CCI Health and Wellness Services is a group practice, empowering patients to partner with staff for an unparalleled healthcare experience. Through integrated teams in a learning environment, we deliver high quality, affordable, care to every patient during all stages of life.
The Registered Nurse uses his/her nursing experience and clinical knowledge to fulfill various roles in the medical services centers. Those roles include, but are not limited to leading the daily workflow and serving as an integral member of the clinical primary care team, patient counseling, fostering the Patient-Centered Medical Home, and administrative tasks. The Registered Nurse reports directly to the Nursing Director.
As a member of the health center's integrated care team, the Registered Nurse fulfills the following KEY FUNCTIONS AND RESPONSIBILITIES for the provision of patient centered, coordinated patient care:
Manages the flow of the clinical team's daily schedule, including leading or participating in team huddles, identifying patients presenting with complex medical problems, who may need additional assistance such as care management or other, and assisting the provider-MA teams in the provision of quality comprehensive patient care.
As an integral member of the primary care team:
o Delivers care in accordance with CCI guidelines and scope of training as a Registered Nurse to clients/patients from infancy to geriatrics.
o Participates in Triad Meeting with Health Center Manager, Health Center Medical Director and Registered Nurse; identifies items or issues, requiring further resolution.
o Develops pre-visit planning to ensure efficiency of care, prior to visit whenever possible.
o Provides direct care to patients, including physical assessment of presenting signs and symptoms, plans care in collaboration with a provider, executes treatment plan as directed by the provider and evaluates results.
o Provides point of care testing, such as urinalysis or pregnancy tests, etc., to aid in diagnosis and treatment; other services include, but are not limited to vaccination of clients, delivery of treatment to severe asthmatic patients, administration of medications including injections as ordered by the provider, care of patients who have or, are exposed to communicable diseases such as tuberculosis, HIV or AIDS.
o Counsels patients in areas of chronic disease management, including but not limited to the following conditions: diabetes, hypertension, hyperlipidemia, heart disease, asthma, cancer and obesity; as well as provide education on preventable health risk behaviors such as lack of exercise or physical activity, poor nutrition, tobacco use, and alcohol or substance abuse that may cause early death.
o Conducts case management as requested by the provider, including follow up of laboratory and X-ray results, treatment plans, and assistance in providing additional community health resources to patients.
o Delivers clinical care and other activities that facilitate flow of patients from entry point to disposition.
o Assists patients in setting SMART (Specific, Measurable, Achievable, Realistic and Time bound) goals for selfmanagement, teaching them how to do self-management tasks and reports abnormal findings to their primary care team.
o Counsels patients on the use, benefits, risks and potential side and adverse effects of any medications prescribed.
o Assists with tracking and reviewing lab results; alerts the ordering provider of abnormal lab results, and notifies patients in a timely manner as directed by the medical provider.
o Upon order from a medical provider, renews standing prescriptive orders for patients.
o Performs routine nursing care to patients, when requested by providers, while utilizing age-specific and universal precaution guidelines.
o Promptly attends to phone calls and completes telephone consults, providing appropriate medical advice to patients complaining of signs and symptoms of illness. Uses approved and current medical advice books for pediatric, adult and obstetric population.
o Supports the transition of care outreach program by ensuring follow up for patients following hospital discharge or ER visit.
o Facilitates referral process as necessary.
Provides quality customer service at all times; communicates effectively with patients in a manner that protects their confidentiality, and is sensitive to their culture, physical, emotional, and spiritual needs.
Works cooperatively with other staff members, providers, Health Center Medical Directors, Managers and Administrators.
Assists with analysis of quality improvement data for the primary care team and help identify ways to improve care using i2i tool. Assists with collecting needed data and generates reports as assigned.
Helps develop policies and procedures.
Assists with new employee training and on-going training for other team members including Medical Assistants.
Triages patients on the phone and as walk-in patients; consults with a provider for appropriate plan of care as needed.
Uses the Electronic Medical Record; maintains patient medical records in good order utilizing standard language and abbreviations; follows accepted medical standards for charting and protects patient's medical records in accordance with HIPAA guidelines.
Helps ensure all medications are kept in a locked location at all times except during dispensary.
Consistently seeks avenues for self-education in order to broaden knowledge base with regards to health risks, diseases, new clinical procedures, treatments, new drugs and best practices.
Identifies appropriate patient education materials/resources, as needed, for patient counseling.
Attends health fairs and other health center events as requested.
Attends meetings as requested.
Ability to implement, monitors, and manage requirements within the primary care setting. Professional nursing skills required include but are not limited to the following:
Critical thinking and patient assessment.
Problem solving analysis, independent judgment, discretion, and creativity in decision making, evaluations, and presentations; bases proposal for resolution upon available resources.
Displays leadership abilities and collaborates with multidisciplinary teams.
Work requires physical ability to stand for long periods of time, talk, listen, write, and sit intermittently.
Must be able to occasionally bend, lift, push and/or move 25 pounds weight
Occasional lifting, pushing and/or moving up to 25 pounds.
Ability to operate computer including keyboard and multi-line phone.
Occasionally works in excess of 8 hours per day or 40 hours per week as needed.
Must have excellent written, verbal, telephone and interpersonal communication skills
Bilingual in English and Spanish (Preferred)
Patient education/counseling experience
Proficient in computer skills.
Ability to organize, solve problems, multi-task, and work well in a high-pressured atmosphere.
Ability to strongly embrace and personify the mission and goals of CCI Health and Wellness Services.
Ability to interact with fellow employees in a way that promotes a harmonious and cooperative working environment
Required Certifications and Licenses:
Associate or Bachelor of Science in Nursing
State of Maryland Registered Nursing License
CPR (classes are regularly provided at CCI)
CCI Health & Wellness Services