The Regional Crisis Stabilization Center (RCSC) is licensed by the Department of Behavioral Health and Developmental Services (DBHDS) for Crisis Stabilization Services, providing a 24 hour residential alternative to acute psychiatric hospitalization.
The Nurse Manager , Crisis Stabilization participates and provides supervision of psychiatric and medical services and care to clients diagnosed with serious mental illness, substance use disorders and co-occurring disorders within the Regional Crisis Stabilization Center (RCSC), a residential crisis stabilization program. Participates in a multidisciplinary approach which provides rapid assessment, evaluation, crisis intervention, psychotherapy, psychiatric and medical monitoring using a brief stay approach for treating diminishing acute symptoms and psychiatry conditions preventing need for hospitalization. Work includes supervision of nursing staff and as assigned psychiatric technicians in coordination with the Program Manager. Assists staff psychiatrist in the prescription, administration and monitoring of client medications; performs client assessments, administers medication and injections and performs other medically based treatment services and provides crisis and supportive counseling. Services includes nursing and needs assessment, treatment planning, service provider linkage/monitoring/coordination, advocacy/counseling, crisis intervention, and daily living support.
DISTINGUISHING ELEMENTS OF THE CLASS:
IMPACT: The immediate and long-term health and safety of the program clients are directly dependent on the work of this position. The incumbent makes client assessments on which medications are prescribed and insures appropriate administration of medical care to the client, the results of which are used by the attending psychiatrists to diagnose and prescribe medications, treatment and/or referral and could result in client death, disability or dangerous behaviors. The incumbent personally responds to medically related crisis interventions in which client, staff and affected others may be at risk of endangerment. The incumbent is responsible for safeguarding dangerous medications and ensuring related records management complies with licensure and other regulations. The incumbent serves as the program’s lead for medication, pharmacy and other medical service activities. Participates in the development and implementation of complex medical policies and procedures that affect the physical health of all consumers. Compliance with mandatory regulations, and the safety and health of consumers and staff are dependent on the work of this class. The incumbent is responsible for the oversight of the program’s medication storage and distribution to ensure compliance with all pharmacy and security regulations.
II. LATITUDE: Professional work is performed independently with regular consultation and review by Program Manager and Psychiatrist. Work is guided by detailed and comprehensive policies and procedures and regulations, although the exercise of professional judgment is required. Nursing expertise is required to perform functions.
III. RESPONSIBILITY FOR THE WORK OF OTHERS: Supervision is exercised over a small staff of Licensed Nurses and Psychiatric Technicians. Works with Program Manager recommending appointment and termination of staff. Evaluates employee performance for the nursing and other assigned staff and submits Employee Performance Evaluates to the Program Manager. Oversees staff timesheets and absences, analyzes evaluates the need for staff training, disciplinary action and provided staff training on patient treatment issues.
IV. INTERPERSONAL CONTACTS: Work requires the continuing interface and liaison with a variety of other individuals both internal and external to the agency including clients and families/caregivers; local health and human service agencies; laws enforcement, magistrates, treatment and case management staff; pharmacists’ private health care and other service providers and other human services organizations and physicians.
V. DIFFICULTY: Work requires resolution of a variety of administrative and clinical problems and includes the accurate assessment of clients experiencing a wide range of medical and emotional dysfunctions, which are often interdependent and may cause psychotic behaviors, which further complicates assessment. Accuracy and attention to detail are essential in the reading an execution of physician orders and the thorough and precise documentation and records management in order to comply with complex and detailed governmental regulations. Requires the continuous use of professional judgment and interpersonal skills. Detailed follow-up is necessary to ensure client safety. Work includes the supervision of subordinate medical staff and involves careful training, supervision and monitoring to ensure the accuracy of medication administration.
VI. COMMUNICATION: Regular oral contact with clients, caregivers, physicians, agency and external provider’s is required. Work involves preparation of detailed and technical records, evaluation reports, correspondence and letters. The incumbent is required to serve on agency committees related to medical issues as appointed.
VII. EQUIPMENT/FACILITIES RESPONSIBILITY: This position assists Program Manager for responsibility of day-to-day management of center and responsibility of equipment and facilities maintain in compliance with regulatory standards. Regular use of phone, computers, and copier/fax. Responsible for the security of medication, medical supplies and materials. Incumbent is responsible for the handling and dispensation of medication and other physical monitoring equipment. Incumbent may infrequently operate an agency’s motor vehicle.
VIII. WORKING CONDITIONS: Work is performed in a residential crisis stabilization program. Work involves exposure to blood and other bodily fluids presenting a health risk to the employee. Work involves exposure to physically and emotionally unhealthy, unstable, hostile, aggressive and verbally abusive clients and who present a risk of personal harm. Incumbent maintains shared on-call and occasionally responds to medical emergencies during off-duty hours and with support and coverage by other designated agency staff.
IX. KNOWLEDGE, SKILLS AND ABILITIES (KSA'S):
- Comprehensive and thorough knowledge of the theories, principles, standards, practices and techniques related to psychiatric nursing.
- Thorough knowledge of principals, practices, current trends and issues in public health and delivery of community behavioral health care services.
- Thorough knowledge of the behavioral modification characteristics, physiological outcomes and precautions to be taken related to the administration of psychotropic medications.
- Through knowledge of the DSM V .
- Thorough knowledge of interviewing and supportive counseling techniques .
- Thorough knowledge of pertinent agency procedures and policies.
- Thorough knowledge of community services and treatment providers.
- Ability to maintain client medical records in accordance with regulations.
- Ability to plan, supervise and evaluate the work of subordinates.
- Ability to communicate effectively and prepare related documentation.
- Ability to establish and maintain effective relationships with others.
- Ability to collect and analyze behavioral and statistical data to determine areas of quality improvement and risk management and prepare reports.
- Good knowledge of basic computer software.
X. LICENSURE: Must be currently licensed as a Registered Nurse by the Commonwealth of Virginia Board of Health Professionals. Valid Virginia Driver's License.
XI. PRINCIPAL DUTIES AND RESPONSIBILITIES OF CLASS (ILLUSTRATIVE ONLY):
- Supervises nursing and psychiatric technicians and the implementation of medical policies and procedures.
- Oversight and direct administration of medication to clients as directed by physicians and documents in client records.
- Orders and interprets laboratory testing for screening and diagnosing, notifies psychiatrist when appropriate.
- Serves as point of contact for medication, pharmacy and medical activities.
- Recommends policy and procedures changes and applicable updates.
- Develops and coordinates schedules for nursing staff and psychiatric technicians to ensure adequate coverage for 24/7 operations.
- Participates in recruitment, hiring and discipline of assigned personnel.
- Evaluates performance appraisal and participates in disciplinary action.
- Reviews the accuracy and completeness of client records.
- Schedules and assists physicians with medical examinations, completes intake forms, administers testing procedures and prepares related records and documentation.
- Provides and/or coordinates direct nursing care and treatment to program clients and makes appropriate referrals.
- Coordinates medical services within the agency and serves as a liaison between the program and other human service agencies in the community.
- Develops and implements staff in-service training sessions.
- Manages the medical supplies inventory and procures stock replenishments.
- Does other related work as necessary.
- Participates in the development and implementation of the program's quality improvement and risk management plan.
- Initiates and participates in quality improvement reviews.
- Serves on standing and ad hoc agency committees as appointed.
- Intervenes in medical crisis and assists in evaluating unusual incidents involving treatment care.
XII. PHYSICAL REQUIREMENTS: Must have the use of sensory skills in order to effectively communicate and interact with other employees and the public through the use of the telephone and personal contact as normally defined by the ability to see, read, talk, hear, handle or feel objects and controls. Physical capability to effectively use and operate various items of office related equipment, such as, but not limited to a, personal computer, calculator, copier, and fax machine. Some standing, walking, moving, climbing, carrying, bending, kneeling, crawling, reaching, and handling, pushing, and pulling.
*Current CSB employees are not eligible for the sign-on bonus*
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