Staff Nurse - Ambulatory Care - Bedford

Job Description Marketing Statement NYC Health + Hospitals/Gotham Health is one of the largest Federally Qualified Health Center (FQHC) in the country, providing coordinated world-class primary and specialty care with dignity and respect for all New Yorkers, without exception. At Gotham Health, we practice a person-centered caring culture that values delivering compassionate, quality healthcare in partnership with our patients, community organizations, and staff. Gotham Health is focused on high-quality, affordable care to everyone regardless of ability to pay or immigration status. Gotham Health serves the community through a two-pronged approach: providing treatment to those who need it while at the same time emphasizing prevention. We strive to deliver services in a way that maximizes each patient's opportunity to achieve successful health outcomes, we believe in every person's right to participate in their care plans, we facilitate partnerships with other community resources to meet the needs of our patients beyond healthcare, and we celebrate and recognize the compassionate care of our committed staff. Join our team if you want to be part of our Gotham Health Family, a person-centered, fully integrated, and innovative ambulatory care network that enables all New Yorkers to live their healthiest lives. Job Description PURPOSE OF POSITION The Registered Nurse will provide professional nursing care including diagnosing and treating human responses to actual and potential health problems through case finding, health teaching, counseling and the provision of care supportive of or restorative to life and well-being in accordance with their scope of practice. Summary Of Duties And Responsibilities Assessment Completes patient assessment according to established guidelines. Identifies patient problems and barriers to providing optimal care (e.g., language, culture, and behavioral health issues) and incorporates patient s perception of illness. Prioritizes the data and information collected based on the patient s condition and preferences, situation, and/or anticipated needs. Diagnosis Formulates nursing diagnosis based on identification data. Identifies the nursing diagnosis, actual or potential based on the analysis of assessment data and information, current ambulatory care RN knowledge, and evidence-based practice. Outcomes Identification Involves the patient, family, and health care team in establishing goals/outcomes that are realistic/measurable/mutually set and expected. Defines expected outcomes in terms of the patient values, preferences, spiritual, emotional, cultural and ethical considerations, age-related issues, and situational environment. Specifies a time estimate for attainment of measurable expected outcomes. Planning As a member of the health care team, participates in pre-visit planning, daily clinical huddles, and other activities to meet Patient Centered Medical Home Standards. Identifies Care Gaps and works with the team to close gaps through proactive outreach, patient education, referrals, and needed services. Develops an individualized ambulatory nursing plan for patients seeking care for health promotion, health maintenance, or health-related situational problems. Considers patient or population needs in terms of age, gender, race, cultural values and practices, ethical and legal considerations, physiological, psychological, and environmental factors, and the anticipated risks and benefits of interventions for individualized plan development. Incorporates a timeline for ambulatory care nursing plan implementation and goal achievement, reevaluation or reassessment, follow-up care, and care coordination as appropriate. Provides a plan of care that is clear and understandable to patient, family, and/or caregivers. Implementation Develops and implements an individualized teaching plan based on the patient s preferences, resources, motivation, and anticipated needs. Utilizes evidence-based, ambulatory care-specific interventions to achieve agreed upon outcomes during clinical visits, nurse visits, telephone encounters, and electronic communications. Provides culturally sensitive care to patients and families in collaboration with other health team members. Assists with diagnostic tests and procedures within scope of practice and facility policy. Communicates and documents pertinent information to the health care team. Adheres to standard work flows and completes EPIC work queues as identified. Coordination of Care Applies effective teamwork and collaboration skills to overcome identified barriers to produce quality and effective patient outcomes. Utilizes an interprofessional approach to engage patient, caregivers, and providers in implementing and coordinating the plan of care across care settings. Manages high-risk individuals and/or population(s) with the aim of preventing or delaying adverse outcomes, utilizing population health database, as needed. Communicates the relevant information to patient, caregivers, and interprofessional health care team across the continuum. Participates in coordination of care activities through Accountable Care Organizations (ACO) and in the development and implementation of other patient care/health care delivery initiatives. Health Teaching and Promotion Assesses a group or patient s learning needs, abilities, readiness, preferences, and barriers to learning. Utilizes health teaching and health-promotion strategies which support the patient s learning needs, values, preferred language, socioeconomic status, cultural, and spiritual preferences. Documents learner assessment, comprehension, and effectiveness of educational strategies, as well as modifications to plan of care. Participates in outreach and preventative care education. Evaluation Participates in the development and maintenance of a system of evaluation of nursing care, practices and procedures, including evaluation of nursing personnel. Reviews effectiveness of plan, evaluates interventions and expected outcomes. Evaluates the quality of care provided to patients. Documentation Records activities, documents assessments, plan of care, interventions, evaluations, and reevaluation of patient status, and contact notes as appropriate in the Electronic Medical Record. Utilizes appropriate downtime documentation procedure when the electronic system is down. Updates care plan according to policy. Education/Self Development Pursues educational and professional experiences that expand ambulatory care nursing knowledge, skills, and competencies. Participates in Nursing Shared Governance and other patient care committees and/or projects within the institution. Demonstrates and awareness of current departmental standards/regulatory /accreditation requirements for nursing. Maintains current state professional nurse (RN) license and certifications. Mentors and supports new nurses to the ambulatory care nursing setting, incorporating them into interprofessional activities and ongoing continuing education. Research and Evidence-Based Practice Reviews and evaluates current literature for research and evidence relevant to ambulatory care nursing practice. Utilizes current research findings and other evidence to expand professional knowledge, enhance role performance, and increase knowledge of ambulatory care nursing professional issues. Performance Improvement Monitors/evaluates assures compliance with quality improvement standards. Participates in Quality Assurance/Quality Improvement data collection and Performance Improvement projects (Nursing, departmental, service based). Communication Communicates pertinent information to health team members in a timely manner. Initiates appropriate referrals to health care providers and other resources. Demonstrates positive verbal and non-verbal communication skills. Addresses patients/visitors in a professional manner; functions as patient advocate. Leadership Delegates assignments for nursing personnel based on patient acuity and employee skill level of competency. Coordinates unit routines and provides guidance/supervision to assigned nursing staff; leads by professional example. Investigates, reports/corrects significant conditions which may affect safety of patient/staff/visitors. Actively participates in patient safety huddles and debriefings. Operates equipment/performs work related duties in a safe manner. Reports equipment malfunctions/requests repairs as necessary. Ensures emergency equipment/supplies are available and working properly. Demonstrates knowledge of infection control procedures. Follows procedures and practices for identification of patients. Adheres to policy for facility fire/safety/understands role in fire drills; Internal/external disaster plans. Recognizes/responds to emergencies appropriately. Orients new personnel to unit policies, procedures, and practices. 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Created: 2024-11-20