Nash County
Public Health Nurse II - STD ERRN
Nash County, Nashville, North Carolina, United States, 27856
A.
Primary Purpose of Position:
Serves as the highest level of provider to see Women's Health Watch and STD patients.
Responsible for providing adult physical assessments (including breast exam, pelvic exam, and bimanual exam as appropriate) in the Women's Health Watch and Sexually Transmitted Disease clinics. Works with the physician and the other disciplines to obtain medical histories, obtain and perform appropriate diagnostic procedures, prescribe treatment under the direction of standing orders, document findings, develop care plans and counsel patients.
B.
Work Schedule:
8 am - 5 pm, Monday through Friday.
Hours may vary depending on services offered by the health department.
80%
Sexually Transmitted Disease
Responsible for assisting Program Coordinator with keeping staff informed of policy, procedure and clinic changes.
Ensures that the activities of the program are carried out in accordance with the policies and procedures of the Health Department.
Assists with orientation of new staff to the STD program and its policies and procedures.
Assists with notifications and follow-up of all positive results from all programs, following STD Treatment Guidelines.
Reviews all records from these clinics and notifies patient as indicated through letters and phone calls.
Counsels regarding results, need for treatment, follow-up and partner notification.
Assists with reporting and follow-up of patients seen with STDs in local Emergency Rooms.
4.
Assists with coordination of patient follow-up and treatment with other program coordinators (Maternity, Family Planning and Adult Health) and STD Management Support person.
5.
Serves as a resource person for fellow staff and provides them with technical assistance.
Also serves as a resource person for Infection Control Nurses from area hospitals and area physicians.
Maintains effective working relationship with STD Regional Office Personnel, area Infection Control Nurses and area physicians.
6.
Responsible for reporting cases of STDs and AIDS/HIV.
7.
Serves as a counselor for patients requesting HIV test and those identified with risk factors.
8.
Serves as back-up member of the Agency's STD Quality Assurance Committee, which includes representation from the Nashville and Rocky Mount Office.
Composed of the following:
Nursing Supervisor, RN, Lab, Management Support, and Health Education.
9.
Responsible for maintaining an up-to-date workflow in the North Carolina Electronic Disease Surveillance System (NC EDSS) according to State Guidelines.
Performs physical assessment exams in STD clinics
Reviews or obtains medical history.
Counsels regarding appropriate communicable disease and discusses general STDs with patients.
Identifies and evaluates high risk behavior.
Provides HIV counseling.
Performs a physical exam including the bimanual pelvic.
Collects lab samples relative to the medical history.
(GC, chlamydia, NGU, herpes, serology for syphilis and HIV, and wet preps for trichomoniasis, bacterial vaginosis and yeast)
Assesses findings.
Prescribes treatment according to the Agency's STD standing orders.
Refers sex partners for treatment.
Provides appropriate individual education and counseling - stressing safer sex practice with condom use.
Advises and notifies patient of follow-up appointments and/or referrals.
Treats genital warts per standing orders after the diagnosis has been established by MD, PA or NP.
6% Women's Health Watch
Performs physical assessment exams in the Women's Health Watch Program
Reviews or obtains medical history.
2.
Counsel's patients regarding acute and chronic disease, communicable disease, lab findings and diet.
3.
Performs breast exams and teaches self-breast examination.
4.
Follows the agency's procedure manual for the collection of specimens for pap smear, gonorrhea cultures, Chlamydia antigen, herpes cultures and wet mounts.
5.
Performs bimanual and rectal examinations as approved under Category II Nursing Procedures outlined in procedure manual.
6.
Evaluates and interprets test results and treats according to Standing Orders signed by Clinician and refers patient as indicated from findings.
7.
If applicable, offers HIV testing/counseling and BCCCP referral.
4% Family Planning
Interviews/collects lab specimens in Family Planning clinics
Counsel's patients regarding birth control methods.
Obtains medical history and other pertinent data such as Blood Pressures.
Assists Clinician with examination.
Interprets instructions to patient, interprets consents and obtains signatures.
Issues supplies of prescribed methods of birth control and dispenses according to pharmacy policy.
Collects specimens such as Paps, GC, Chlamydia, and wet preps.
4% Maternity
Interviews in maternity clinics
Obtains prenatal history.
Teaches patient important information to help her have a healthy pregnancy and baby.
Counsel's patient about complications of pregnancy, labor and delivery.
Assists Clinician with exams and interprets instructions to the patient.
Schedules test needed to be performed outside of agency and schedules return appointments.
Issues vitamins and iron tablets according to Pharmacy Policy.
2% Pediatrics
Interviews and Administers Immunizations in Pediatric Clinics
Interviews parents of infants and children to obtain medical history.
Counsel's parents regarding diet, growth, development and preventative health care.
Administers vision and hearing tests.
Evaluates patient for needed lab work and administers immunizations.
2% General Clinic
Works General clinic administering immunizations, checking rashes, head lice, blood pressures, administering immunizations for WIC recert appointments, etc.
Obtains medical history and orders lab work on TB patients, contacts, reactors.
Administers and reads TB skin tests, issues sputum containers, and dispenses medicines per Standing Orders.
1% Community Health
Staff's emergency shelters for disaster services.
Backs up school nurses and assists other health department staff with school activities (ex., school-based screenings, immunizations, communicable diseases services, etc.).
Assists with department wide community activities (ex., community flu programs, health fairs, etc.).
1% Other Duties
As assigned.
Maintain Personnel records.
Attends staff meetings and other county education programs.
Participates in disaster services as required.
II.
B.
OTHER POSITION CHARACTERISTICS:
Accuracy Required in Work:
Accuracy required in reviewing lab data results, physical assessment exams, in identifying problems and needs and initiating appropriate referrals and treatments.
Legal responsibility falls to acting nurse for herself, her patient and her place of employment.
Consequence of Error:
Errors may result in bodily harm either physically or mentally.
Timely and accurate interpretation is vital to protect patient.
Instructions Provided to Employee:
This position has scheduled clinic assignments.
Management responsibilities and program responsibilities are prioritized by the employee.
Guidance is available from the nursing supervisor if requested.
Guides, Regulations, Policies and References Used by Employee:
Nash County Policies, Procedures, and Standing Orders.
The Breast Screening Manual:
A Guide for Health Departments and Providers.
NC BCCCP Guidelines on Mammography Screening (directive of CDC National Breast and Cervical Cancer Early Detection Program).
DEHNR directive.
Nash County Health Department Personnel policies.
Sexually Transmitted Diseases Treatment Guidelines from CDC.
NC Nurse Practice Act.
Federal and State Statutes and Rules.
ACIP Manual.
NC STD Manual.
Supervision Received by Employee:
Work is supervised by the Personal Care Nursing Supervisor.
Sexually Transmitted Disease and HIV/AIDS Policies and Procedures, and Standing Orders are reviewed quarterly by members of the Adult Health STD Quality Assurance Committee and updated as needed by the Program Coordinator and Nursing Supervisor.
Variety and Purpose of Personal Contacts:
Variety of contacts include:
Local physicians' office.
State laboratory staff.
Surrounding area Health Department Personnel.
Patients on a daily basis to assure that all needed services are provided for referrals made.
Local hospitals, Emergency Department, Infection Control, Prison Systems, etc.
Physical Effort:
Requires the provision of patient services each day whether physically through applying direct clinical skills, phone calls, mail, record management, or attending a continuing education workshop.
Requires travel between the Nashville and Rocky Mount offices.
Requires home visits as needed.
Work Environment and Conditions:
Usual work environment is the office or clinic setting.
Has the potential to be exposed to body fluids.
Adheres to the BBP and Infection Control Policies of the Agency to minimize this exposure.
Also provides care in STD clinics to inmates. Inmates are always accompanied by a deputy.
Driving is required sometimes during bad weather for clinic duties and home visits.
Machines, Tools, Instruments, Equipment and Materials Used:
Blood Pressure Cuff/Stethoscope, Doppler, Copy Machine, Speculums, Computer/EMR, Scales, Fax Machine, telephone, stadiometer and OAE.
Visual Attention, Mental Concentration and Manipulative Skills:
Must be able to organize work efficiently.
Must be able to perform quality work independently.
Must have proficiency in Level II Nursing Procedures.
Requires good communications skills.
Must have good writing skills to record documentation and initiate referrals.
Assertive.
Safety for Others:
Must follow recommended guidelines to prevent transmitting any communicable diseases.
Universal precautions are used for safety of staff and patients.
Must be knowledgeable of local policies, procedures, and standing orders.
Must have nursing expertise to provide appropriate patient care.
Must be adequately immunized per agency policy.
Dynamics of Work:
Flexibility is an important component of this position.
New situations arise every day.
Ability to prioritize work is essential since workload and schedule may change.
Positive attitude is crucial to be able to motivate patients.
Diplomacy and tactfulness in dealing with physicians regarding referrals is very important.Position requires strong assessment skills and qualification to perform breast exams, pap smears, bi-manual/rectal vaginal exams, and collect lab specimens.
Good verbal and writing skills are needed to document findings and communicate with patients.
Requires knowledge of available resources and appropriate referral methods.
Requires the ability to plan and coordinate work with others, to deal tactfully with others and to exercise good judgement in appraising situations and making decisions.Required Minimum Training:
Graduation from an accredited school of professional nursing and one year of professional nursing experience.
Additional Training/Experience:
NC Credentialed Public Health Nursing Course (NCCPHN)
Introductions to Public Health in North Carolina Online Training Series,
Certificate of Public Health Nursing in North Carolina
Completion of a State approved Adult Physical Assessment Course
Completion of a State approved STD course
Red Cross Disaster Training
CPR Certification
CPR/Defibrillator training
HIV counseling and testing program
ICS Trainings
License or Certification Required by Statute/Regulation/Agency:
Current license to practice as a Registered Nurse in North Carolina by the N.C. Board of Nursing
Valid North Carolina Driver's License
Primary Purpose of Position:
Serves as the highest level of provider to see Women's Health Watch and STD patients.
Responsible for providing adult physical assessments (including breast exam, pelvic exam, and bimanual exam as appropriate) in the Women's Health Watch and Sexually Transmitted Disease clinics. Works with the physician and the other disciplines to obtain medical histories, obtain and perform appropriate diagnostic procedures, prescribe treatment under the direction of standing orders, document findings, develop care plans and counsel patients.
B.
Work Schedule:
8 am - 5 pm, Monday through Friday.
Hours may vary depending on services offered by the health department.
80%
Sexually Transmitted Disease
Responsible for assisting Program Coordinator with keeping staff informed of policy, procedure and clinic changes.
Ensures that the activities of the program are carried out in accordance with the policies and procedures of the Health Department.
Assists with orientation of new staff to the STD program and its policies and procedures.
Assists with notifications and follow-up of all positive results from all programs, following STD Treatment Guidelines.
Reviews all records from these clinics and notifies patient as indicated through letters and phone calls.
Counsels regarding results, need for treatment, follow-up and partner notification.
Assists with reporting and follow-up of patients seen with STDs in local Emergency Rooms.
4.
Assists with coordination of patient follow-up and treatment with other program coordinators (Maternity, Family Planning and Adult Health) and STD Management Support person.
5.
Serves as a resource person for fellow staff and provides them with technical assistance.
Also serves as a resource person for Infection Control Nurses from area hospitals and area physicians.
Maintains effective working relationship with STD Regional Office Personnel, area Infection Control Nurses and area physicians.
6.
Responsible for reporting cases of STDs and AIDS/HIV.
7.
Serves as a counselor for patients requesting HIV test and those identified with risk factors.
8.
Serves as back-up member of the Agency's STD Quality Assurance Committee, which includes representation from the Nashville and Rocky Mount Office.
Composed of the following:
Nursing Supervisor, RN, Lab, Management Support, and Health Education.
9.
Responsible for maintaining an up-to-date workflow in the North Carolina Electronic Disease Surveillance System (NC EDSS) according to State Guidelines.
Performs physical assessment exams in STD clinics
Reviews or obtains medical history.
Counsels regarding appropriate communicable disease and discusses general STDs with patients.
Identifies and evaluates high risk behavior.
Provides HIV counseling.
Performs a physical exam including the bimanual pelvic.
Collects lab samples relative to the medical history.
(GC, chlamydia, NGU, herpes, serology for syphilis and HIV, and wet preps for trichomoniasis, bacterial vaginosis and yeast)
Assesses findings.
Prescribes treatment according to the Agency's STD standing orders.
Refers sex partners for treatment.
Provides appropriate individual education and counseling - stressing safer sex practice with condom use.
Advises and notifies patient of follow-up appointments and/or referrals.
Treats genital warts per standing orders after the diagnosis has been established by MD, PA or NP.
6% Women's Health Watch
Performs physical assessment exams in the Women's Health Watch Program
Reviews or obtains medical history.
2.
Counsel's patients regarding acute and chronic disease, communicable disease, lab findings and diet.
3.
Performs breast exams and teaches self-breast examination.
4.
Follows the agency's procedure manual for the collection of specimens for pap smear, gonorrhea cultures, Chlamydia antigen, herpes cultures and wet mounts.
5.
Performs bimanual and rectal examinations as approved under Category II Nursing Procedures outlined in procedure manual.
6.
Evaluates and interprets test results and treats according to Standing Orders signed by Clinician and refers patient as indicated from findings.
7.
If applicable, offers HIV testing/counseling and BCCCP referral.
4% Family Planning
Interviews/collects lab specimens in Family Planning clinics
Counsel's patients regarding birth control methods.
Obtains medical history and other pertinent data such as Blood Pressures.
Assists Clinician with examination.
Interprets instructions to patient, interprets consents and obtains signatures.
Issues supplies of prescribed methods of birth control and dispenses according to pharmacy policy.
Collects specimens such as Paps, GC, Chlamydia, and wet preps.
4% Maternity
Interviews in maternity clinics
Obtains prenatal history.
Teaches patient important information to help her have a healthy pregnancy and baby.
Counsel's patient about complications of pregnancy, labor and delivery.
Assists Clinician with exams and interprets instructions to the patient.
Schedules test needed to be performed outside of agency and schedules return appointments.
Issues vitamins and iron tablets according to Pharmacy Policy.
2% Pediatrics
Interviews and Administers Immunizations in Pediatric Clinics
Interviews parents of infants and children to obtain medical history.
Counsel's parents regarding diet, growth, development and preventative health care.
Administers vision and hearing tests.
Evaluates patient for needed lab work and administers immunizations.
2% General Clinic
Works General clinic administering immunizations, checking rashes, head lice, blood pressures, administering immunizations for WIC recert appointments, etc.
Obtains medical history and orders lab work on TB patients, contacts, reactors.
Administers and reads TB skin tests, issues sputum containers, and dispenses medicines per Standing Orders.
1% Community Health
Staff's emergency shelters for disaster services.
Backs up school nurses and assists other health department staff with school activities (ex., school-based screenings, immunizations, communicable diseases services, etc.).
Assists with department wide community activities (ex., community flu programs, health fairs, etc.).
1% Other Duties
As assigned.
Maintain Personnel records.
Attends staff meetings and other county education programs.
Participates in disaster services as required.
II.
B.
OTHER POSITION CHARACTERISTICS:
Accuracy Required in Work:
Accuracy required in reviewing lab data results, physical assessment exams, in identifying problems and needs and initiating appropriate referrals and treatments.
Legal responsibility falls to acting nurse for herself, her patient and her place of employment.
Consequence of Error:
Errors may result in bodily harm either physically or mentally.
Timely and accurate interpretation is vital to protect patient.
Instructions Provided to Employee:
This position has scheduled clinic assignments.
Management responsibilities and program responsibilities are prioritized by the employee.
Guidance is available from the nursing supervisor if requested.
Guides, Regulations, Policies and References Used by Employee:
Nash County Policies, Procedures, and Standing Orders.
The Breast Screening Manual:
A Guide for Health Departments and Providers.
NC BCCCP Guidelines on Mammography Screening (directive of CDC National Breast and Cervical Cancer Early Detection Program).
DEHNR directive.
Nash County Health Department Personnel policies.
Sexually Transmitted Diseases Treatment Guidelines from CDC.
NC Nurse Practice Act.
Federal and State Statutes and Rules.
ACIP Manual.
NC STD Manual.
Supervision Received by Employee:
Work is supervised by the Personal Care Nursing Supervisor.
Sexually Transmitted Disease and HIV/AIDS Policies and Procedures, and Standing Orders are reviewed quarterly by members of the Adult Health STD Quality Assurance Committee and updated as needed by the Program Coordinator and Nursing Supervisor.
Variety and Purpose of Personal Contacts:
Variety of contacts include:
Local physicians' office.
State laboratory staff.
Surrounding area Health Department Personnel.
Patients on a daily basis to assure that all needed services are provided for referrals made.
Local hospitals, Emergency Department, Infection Control, Prison Systems, etc.
Physical Effort:
Requires the provision of patient services each day whether physically through applying direct clinical skills, phone calls, mail, record management, or attending a continuing education workshop.
Requires travel between the Nashville and Rocky Mount offices.
Requires home visits as needed.
Work Environment and Conditions:
Usual work environment is the office or clinic setting.
Has the potential to be exposed to body fluids.
Adheres to the BBP and Infection Control Policies of the Agency to minimize this exposure.
Also provides care in STD clinics to inmates. Inmates are always accompanied by a deputy.
Driving is required sometimes during bad weather for clinic duties and home visits.
Machines, Tools, Instruments, Equipment and Materials Used:
Blood Pressure Cuff/Stethoscope, Doppler, Copy Machine, Speculums, Computer/EMR, Scales, Fax Machine, telephone, stadiometer and OAE.
Visual Attention, Mental Concentration and Manipulative Skills:
Must be able to organize work efficiently.
Must be able to perform quality work independently.
Must have proficiency in Level II Nursing Procedures.
Requires good communications skills.
Must have good writing skills to record documentation and initiate referrals.
Assertive.
Safety for Others:
Must follow recommended guidelines to prevent transmitting any communicable diseases.
Universal precautions are used for safety of staff and patients.
Must be knowledgeable of local policies, procedures, and standing orders.
Must have nursing expertise to provide appropriate patient care.
Must be adequately immunized per agency policy.
Dynamics of Work:
Flexibility is an important component of this position.
New situations arise every day.
Ability to prioritize work is essential since workload and schedule may change.
Positive attitude is crucial to be able to motivate patients.
Diplomacy and tactfulness in dealing with physicians regarding referrals is very important.Position requires strong assessment skills and qualification to perform breast exams, pap smears, bi-manual/rectal vaginal exams, and collect lab specimens.
Good verbal and writing skills are needed to document findings and communicate with patients.
Requires knowledge of available resources and appropriate referral methods.
Requires the ability to plan and coordinate work with others, to deal tactfully with others and to exercise good judgement in appraising situations and making decisions.Required Minimum Training:
Graduation from an accredited school of professional nursing and one year of professional nursing experience.
Additional Training/Experience:
NC Credentialed Public Health Nursing Course (NCCPHN)
Introductions to Public Health in North Carolina Online Training Series,
Certificate of Public Health Nursing in North Carolina
Completion of a State approved Adult Physical Assessment Course
Completion of a State approved STD course
Red Cross Disaster Training
CPR Certification
CPR/Defibrillator training
HIV counseling and testing program
ICS Trainings
License or Certification Required by Statute/Regulation/Agency:
Current license to practice as a Registered Nurse in North Carolina by the N.C. Board of Nursing
Valid North Carolina Driver's License