REGISTERED NURSE


Ketchikan Indian Community (KIC) Overview:

Ketchikan, Alaska is a cozy coastal town, rich in community and culture. Ketchikan Indian Corporation has the honor to be the governing body for the Natives in the Ketchikan area. The Tribe began direct delivery services to the native residents with only two staff Members in 1975. The staff has grown to over 100 employees with the increased identification of the Tribal community needs. Beginning in 1992 KIC became a signatory in a compact of self-governance between Southeast Tribes and the United States of America, providing services to Tribal Members in a Government to Government Relationship, upholding Sovereignty for Tribal Members. The Tribal Council, as the established governing body, provides oversight and works in collaboration with the KIC staff, who focus on daily business operations to provide the highest quality of programs and services to Tribal Members. Traditional Southeast Tribal values drive KIC. The KIC mission is to preserve Tribal Member’s sovereignty, enhancing economic and cultural resources and promote self-sufficiency and self-governance for their citizens through collaboration, service, and advocacy. KIC partners with the community and Tribal Members to deliver services and provide assistance in improving the lives of all Tribal Members.

Work LOCATION: 201 Deermount Street, Ketchikan, AK, 99901

INDIAN PREFERENCE:

Consistent with Public Law 93-638 and other federal laws recognizing inherent right of the Tribe to exercise Indian Preference. Documentation of Tribal Enrollment must be included with application submission.

Job Summary

Incumbent will provide professional nursing care, assess, plan, implement, and evaluate the care rendered to well patients and those with health problems.  Provide physical and psychological support to patients, friends, and families when necessary. RN Triage helps our patients make informed decisions regarding health care, helps KICTHC to maintain a good relationship with patients, and ensures appropriate use and scheduling of same day appointments.

Essential Job Functions:

ESTABLISHES A COMPASSIONATE ENVIRONMENT BY

  • Providing emotional, psychological, and spiritual support to patients, friends and families.

PROVIDES PATIENT CARE SERVICES BY

  • Triage RN will take phone calls from KIC patients requesting medical attention or to be seen by a provider and disposition them using telephone protocols, clinical judgement, and collaboration with a provider;
  • Triage RN will see walk-in patients as time allows, creating a Nurse Appointment and having the patient check in with registration or call down to registration and have them checked in;
  • If not urgent or emergent, all attempts will be made to schedule patient with appropriate provider, even to include waiting for an appointment;
  • Triage RN works with the Registration staff to schedule appointment with a provider per triage protocols and clinical assessment;
  • Triage RN will place a referral for ER if patient is directed to go to the ER for urgent or emergent care, advising provider to sign off on the order;
  • Triage RN will review telephone triage notes from outside companies and disposition per clinic procedure;
  • Other duties as assigned;
  • Safely and appropriately administering routine immunizations, therapeutic injections and skin tests, as ordered by a provider;
  • Performing routine treatments such as inhalation therapy, catheterization, dressing changes, venipuncture, IV therapy, and other procedures within the scope of nursing practice and as ordered by the practitioner;
  • Assisting the provider in examinations and diagnostic procedures;
  • Setting up a variety of medical diagnostic equipment and procedures as requested by provider;
  • Conducting nurse appointments for counseling and other patient care needs;
  • Informing practitioner of unusual changes.

DOCUMENT PATIENT CARE SERVICES BY

  • Accessing patient information through RPMS system;
  • Providing accurate, complete, legible, and timely documentation of all nursing assessment and procedures.

DOCUMENTATION OF TELEPHONE/Walk-In TRIAGE

            Triage RN will follow the Telephone Triage policy and current guidelines for documentation.

PROMOTES PATIENT’S INDEPENDENCE BY

  • Establishing patient care goals;
  • Teaching patient, friends, and family to understand condition, medications, and self-care skills;
  • Answering patient questions and requests;

ASSURES QUALITY OF CARE BY

  • Adhering to therapeutic standards;
  • Measuring health outcomes against patient care goals and standards;
  • Making or recommending adjustments;
  • Following clinic nursing philosophies and standards of care set by the state board of nursing and to other governing agency regulations.

MAINTAINS PATIENT EXAM ROOMS BY

  • Performing daily and weekly environmental cleaning, equipment quality control, and maintenance as appropriate;
  • Obtaining supplies through Supply Clerk and medications from Pharmacy Department;
  • Maintaining competency in operation and interpretation of monitoring devices such as pulse oximeter, cardiac monitor, and non-invasive B/P monitor;
  • Maintaining competency in operation of specialized equipment including but not limited to typanometer, electrocardiograph, and infusion pump;
  • Using equipment and supplies and needed to accomplish job results.

PROTECTS PATIENTS AND EMPLOYEES BY

  • Adhering to infection-control policies and protocols, medication administration, storage procedures, and controlled substance regulations;
  • Checking for outdated medication prior to administration;
  • Calling for assistance from other health care support personnel.

MAINTAINS A COOPERATIVE RELATIONSHIP AMONG HEALTH CARE TEAMS BY

  • Documenting and communicating actions, irregularities, and continuing needs;
  • Responding to requests;
  • Building rapport;
  • Utilizing multidisciplinary team strategy;
  • Participating in team problem-solving methods.

PARTICIPATES IN MENTORSHIP PROGRAM BY

  • Assisting in the orientation of new clinic personnel;
  • Appropriately delegating tasks to LPN and CNA staff and verifying task completion.

MAINTAINS SAFE WORKING ENVIRONMENT BY

  • Reporting any unsafe conditions to appropriate supervisor upon discovery;
  • Adhering to all local, state, and federal regulations;
  • Complying with federal and state laws and regulations regarding the protection of the health of employees and provide for appropriate occupational health services for those employees.

ENSURES OPERATION OF EQUIPMENT BY

  • Completing preventive maintenance requirements;
  • Following manufacturer’s instructions;
  • Troubleshooting malfunctions;
  • Calling for repairs;
  • Maintaining equipment inventories;
  • Evaluating new equipment and techniques.

MAINTAINS PROFESSIONAL AND TECHNICAL KNOWLEDGE BY

  • Attending educational workshops;
  • reviewing professional publications;
  • establishing personal networks;
  • Participating in professional societies.

CONTRIBUTES TO TEAM EFFORT BY:

  • Participating in the appropriate patient care services committees and other workgroups;
  • Performing other related duties as directed by supervisor.

MAJOR DUTIES AND RESPONSIBILITIES

  • In cooperation with the Medical Director and staff, the Case Manager identifies:
    • Patient populations known to be at high risk due to chronic illness, to lack of follow-up or to non-compliance;
    • Patients in need of intensive monitoring or case management, such as recipients of cancer chemotherapy, AIDS patients, asthma patients, at risk elders, chronically-ill and at-risk pediatric patients;
    • Patients who utilize large amounts of clinic resources and who could benefit from case management assistance, such as team conferences, care planning, patient contracting and family meetings;
    • Priorities for establishing tracking systems, such as cervical cancer screening, breast cancer screening, immunization status, HIV screening, prostrate cancer screening, and colon cancer screening.
  • Assists the Director of Nursing in development, implementation, and evaluation of monitoring and tracking systems to assure continuity of care and follow-up according to KIC, AAAHC, State, Federal and Indian Health Service standards of care;
  • Manages the Tumor Registry, including required reporting to the appropriate state, local, and HIS agencies and organizations.  Conducts chart reviews, and patient referrals according to physician order, guidelines, and/or protocols for cancer follow-up;
  • Serves as a resource person in use of the RPMS Case management System or other tracking systems used in this position;
  • Works collaboratively with Social Services in identifying and accessing supportive community resources such as hospice, home health, and patient support groups;
  • Serves as a professional nursing resource to the Clinical Staff for case management including attendance at meetings held with providers, patients and their families, when requested by the provider;
  • Conducts interdisciplinary education on the services and advantages of using Case management Systems, including orientation of physicians to the Case Manager’s services;
  • Serves as Chairperson of the Case Management Committee, whose purpose is improved continuity of care through interdisciplinary care plan development;
  • Serves as a member of the Contract Health, Risk Management, and Clinical Records Committee;
  • Participates in Quality Improvement activities related to the Case Management programs and in support of meeting AAAHC standards for peer review;
  • Acts as a professional nursing advisor to the Specialty Clinic nurse in evaluating referrals for appropriateness according to criteria established by the visiting physicians;
  • Depending upon qualifications and competency may provide direct patient care for some patients requiring I.V. or chemotherapy and may perform the duties of Clinical Nurse on a temporary basis;
  • Develops policies and procedures for clinic practices related to Case Management and other needs to assure compliance with accreditation standards.

FACTORS

Factor 1. Knowledge, Experience, and Skills Required

  • Clinical/Technical Skills as needed for the position, such as cognitive skills, psychomotor skills, and technical understanding;
  • Knowledge of standards of care, contract health care, and clinical protocols used by the Indian Health Service;
  • Knowledge of the RPMS PCC Information System and the RPMS Case Management System or other applicable case management systems for use in the outpatient clinic setting;
  • Recent experience in nursing in both hospital and outpatient settings and the knowledge of professional nursing principles and procedures;
  • Critical Thinking Skills as needed for the position such as problem solving, time management, priority setting, planning, creativity, ethics, resource allocation, clinical reasoning, reflective practice, learning, and change management;
  • Extensive clinical experience and training necessary to utilize screening criteria as measured against the documented medical record with respect to patient needs for health care. Skill in developing and implementing an effective system of evaluating the Case Management systems used in the clinic setting;
  • Interpersonal Skills as needed for the position, such as communication, customer service, conflict management, delegating, facilitation, collaborating, directing, articulating, understanding diversity, and team skills;
  • Advanced skills in collaborating with patients, families, and caregivers, including physicians, mid-levels, nurses, pharmacists, social workers, and other personnel in development and implementation of Case Management;

Factor 2.  Supervisory Controls

Performs duties independently and in compliance with regulations and policies established by the KIC THC;

This position is under the supervision of the Director of Nursing.  The Medical Director may provide guidance concerning patient care evaluation. Projects are reviewed to determine that the objectives are met and for compliance with agency policies and regulations.

Factor 3.  Guidelines

Guidelines include the procedures established by the Case Management Committee, the Clinical Staff as reflected in the Clinical Policies and Procedures, Standing Orders, Indian Health Service protocols, agency policies and procedures as related to AAAHC Standards.  In the absence of appropriate guidelines, the incumbent will use sound professional judgment in developing new methods.  Individual cases may vary from established protocols and guidelines to comply with physician and midlevel orders.

Factor 4.  Complexity

This position is highly complex requiring critical decision making that potentially affects patient health and medical outcome.  The process of identifying and coalescing information from multiple sources for decision-making purposes, i.e., the patient’s medical record, protocols of care, discharge plans, patient care plans, and official sources presents a complex but essential aspect of the job.

It requires the ability to understand complex medical information, then interpretation and communication of the information in ways that are understood by patients and their families.

The position requires interpretation and compliance with rules and regulations governing disease reporting requirements and management of confidential medical information.

Factor 5.  Scope and Effect

The role of the Case Manager is central to coordination and continuity of patient care in the outpatient ambulatory care setting.  Effective case management improves patient outcomes by assuring planning, implementation, and evaluation of care provided to all patients.

It reduces organizational risk by specifically addressing special issues of high risk, high volume, and high intensity needs. The scope includes interdisciplinary teams, collaboration with agencies and institutions outside of the clinic setting, referral centers, visiting physicians, and families of patients.

Factor 6.  Personal Contact

Contacts are essentially with professional and paraprofessional health care providers working in hospitals, outpatient clinics, and community-based organizations.  Contacts are with patients of all ages and their families in education and information related to development of mutually acceptable plans of care for complex medical and psychosocial problems.

Factor 7.  Purpose of Contacts

Contacts provide for development of case management systems to improve continuity of care.  The Case Manager provides care coordination among providers, patients and families of patients.

Factor 8.  Physical Demands

The work involves a moderate amount of walking to and through the various clinical areas and departments, numerous telephone contacts, and great deal of time utilizing computer systems.

Factor 9.  Work Environment

The environment involves the usual risks and stress of an office environment within an ambulatory health care facility.  The employee may be exposed to communicable diseases.  Safety precautions for employees such as blood drawing for screening of various diseases such as hepatitis, required immunizations, etc. are necessary.  The employee is occasionally subject to verbal abuse, threats, and physical violence from angry, hostile, or disgruntled patients and/or family members.

KIC Competencies:

Cultural Competency: To be respectful and responsive to the health beliefs, practices, and cultural and linguistic needs of KIC Tribal Members. Developing cultural competence is an evolving, dynamic process that takes time and occurs along a continuum.

Commitment: To serve Tribal Members and set a high standard for yourself in your performance; strive for results and success; convey a sense of urgency and bring issues to closure; and stay persistent despite obstacles and opposition. 

Customer Service: Meet/exceed the expectations and requirements of internal and external customers; identify, understand, and monitor the needs of both internal and external customers, always talk and act with customers in mind; and recognize working colleagues as customers.

Effective Communication: Ensure important information is passed to those who need to know; convey necessary information with respect, clearly and effectively orally or in writing

Responsiveness and Accountability: Demonstrate a high level of conscientiousness; hold oneself personally responsible for one's own work; and do the required fair share of work.

KNOWLEDGE, SKILLS, AND ABILITIES

  • Knowledge of professional nursing principles, practices and procedures for age appropriate basic to the ambulatory setting;
  • Knowledge of a wide variety of medical disorders, their normal course, anticipated complications and therapeutic interventions for patients of all ages;
  • Knowledge  of clinical/technical skills such as cognitive, psychomotor, and technical understanding;
  • Knowledge of critical thinking skills such as problem solving, time management, priority setting, planning, creativity, ethics, resource allocation, clinical reasoning, reflective practice, learning theory, and change management;
  • Knowledge of RPMS computer application skills - word processing, database management, and spreadsheet programs;
  • Knowledge and ability to carry out rules of Health Insurance Portability and Accountability Act (HIPAA), which protects patient rights;
  • Skill in administering, implementing, and documenting therapeutic measurers in a correct and safe manner;
  • Skill in operating specialized medical equipment;
  • Ability to recognize and interpret adverse signs and symptoms of the patient and to act appropriately in emergency situations;
  • Ability to conduct an age appropriate patient assessment to determine nursing diagnosis, plan of care and ongoing data reflecting patient outcome and changing conditions;
  • Ability to communicate professionally over the telephone and in person in a positive and clear manner;
  • Ability to be flexible in order to perform at the highest level as a team player;
  • Ability to utilize maximum degree of professionalism and diplomacy with those who may be experiencing a high degree of stress both mentally and/or physically;
  • Ability to work independently with minimal supervision and able to prioritize assignments.

Physical Activities Include

Must be able to hear.  Specific vision abilities include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.  Ability to use hands to finger, handle, or operate objects tools, or controls; reach with hands and arms; climb or balance; stoop, kneel, crouch; and taste or smell.  Each of the listed activities also requires standing, sitting, walking, bending, and stooping, climbing on stools and ladders, and routinely lifting and carrying items and boxes up to forty (40) pounds.

License(s)

Possess current State of Alaska Registered Nurse license or eligible to practice in the United States as a Commission Officer of the U.S. Public Health Service. 

Possess a current CPR and ACLS Certificate.

Possess current and valid State of Alaska driver's license with a record acceptable to KIC’s Insurance carrier.

Education and Experience

Graduate from an accredited school of Nursing (prefer Bachelor’s Degree in Nursing) and one year experience in acute patient care services. 

Ketchikan, AK

2 month(s) ago