Registered Nurse (RN) - Public Health
Nash County
Nashville, NC

Public Health Nurse II - Family Planning Coordinator

Primary Purpose of Position:   Serves as the Department's Coordinator for the Family Planning Program.   Provides nursing services to patients in the Family Planning Program.  Provides nursing in the generalized clinics, i.e.: Maternity Program, STD Program, Adult Health, Child Health Program, and Communicable Disease Program.  Works with physicians and other disciplines to obtain medical histories, prescribe treatment according to Health Department Standing Orders, document findings, develop care plans and counsel patients.   Work Schedule:   8:00 AM to 5:00 PM Monday through Friday.   Rotates with other nurses in weekly OB/Family Planning clinic.  Occasional after hours on weekend activity, depending on services provided by the department.DESCRIPTION OF RESPONSIBILITIES AND DUTIES:           65%            1.  Family Planning Program   Serves as Program Coordinator for Family Planning Responsible for the coordination of Family Planning services.   Reviews and monitors programmatic services performed to assure they meet Health Department, State, and Federal guidelines.   Makes recommendations to the nursing supervisor regarding needed clinical or policy changes.    Responsible for keeping local policies, procedures, and Standing Orders current with State guidelines and for updating staff regarding revisions.   Assists nursing supervisor in completing annual contract addenda and implementing contract addenda requirements to ensure that goals are met.    Assists supervisor by informing her of changes that affect the budget, i.e. cholesterol checks on women on OCPs > 35 years, getting prices on low dose OCPs request by physicians, etc.   Acts as a resource person to other staff, patients, and community in the area of Family Planning.   Serves as the coordinator of the Agency's Quality Assurance Family Planning Committee which includes representation from the Rocky Mount and Nashville offices.  Meets quarterly to review program needs for future planning, review policy, update changes as necessary, and perform record audits.   Serves as liaison and coordinates services with state consultants, local physicians, area hospitals, surrounding health departments and other disciplines within the department WIC, OBCM and Health Education Department (regarding program to prevent subsequent pregnancies for 18 months, etc.) to assure that goals are met.   Maintains stock of Family Planning educational materials for the Nashville and Rocky Mount office.  Utilizes the Health Education and Community Health Assistant resources in this area.   Responsible for orienting new staff to the program.   Family Planning Follow-up Serves as liaison with local physicians, local and regional hospitals, surrounding health departments, and other disciplines within the department to assure patient needs are met.   Notifies patient of abnormal findings and arranges follow-up/referrals as needed.   Reviews medical records with physician obtaining individual orders for patient needs that cannot be met using Standing Orders and secures physician's signature.   Responsible for follow-up on referrals made or ordered during clinic screenings by maintaining quality assurance logs/tickler system of patient referrals.   Responsible for maintaining Family Planning records in accordance with local and state policies. Reviews records, in the Nashville and Rocky Mount office, after each clinic for proper documentation of findings and services rendered.   Reviews with OB/Gyn clinical records of Family Nurse Practitioner, special labs ordered and referral reports received, and follows up on orders afterwards, in a timely manner.   Maintains quality assurance tickler system/log of medically indicated return appointments for long term birth control methods such as IUD's and Implants.   Coordinates follow-up for Family Planning patients with abnormal blood work, ultrasounds, or other abnormal physical findings noted on examination.   Works closely and makes referrals to WIC/Nutritionist, CMHRP, CMARC and Health Education programs to insure that needed services are rendered and/or scheduled at each visit, as much as possible, depending on patient's needs.   Responsible for signing off on STD labs in EHR - STD nurse notified through reporting system.   Coordinates plan of care for patients diagnosed in clinic with high risk condition (blood clots, migraines, etc.) requiring outside referral.   Accepts referrals from abortion clinics, postpartum home visit nurses, and local OB/Gyn offices, deciding what services are needed and scheduling accordingly.   Clinic Duties for Family Planning  Completes an initial or interim medical, surgical, contraceptive, obstetrical, sexual, family, menstrual, substance use, and psychosocial history.   Checks blood pressure and records.   Records height and weight, usually obtained by Community Health Assistant or interpreter.   Provides appropriate individual education and counseling re: medical and psychosocial problems identified.   Provides preconceptual counseling when indicated.   Submits laboratory test as indicated by history and type visit:  i.e.:   urinalysis, hgb, RPR, pregnancy test, sickle cell, and glucose.   Dispenses contraceptive prescriptions and supplies with appropriate instructions, education, and counseling according to the Department's Women's Preventive Health and Pharmacy Policies, Procedures and Standing Orders.   Dispenses appropriate medications as ordered by the clinician and/or per Standing Orders of the program for treatment of vaginitis or STD's with appropriate instructions, education, and counseling according to the Department's Women's Health Watch, STD, and Pharmacy Policies and Procedures.   Updates immunizations per Standing Orders.   Assists physician in completing physical examinations.   Initiates necessary referrals.   Documents findings and all activities in the patient's medical record according to the Department's Medical Record Policy and Procedures.   15%            Maternity Program   Completes an initial or interim medical and psychosocial history.   Takes blood pressure and orders appropriate lab test.   Provides education and counseling regarding medical and psychosocial problems identified. (ex.: nutrition,  danger signs of pregnancy).   Assists physician with exam, measuring fundal height and fetal heart rate.   Dispenses appropriate medications and or vitamins and iron according to the Department's  Pharmacy Policy and Procedures and Prenatal Policy and Procedures.   Initiates referrals for abnormal findings and needs identified.   Documents findings and all activities in the patient's medical record according to the Department's Medical Record Policy and Procedures. 5% Child Health Program   Completes an initial or interim medical, psychosocial, and developmental history.   Performs visual acuity, hearing screening, and takes blood pressure on children 4 years and older.   Orders appropriate lab work.   Counsels parent regarding nutrition, growth and development, medical concerns, immunizations, care of the newborn and older child, etc.   Assists physician with well child care exam.   Dispenses or administers medications and immunizations according to the Policy and Standing Orders of the Child Health Program and the Pharmacy Policy and Procedures.   Issues prescriptions according to the Standing Orders of the Child Health Program.   Initiates referrals for abnormal findings.   Documents findings and all activities in the patient's medical record according to the Department's Medical Record Policy and Procedures.            5% STD/HIV Program   Completes an initial or interim medical history including presenting compliant, sexual exposure, contraception, current medicines, allergies, illicit drugs and prior STD's.   Orders appropriate lab tests.   Provides education and counseling regarding problems identified.   Dispenses or administers appropriate treatment and/or medications according to the STD Policy, Procedures and Standing Orders, and according to the Department's Pharmacy Policy and Procedures.   Provides Pre and Post Test HIV Counseling.   Updates immunizations per Standing Orders.   Initiates referrals on abnormal findings and needs identified.   Documents findings and all activities in the patient's medical record according to the Department's Medical Record Policy.   5% Adult Health Program (Women's Health Watch)   Completes an initial or interim medical, surgical, contraceptive, obstetrical, sexual, family, menstrual, substance use, and psychosocial history.   Takes blood pressure and orders appropriate lab tests.   Provides education and counseling regarding problems identified.  (ex.:   chronic disease and disease prevention).   Dispenses medications according to the Women's Health Watch and STD Policies and Standing Orders and Pharmacy Policy and Procedures (ex.:   treatment for vaginitis).   Updates immunizations per Standing Orders.   Initiates referrals for abnormal findings and needs identified.   Documents findings and all activities in the patient's medical record according to the Department's Medical Record Policy and Procedures.   5% Other Duties   Participates in Preparedness/Disaster Shelters.   Assists with department wide community activities, i.e. community flu/pneumonia/COVID programs, health fairs, etc.   Assists with general clinic patients; i.e.:  those presenting for pregnancy tests, TB medications, hepatitis B vaccine, blood pressure checks, B12 injections, etc.   Maintains required personnel records.  (ex.:  time, travel, and telephone logs).   Attends staff training, other continuing education programs, and job-related workshops.   Participates in staff meetings.   Helps maintain a safe working environment.   Performs other duties as needed.   OTHER POSITION CHARACTERISTICS   Accuracy Required in Work:   Must be accurate in determining patients' needs through the interviewing process; observing patients' behavior; assessing the patients' medical/physical status; presenting patient education; documenting in the patients' medical records; making appropriate referrals; developing a plan of care; and in counseling patients, and for legal purposes all charting must be accurate and comprehensive.   Consequence of Error:   Errors may result in missed or inadequate follow-up of patients' needs, fraud if billing is incorrect, medical problems for patients, liability suits for the county, and poor community relations.   Instructions Provided to Employee:   Orientation to health department.  Training provided by DHHS and other appropriate workshops.   In-service education programs and staff team meetings.  One-on-one assistance and training from Health Education, Prenatal, Child Health, WIC, OBCM, and CC4C.  Clinical assignments are scheduled monthly by the clinical supervisor and changes are posted.   Management responsibilities and program responsibilities are prioritized by the employee.  Guidance is available from the nursing supervisors, and the coordinator for Women's Preventive Health. 4.   Guides, Regulations, Policies and References Used by Employee: Medicaid guidelines, OSHA/infection control measures, local policies and procedures, local personnel policies, North Carolina Nursing Practice Act, DHHS directives, Nash County Standing Orders, and Nash County Health Department Personnel Policies.   Supervision Received by Employee:   Records are reviewed by the Quality Assurance Committee within the Department quarterly for compliance with State and local policies.   Records of clients receiving Medicaid are subject to Medicaid audit to see if components for reimbursement are being met.  Under the administrative supervision of the Nursing Supervisor.  Written performance evaluations are done per the Department's policy.  Work is supervised by the Personal Care Nursing Supervisor.   Variety and Purpose of Personal Contacts:   Works directly with patients of all social, racial, and economic groups.  Sensitive issues frequently arise and this employee must always be sensitive to others and be knowledgeable and tactful.   Interaction with other providers includes local physicians, other agencies, DSS, the hospital, etc., while making referrals for patients.   State Laboratory staff including cytology section.   Surrounding area health department personnel.   Patient's on a daily basis to assure that all needed services are provided for referrals made.   Physical Effort:   Must be able to drive a car.  Requires the provision of patient services each day whether physically, through applying direct clinical skills, phone calls, record management, or attending a continuing education workshop.  Requires occasional travel between the Nashville and Rocky Mount offices.   OTHER POSITION CHARACTERISTICS (Con't)   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 Bloodborne Pathogens 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.   9.   Machines, Tools, Instruments, Equipment and Materials Used: Blood Pressure Cuff and stethoscope, automobile, copier, fax machine, computer/EMR, educational materials, medical record, scales, thermometer, ultrasonic stethoscope, and tape line. 10. Visual Attention, Mental Concentration and Manipulative Skills: Must be able to identify, organize, and complete the work process efficiently; document on the medical record; administer medications.  Must be able to perform quality work independently.  Requires good communication skills.  Must have good writing skills to record documentation and initiate referrals.   11. Safety for Others:   Must be knowledgeable of current policies, procedures, and standing orders.  Follow infection control guidelines and be adequately immunized according to the Department's Employee Health Policy.  Must have nursing expertise to provide appropriate patient care.  Universal precautions are used for safety of staff and patients.   12. Dynamics of Work:   Changes in policies occur as state guidelines are updated and their recommendations are incorporated into local policy.  Changes occur when recommended by the local medical consultant.  Day to day activities are centered around the needs of the patients and changes that occur when co-workers are absent.   Flexibility is an important component of this position.  New situations arise everyday.  Ability to prioritize work is essential since work load 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.Considerable knowledge of and skill in the application of nursing theory, practices, principles, and techniques employed in the field of public health and related programs; general knowledge of and ability to apply the principles and practices of public health; working knowledge of current social and economic problems relating to public health; working knowledge of available resources and organizations, and appropriate referral methods.   Ability to deal tactfully with others and to exercise good judgement in appraising situations and making decisions; ability to secure the cooperation of clients, to elicit needed information and to maintain effective working relationships; ability to record accurately services rendered and to interpret and explain records, reports and medical instructions; some ability to plan, coordinate, and supervise the work of others.  Good verbal and writing skills are needed to communicate with patients.  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 Education and Experience:   Graduation from an accredited school of professional nursing and one year of professional nursing experience.     2.   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 Red Cross Disaster I and II Training ICS Training 100, 200 and 700 CPR Certification CPR/Defibrillator training   HIV counseling and testing program     License or Certification Required by Statute or Regulation: Current license to practice as a RN in North Carolina by the North Carolina Board of Nursing.  Valid North Carolina Driver's License.