pre-OP clinic will follow these flowsheets to ensure safety of the surgical patient. This pre-op clearance process will allow EKG’s, labs, concerning physical disabilities, medication issues, and allergies to be pre-assessed prior to the day of surgery optimizing patient outcomes and preventing medical errors. The NP of Pre-op clinic will work along with the Chief CRNA to improve overall flow, function, safety and efficiency of the pre-operative and pre-anesthesia processes. Qualifications NECESSARY QUALIFICATIONS Education: Master of Science in Nursing (MSN) – Family Nurse Practitioner (FNP ) Experience: Must have completed a nurse practitioner degree Experience in a pre-op clinic setting preferred Must have active CPR/BLS certification 1-3 years of experience as an RN Mental: Licensure/Certification: Must possess a valid, current, full and unrestricted license to practice as a Nurse Practitioner in any state within the United States, District of Columbia, or the Commonwealth of Puerto Rico Must be credentialed to serve on the Medical Staff (provide all related information as requested and needed for credentialing process) Other Skills and Abilities: A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers. All employment references must address and indicate success in each one of the following areas: Positive working relationships with others Possession of high ethical standards and no history of complaints Reliable and dependable; reports to work as scheduled without excessive absences Successful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of TCRHCC a record of satisfactory performance and that the applicant can perform the essential functions of the job Successful completion of fingerprint clearance requirements, physical examinations, and other screenings indicating that the applicant is qualified to be employed by TCRHCC and demonstrating to the satisfaction of TCRHCC that the applicant can perform the essential functions of the job Submission of all required employment-related documents, applications, resumes, references, and other required information free of false, misleading, or incomplete information, as determined by TCRHCC. MENTAL AND PHYSICAL EFFORT The physical and mental demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical: The Incumbent must be able to frequently sit, stand, walk, bend, kneel, crouch, twist, maintain balance, and reach. Must be ability to lift, push, pull up to 10 pounds frequently and occasionally help with lifting, pushing, pulling greater than 10 pounds. Must have the ability to frequently utilize sensory requirements of far vision, near vision, depth perception, seeing fine details, and hearing normal speech frequently. Incumbent must also be able to hear overhead pages over a loudspeaker at times. The Incumbent must have the hand manipulation ability to do simple grasping and use of keyboards. The position will require the Incumbent to be exposed frequently to infectious disease, chemical agents, dust, fumes, gases, and hazardous or moving equipment frequently. Occasionally may be exposed to extremes in temperatures or humidity, unprotected heights, and loud noises. Mental: The Incumbent must be autonomous with working alone for prolonged periods of time. Must be able to frequently cope with high level of stress; cope with anger/fear/hostility of others in a calm way; concentrate; handle a high degree of flexibility; handle multiple priorities in stressful situation; demonstrate a high degree of patience; and work in areas that are close and crowded. The Incumbent may frequently need the ability to make decisions under high pressure; manage altercations; and, adapt to shift work. Responsibilities ESSENTIAL FUNCTIONS Serves as Nurse practitioner of the pre-op clinic, incumbent assigns, directs all nurses and staff in the pre-op clinic. Serves under the Chief of CRNA and is directed by the Chief CRNA and all responsibilities. Oversees the day-to-day tasks and activities of pre-op clinic. This includes evaluating ALL patients sent from surgical clinics in a timely fashion to be evaluated and cleared for surgery. This will include a medical history to include allergies and medications, family history of anesthesia complications, physical exam and assessment through algorithms for readiness for surgery. When health or medical concerns arise, the NP will have a dual collaboration with the CRNA present a plan for surgical clearance. Consults to CRNA and IM should be made for all high risk patients. Cardiac clearance and pulmonary clearance may be needed and future testing will ultimately be determined by the CRNA or IM physician. The NP will be responsible for collecting labs and performing the EKG in the pre- op clinic. Supervises the activities of the staff in the pre-op clinic. Ensuring the patients are receiving the appropriate educational information from the pre-op nurse as well as appropriate pre-operative preps to include but not limited to bowel preps, antibiotics, and pre-op at home surgical preps. Provides input and attends meetings for all departments directly affected by pre-operative services. Plans, organizes, coordinates, and directs the operational services of pre-op clinic along with the Chief CRNA, both advise the Chief of Surgical Services, Medical Officer and the Chief Executive Officer of TCRHCC on perioperative matters concerning the pre-anesthesia testing clinic. Participates with members of other departments, in planning joint administrative and technical programs; and making recommendations for maximum coordination of pre-operative services with other patient services. Along with the Chief of Anesthesia, incumbent is also responsible for assuring that TCRHCC meets the requirements of the Joint Commission on Accreditation of Hospitals (JCAHO) with regard to quality of care within the pre-operative anesthesia clinic and assures that hospital policies and procedures are followed. Committee responsibilities include OR committee attendance. Incorporates cultural and developmental needs into plan of care. Provides documentation of patient care in the patient record according to established standards of care. Participates in performance improvement activities which include collecting, analyzing data to identify quantifiable measures to maintain quality and the promotion of desired outcomes. Perform preoperative diagnostic procedures accurately and according to standards, policies, and procedures. Demonstrates competency in performing phlebotomy, obtaining various types of laboratory specimens, electrocardiograms, or other diagnostic tests. Effectively explains perioperative instructions, perioperative treatments, patient care principles, and nursing goals to patient and family/significant others. Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates) Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee, and external customer satisfaction. Completes all patient care documentation in the electronic health record entries accurately and in real-time. Participates in departmental workflow and or testing teams as related to electronic health record or other project initiatives Perform other duties as assigned or directed.
Navajo Preference Employment Act In accordance with Navajo Nation and federal law, TCRHCC has implemented an Affirmative Action Plan pursuant to the Navajo Preference in Employment Act. Pursuant to this Plan and corresponding TCRHCC Policy, applicants who meet the necessary qualifications for this position and (1) are enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe will be given preference in hiring and employment for this position, (2) are legally married to enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe and meet residency requirements will be given secondary preference, and (3) are enrolled members of other federally-recognized American Indian Tribes will be given tertiary preference. Overview POSITION SUMMARY The Clinical Nurse performs a variety of nursing care procedures requiring professional knowledge and consideration for specific patient conditions and treatments, and ability to work independently in completing assignments. Guidelines include physician’s orders, standards of care, nursing policies and procedures manuals, hospital policies. Nursing duties include support to individuals of all ages and their families. Qualifications NECESSARY QUALIFICATIONS Education: Associate of Science Degree in Nursing or Bachelor of Science Degree in Nursing License/Certification : A valid, current, full and unrestricted Professional Nursing License to practice nursing in any state of the United States of America, The Commonwealth of Puerto Rico, or a territory of the United States. Must maintain a current valid certification of the following throughout employment: Basic Life Support (BLS) from the American Heart Association Advanced Cardiac Life Support (ACLS) from the American Heart Association Pediatric Advanced Life Support (PALS) from the American Heart Association Neonatal Resuscitation Program (NRP) required within one (1) year of hire from American Heart Association Trauma Nurse Core Course (TNCC) required within one (1) year of hire Emergency Nurse Pediatric Course (ENPC) required within one (1) year of hire National Institutes of Health (NIH) – NIHSS – NIH Stroke Scale must be completed (within 6 months of hire) Emergency Severity Index Level 5 within 3 months of hire Complete Patient Sitter Competency Training (upon hire) Experience: Must have one (1) year registered nursing experience in an emergency department or critical care unit. Other Skills and Abilities: A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers. All employment references must address and indicate success in each one of the following areas: Positive working relationships with others Possession of high ethical standards and no history of complaints Reliable and dependable; report to work as scheduled Knowledge of normal growth, development, and life cycle changes. This also includes knowledge of the physical, psychosocial, and behavioral characteristics of the group for which care is provided. Knowledge of disease entities to recognize complications and therapeutic interventions required. Knowledge of assessment practices related to pain management and various treatment modalities of pain relief. Knowledge of pharmaceuticals to recognize the desired effects, side effects and complications on their use, with emphasis on vasopressors and emergency medications titration of these medications. Knowledge of infection control procedures and safety precautions. Possess and employ an ability to communicate with patients and families during time of emotional and physical stress Successful completion of and positive results form all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of TCRHCC a record of satisfactory performance and that the applicant can perform the essential functions of the job. Successful completion of fingerprint clearance requirements, physical examinations, and other screenings indicating that the applicant is qualified to be employed by TCRHCC and demonstrating to the satisfaction of TCRHCC that the applicant can perform the essential functions of the job. Submission of all required employment-related documents, application, resumes, references, and other required information free of false, misleading or incomplete information, as determined by TCRHCC. MENTAL AND PHYSICAL EFFORT The physical and mental demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical: Work requires prolonged periods of standing; walking; talking or hearing; sitting watching, observing, concentrating on computer monitors and equipment; use of hands to finger, handle, feel; bending, stooping, kneeling, crouching; reaching with hands and arms; and, taste or smell. Agility and the ability to lift, pull and bend are required to move patients to and from beds, wheelchairs, stretchers, et cetera, and in moving equipment and medical supplies. Must be able to lift to 50 lbs. frequently through entire shift. Must be able to move, pull/push, lift, maneuver more than 100 lbs. when caring for patients and must be able to use proper body mechanics and lifting equipment when available. Must be able to discern when working with over a hundred pounds when, how, and who to ask for assistance to protect and prevent self-injury. Must have the ability to hear and recognize alarms on equipment; client calls; instructions from physicians/department staff; and, hear overhead pages through loudspeaker. This position requires vision required to see close; distant; colored; peripheral; and depth perception. Must be able to adjust visual focus as needed. to ask for assistance. This position requires the ability to perform repetitive motion actions in both feet; and, hands including prolonged grasping of simple/light action; intermittent grasping of firm/heavy action; and prolonged ability of fine dexterity. Mental: Contacts often require tact and sensitivity as those related to stressful situation such as death, dying, and catastrophic illnesses. Must be able to prioritize and use good judgment. Must be able to coordinate a variety of issues while being frequently interrupted. Must be able to work with the attitude of team building with other staff; collaborate with multiple departments and job positions. Must be willing to assist when able and as needed with other team players. Environmental: Required to work prolong periods of time in an environment of toxic or caustic chemicals. Will be working occasionally around the following environmental conditions: wet, humid conditions (non-weather); work near moving mechanical parts; toxic or caustic chemicals; outdoor weather condition; extreme cold (non-weather); extreme heat (non-weather); risk of electrical shock; risk of radiation; vibration; and, risk of electric shock. Typical environmental noise level is moderate. As with any area of a Health care setting, must be able to work around and with infectious diseases. Responsibilities ESSENTIAL FUNCTIONS: Responsible for providing direct observation of patients as directed by the nursing plan of care and under the supervision of the nursing staff and/or nursing department supervisor. Responsible for assisting nursing staff to create, maintain and provide a safe environment Develop individualized patient care plans and periodic evaluation of plans to ensure that intended results are being achieved. Interview patients and family members and consults with attending physicians, other staff members to determine and evaluate the kind of health and physical care needed. Recognize adverse signs and symptoms, which are not always apparent and to react promptly in emergency situations including the implementation of life saving procedures. Carry out treatments and procedures per scope of practice. Maintains health records by documenting observations, nursing interventions and therapeutic measures administered in an accurate, efficient, and timely manner. Provide counseling and teaching to patients and families or surrogates on preventive, curative and rehabilitative measures involved in health care. Make every effort to have positive working relationships with the ER staff and contribute to teamwork within the department. Monitor and initiate corrective action to maintain the environment of care including equipment and material resources Maintain professional knowledge and proficiency in nursing through continuing education, staff meetings, workshops and serve on nursing committees, as requested. Understand and adhere to established compliance and quality assurance standards. Participate in the development, implementation and evaluation of standards of care, Quality Assurance and Infection Control activities/projects. Participate in the identification of clinical or operational performance improvement opportunities and in performance improvement activities. Delegate tasks and supervise the activities of other licensed and unlicensed care providers as appropriate in accordance with licensure standards, when assigned as team leader; and provide guidance, direction and training to ancillary nursing and other personnel. Act as charge nurse for a group of patients or an entire unit when assigned. Responsible for electronic health records data entry pertinent to patient service role. Float to other units are needed. Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates) Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee and external customer satisfaction Perform other duties as assigned.
