Since 1980 Centre for Neuro Skills (CNS) has been a leader in medical treatment, rehabilitation and disease management for people with brain injuries. CNS offers residential, inpatient, outpatient and assisted living programs. Multi-disciplinary staff work together to develop/implement personal rehabilitation plans. We trust each employee to use their life and educational experiences to promote and build strong patient programs that improve patient outcomes. We offer exciting career opportunities where staff accomplish great things with a deep sense of service.
The Nurse Practitioner (NP) provides on-going medical management and acute interventions for persons served in the post-acute care setting with collaborating physicians and an interdisciplinary team to effectively meet the needs of the persons served. The Nurse Practitioner is responsible for the administration and coordination of services associated with a patient program. He/she supervises the care of patients throughout the care continuum, participates in planning program development, staff education, patient education, community education, and help lead quality improvement efforts. Work is full time during the weekdays with some overtime and on-call work required. Work is performed at the clinic with some work in the community and residential site.
A high degree of accuracy in documentation and observation, adaptability to a variety of situations, strong organizational and communication skills, decision making and an ability to evaluate situations as they occur is needed for this position.
ESSENTIAL DUTIES AND REQUIREMENTS:
1. Evaluates and treats patients with acute, chronic complaints and health maintenance concerns.
Prescribes, directs, administers and supervises the administration of prescribed medications and treatments. Observes patients' reactions to medications and treatments. Visual and verbal ability required to detect adverse reactions.
Performs, requests, and evaluates diagnostic studies. Orders and collects specimens for routine laboratory tests, screening procedures, and therapeutic procedures including blood and blood products. Orders physical therapy, occupational therapy, and other services.
A primary format of care is emphasized, with the NP assuming responsibility for coordination of care and management of all necessary medical issues.
Requires basic computer skills to complete conferences, make charting entries, communicate openly and clearly with associated therapies at the clinic and residential sites, formulate specific programs to outline particular patient needs in a format comprehended and utilized by the residential and clinic staff. Requires fine motor manipulation, visual ability, hearing, numerical ability to administer medications, treatment and tests. Reaches, lifts, carries and fingers through files weighing up to 15 pounds.
Recognizes situations which require the immediate attention of a physician, and initiates life-saving procedures when necessary.
2. At the clinic and during visits to residential site if needed, will assess patients' medical status, administer or supervise medication and perform treatment procedures. The Nurse Practitioner is expected to analyze the data from the assessment and determine the appropriate course of action. Requires standing, walking, bending, stooping, and repeated stair climbing. Completes assessments at the residential or clinic site utilizing the nursing process, including:
Assessment: Vital signs, head to toe assessment, listening to the patient’s comments and questions about health status, observing reactions and interactions with others.
Diagnosis: After identifying problems related to health status, formulating a plan to address this problem or potential problem in promoting an expected outcome.
Planning: Setting goals to improve the outcomes for the patient are a primary focus of the nursing process. This directly equates with improving the quality of life for the patient and what the patient needs to do to improve his/her health status or better cope with concerns identified.
Implementation: Setting treatment plans in motion and delegating responsibilities for each step. Communication is essential to the nursing process. All members of the health care team should be informed of the patient’s status, health concerns and goals of care. In return, nursing should receive feedback from the healthcare team including observations and interventions as well as patient’s outcomes and responses.
Evaluation: The treatment process is ongoing. Evaluation not only analyzes the success of goals and interventions but examines the need for adjustments and changes as well. The evaluation incorporates all input from the entire rehabilitation team, including the patient.
3. Assists with weekly and/or bi-monthly medical staffings as well as providing and coordinating patient teaching and counseling.
4. Performs reporting procedures.
Observes, records, and reports medical progress, reaction to drugs and treatments, and significant incidents to Nursing Department Coordinator, Director of Rehabilitation, in conjunction with Clinical Case Managers, other staff members, insurance carriers, and patients' families.
Maintains medical records for each patient with staff observations, interventions, patient reactions, tests, intake and emission of liquids and solids, temperature, pulse, and respiration rate documented. Requires visual and fine motor coordination, ability to read and write, and cognitive ability to observe and record data.
Submits monthly conference reports for own patients.
Reports verbally and/or in writing (according to patient/carrier/company needs) in conferences, staffings and other meetings to inform necessary personnel, insurance carriers, patients' families and patients (as appropriate) of patient testing, treatment and progress. Requires visual ability and fine motor manipulation to dictate and review/edit reports.
5. Perform comprehensive assessments and document findings in a concise and comprehensive manner. Ensure all diagnoses are ICD9/ICD10 coded accurately to support the diagnosis at that visit.
6. Provides for the safety of patients, visitors, staff and self when interacting with patients who may have behavioral outbursts, which can include yelling, exiting, hitting, kicking, biting, spitting, scratching, and throwing objects.
Must be able to recognize patient escalation, via verbal, physical and visual cues.
Must be able to attempt to verbally and physically de-escalate patient using Behavior Modification techniques according to each patient's program, which may include Professional Crisis Assault Training (Pro-ACT) such as evasive self-defense (ability to get out of the way) and controlling self-defense (restraints).
Physical intervention and restraints can include calling for help, lifting, standing, walking, running, stooping, bending, kneeling, squatting, carrying, pulling, pushing and assisting with the restraint of patients weighing up to 150 pounds or more.
7. Performs toilet and chair transfers with assistance for patients up to 150 pounds utilizing approved transfer techniques. Transfer techniques include standing, walking, stooping, bending, kneeling, squatting, lifting, carrying, pushing and pulling. Patients requiring moderate to maximum assistance and weighing over 150 pounds are lifted and/or transferred by two or more persons.
8. Uses special equipment as required by each patient including, but not limited to wheelchairs, tracheostomy tubes, gastric feeding tubes, and external catheters, at any given time according to the outline of each patient's program. May require find motor manipulation, lifting, reaching, carrying, pushing and pulling when working with equipment.
9. Maintains professional and ethical relationships with staff, patients, patient families, and other visitors.
10. Attends staff meetings, in-services, and all scheduled shifts. May work on-call shifts as required. Demonstrate flexibility with regards to patient census, staffing needs and scheduling. Occasional travel between sites is mandatory.
11. Comprehends and follows instructions:
Maintain attention and concentration for necessary periods
Apply common sense understanding and carry out instructions (written, oral or diagrammatic)
Adapt to situations requiring the precise attainment of set limits, tolerances or standards
12. Performs simple and repetitive tasks:
Ask simple questions or request assistance when needed
Perform routine, concrete, organized activities
Remember locations and work procedures
Make decisions based on simple sensory data
13. Maintains work pace appropriate to given work load:
Perform activities on schedule, maintain regular attendance, and be punctual within specified tolerance
Complete normal workday and/or week, perform at a consistent pace without excessive rest periods
14. Performs complex or varied tasks:
Synthesize, coordinate and analyze data
Perform job requiring precise attainment of set limits, tolerances or standards
15. Relates to other people beyond giving and receiving instructions:
Can get along with co-workers or peers without exhibiting behavioral extremes
Maintain open door policy to encourage active, empathetic listening
Perform work activities requiring negotiating, instructing, supervising, persuading or speaking with others.
Respond appropriately to criticism from a supervisor and/or other staff member(s)
16. Effectively influences people on a consistent basis:
Convince or redirect others
Understand the meaning of words and use them effectively
Interact appropriately with people which includes the provision of appropriate internal and external customer service
17. Makes generalizations, evaluations or decisions without immediate supervision:
Recognize potential hazards and observe appropriate precautions
Understand and remember detailed instructions
Make independent decisions or judgments based on sensory data or known guidelines
18. Accepts and carries out responsibility for direction, control and planning:
Set realistic goals or make plans independently of others
Negotiate, instruct or supervise people
Respond appropriately to changes in the work setting
PREFERRED DUTIES AND REQUIREMENTS
1. Coordinates and may attend medical appointments requiring transporting patients in company or personal vehicle. Requires ability to drive vehicle and transfer patient using approved methods.
2. Assists with employee in-services.
3. Performs other duties as assigned.
SPECIAL SKILLS UTILIZED, EDUCATION LEVEL, TRAINING
1. Graduation from an accredited Nurse Practitioner program. Current licensure in state employed is required.
2. Experience in acute care, skilled nursing and rehabilitation concepts preferred.
3. Maintain CPR certification.