Clinical Nurse III - Custody Health Services

Description

Under general supervision, to apply the theoretical concepts of the nursing profession while providing direct patient care within the parameters of established nursing policies and procedures in patient care situations required by the assigned clinical setting; to initiate and perform established nursing interventions utilizing current clinical knowledge.

Custody Health Services (CHS) provides medical, mental health, and dental services to patients in custody at the four County detention facilities: Main Jail, Elmwood, Juvenile Hall, and James Ranch. On-site routine and urgent/emergent medical services are provided at both Main Jail and Elmwood adult jail facilities in Santa Clara County. Health care of incarcerated patients includes care of acute and chronic illness as well as preventative and specialty care. CHS also operates a 40-bed acute psychiatric inpatient housing unit at the Main Jail facility for incarcerated adults who require acute inpatient services for stabilization. Juvenile Custody Health Services provides integrated medical services including comprehensive pediatric medical, mental health, and dental care to justice-involved youth housed in Juvenile Hall and James Ranch.

Selected candidate(s) must be able to work in a correctional facility, which requires passing a background check for security clearance.

Distinguishing Characteristics 

The Clinical Nurse III classification is expected to have the knowledge and abilities to assume charge nurse responsibility. The Clinical Nurse III classification is distinguished from the Clinical Nurse II classification in that the Clinical Nurse III performs under general supervision and is expected to identify and implement nursing interventions that have less predictable outcomes and evaluate the results of these interventions for a given patient population, whereas the Clinical Nurse II works under supervision while performing specific patient care assignments. 

The Clinical Nurse III classification is distinguished from the Nurse Coordinator classification in that the Nurse Coordinator has permanent, ongoing responsibility to teach staff and organize the patient care of a specific patient population or designated clinical program.

The Clinical Nurse III classification is distinguished from the Assistant Nurse Manager classification in that the Assistant Nurse Manager has permanent, ongoing responsibility to supervise a designated nursing unit or ambulatory care clinic. 

The Clinical Nurse classification series is distinguished from the Public Health Nurse classification series in that the Clinical Nurse classification series works directly with individual patients or a defined patient assignment, where patients are injured, ill, or in life-threatening situations requiring nursing interventions, whereas the Public Health Nurse works in clinics, homes, and community settings caring for the health of the population to prevent disease and improve population health. 

The Clinical Nurse classification series differs from the Psychiatric Nurse classification series in that the Psychiatric Nurse classification series works in mental health hospitals and clinics providing psychiatric and nursing interventions

The following are the duties performed by employees in this classification. However, employees may perform other related duties at an equivalent level. Each individual in the classification does not necessarily perform all duties listed.

Assessment

• Analyzes and validates data taken from interviews of patients; revises assessments based on observation of patient behaviors; 
• Identifies common recurrent patient problems, symptoms, and behavioral changes in relation to standards of care and individual patient needs; 
• Assesses the needs of a specific patient population by making purposeful rounds, participating in clinical conferences, and collaborating with physicians and other healthcare team members;
• Assesses the competencies of personnel assigned to a specific patient group; 
• Assesses the need for development of standards of care for a specific patient population;
• Assesses the numbers and levels of personnel needed to provide nursing care for a specific patient population.

Planning 

• Identifies patient care problems, establishes priorities, and develops individual patient care plans based on nursing and medical diagnosis; 
• Plans strategies for solving patient care problems with other members of the healthcare team; 
• Plans for patient needs within current assignment to determine amount and type of assistance needed; 
• Develops a plan for teaching patients and family regarding recurrent health problems, coping mechanisms, and health practices related to maintenance of wellness and prevention of disease;

Implementation

• Collaborates with appropriate personnel in performing new procedures and/or in functioning in unfamiliar situations;
• Coordinates activities needed to implement the plan of care;
• Coordinates patient and family teaching; 
• Coordinates discharge plans with appropriate support personnel; 
• Complies with external and internal regulations pertaining to nursing practice;
• Recognizes legal and ethical duties and responsibilities of registered nurses; 
• May participate in conducting research activities; 
• When assigned charge responsibility, makes recommendations for the unit level staffing pattern and assigns personnel to provide for patient care during an 8-hour period; 
• Assists in teaching students and staff; 
• May assume role of primary nurse with accountability to specific assigned patients;
• May be assigned as a Disaster Service Worker (DSW), as required*;
• Performs other related duties, as required.

Sufficient education, training, and experience to demonstrate the ability to perform the above tasks, plus the possession and direct application of the following knowledge and abilities:

Training and Experience Note: The required knowledge and abilities are attained through possession of an active California Registered Nurse License without restrictions;

and

Three (3) years of full-time Registered Nurse (RN) experience, of which one (1) year must have been within the last three (3) years, in an accredited hospital, clinic, or healthcare setting. 

and

One (1) year of full-time RN experience, within the last three (3) years, in the nursing specialty area. A nursing specialty is a field of nursing that focuses on either a particular patient population or a health condition. 

Possession of a Bachelor of Science in Nursing (BSN) and possession of a nationally recognized certification in a specialty area is preferred.

Special Requirements

• Must possess and maintain the following certification(s) during employment:

o     Basic Life Saving Certification (BLS)

• For clinical specialty areas, must possess and maintain the following certification(s) during employment: 

o     Advance Cardiovascular Life Saving Certification (ACLS) 

o     Other identified specialty area certification(s) for specialty patient populations at appointment, as required. 

• Ability to travel to alternate locations in the course of work. If driving, possession of a valid California driver’s license prior to appointment and the ability to qualify for and maintain a County driver authorization.
• *As a condition of employment, pursuant to California Government Code Sections 3100-3109 and Local Ordinance, all County of Santa Clara employees are designated Disaster Service Workers (DSWs), including extra help. A DSW is required to complete all assigned DSW-related training, and in the event of an emergency, return to work as ordered.

Knowledge of:

• California Nurse Practice Act;
• American Nursing Association Code of Ethics;
• Nursing Professional Practice Model;
• Federal and State healthcare laws and regulations appropriate to the operation of California hospitals;
• Current nursing and related medical theory necessary to administer nursing care within assigned clinical setting;
• Principles, practices, and methods of acute and primary care clinical nursing, including community aspects and continuity of patient care;
• Diagnosis and treatment of common medical problems as related to a clinical specialty area;
• Clinical systems, supplies, and equipment;
• Safety and Infection Control practices;
• Sciences basic to nursing (anatomy, physiology, pharmacology, microbiology);
• English usage, style, grammar, punctuation, and spelling;
• Common computer systems and charting applications.

Ability to:

• Establish relationships with patients/families in difficult or crisis situations;
• Advocate for the patient/family perspective and work toward resolution of conflict;
• Develop and implement complex teaching plans;
• Be a subject matter expert and be recognized by other staff nurses and physicians for their expert knowledge;
• Support less experienced Registered Nurses;
• Recognize and report subtle variations in patient responses;
• Anticipate and identify the needs of other patients and the capabilities of the nurses assigned to them;
• Develop innovative strategies to enhance patient care;
• Model high performance leadership behaviors (e.g., thoughtful listening, effective questioning, and empowerment); 
• Act as a change agent and facilitate implementation and evaluation of change;
• Perform skillfully under pressure;
• Juggle and integrate needs and requests of multiple patients without losing important information or overlooking significant needs;
• Communicate effectively, both orally and in writing, with people of diverse backgrounds and cultures; 
• Establish and maintain effective working relationships with those contacted in the course of work, at all levels, including colleagues, the public, and representatives of other agencies.

The physical requirements may include: 

• Ability to work alternate work schedules, weekends, and holidays as necessary;
• Ability to perform physical skills required to deliver patient care;
• Bend, stoop, reach, perform fine motor movements, see, hear, and touch;
• Strength to lift, move, and transfer most patients; to restrain and carry children; to move and carry equipment; and to perform cardiopulmonary resuscitation (CPR), which requires sufficient body weight and adequate lung expansion;
• Mobility: bend, stoop, get down on the floor; combination of strength, dexterity, mobility, and coordination to assist patients; ability to move around physically and adequately in confined spaces (patient rooms, bathrooms, treatment settings, around patient equipment, etc.); 
• Be able to perform all physical skills required to deliver patient care;
• Fine Motor Movements: manipulate syringes and IVs; assist patients with feeding and hygiene; write appropriate notations; document in health record; and perform sterile procedures and other skilled procedures;
• Vision: Visualize patients in order to assess and observe their health status; skin tone, color changes, dermatological conditions, non-verbal behaviors, changes in signs and symptoms of illness, health improvement or deterioration, etc.;
• Hearing: Hear and see patients, monitor signs and symptoms, hear alarms, patient voices, call lights, and assess patient conditions, non-verbal behaviors, changes in signs and symptoms of illness, health improvement or deterioration, hear through the stethoscope to discriminate sounds, and accurately hear on the telephone;
• Touch: Ability to palpate both superficially and deeply and to discriminate tactile sensations.