Public Health Nurse III -Primary Care

Wilson County Health Department is seeking a highly motivated and skilled Public Health Nurse III to join our Primary Care team. This is an advanced-level nursing position focused on providing comprehensive nursing services in a public health primary care setting. The successful candidate will play a critical role in promoting, protecting, and maintaining the health of individuals and the community through direct patient care, health education, disease prevention, and chronic disease management.This is advanced and specialized professional level nursing work in providing primary, preventive, and rehabilitative care to individuals, families, and communities in a Public Health program. Employees may have duties similar to the Public Health Nurse I and II, but spend the majority of the time in one or more of the following roles: 1. Function in the expanded nursing role with duties relating to the employees' expertise in any of the practice areas supported by the Division of Public Health. Employees obtain a health history, perform a physical examination sufficient to determine if there is a deviation from normal, help the client to maintain a state of wellness through periodic screening procedures, health counseling, treatment under physician's standing orders, and/or referral to the appropriate physician or clinic. 2. Serve as Project Managers or Clinic Coordinators: Employees spend time in assessing, planning, and coordinating a variety of services in a specific practice or geographical area and have strong input into administrative and personnel duties and responsibilities. Employees will also be more aware of agency and program policies, procedures, and changes and ensure that these are followed. Employees will have responsibilities for gathering, managing, and reviewing data, and will report it to higher management in a usable format. Employees in this role might be assigned specific (typically supervisory level) tasks for staff in the project or clinic, such as performance appraisals or making work assignments; however, a higher level manager will monitor these tasks and have ultimate responsibility for them. 3. Provide skilled nursing services as staff of a specific Home Health program located within the Public Health Department. Staff in Home Health programs perform skilled nursing functions with a goal of allowing homebound patients to remain in their homes. Patients in Home Health programs often have multi-system diagnoses and critical care needs, and might vary in age from infancy to old age. Tasks and assessments performed by Home Health nurses are often highly technical. Employees make referrals to medical facilities, social service agencies, etc. when needed and agreed on by the patient or family. Employees, working in partnership with patients and their families, take a lead role in coordinating all plans and resources for these clients. I. DIFFICULTY OF WORK: Variety and Scope - Employees spend the majority of the time in one of the described roles, which require performing a greater variety of duties, responsibilities, and coordination of work with others (employees will be making professional and/or administrative decisions of higher complexity than Public Health Nurse IIs). Employees serving in the Expanded Nurse role will be expected to determine if findings are normal or abnormal, and to intervene based on standing orders. Employees in the Project Manager or Clinic Coordinator role will be expected to assist higher level supervisors in determining staffing and resource needs, be the first-line contact for the program area, make recommendations for policy development or change, orient new staff and assist students. Project Managers will often have the responsibility for making formal presentations regarding the program. Employees in the Home Health role will be expected to assess complex patient conditions, recognize deviations from the patient's baseline, and report to the medical care provider. They will also be expected to recognize needed changes in patient treatment, and provide this information to the medical provider. Employees will be expected to participate in Public Health Preparedness activities as directed by agency management. They will usually be expected to perform staff nursing duties in the event of a natural or induced disaster or in related practice drills, or might be expected to assist in coordinating or overseeing specific operations related to the event or drill. Intricacy - Work requires considerable assessment, data gathering and study and analysis to plan and determine the best course of action in all roles. Employees must also be able to assemble and report data to higher level management. Subject Matter Complexity - Work requires a thorough understanding of public health concepts and programs, nursing theory and practices, general medicine, and of administrative responsibilities if in the Project Manager or Clinic Coordinator role. Work requires an understanding of the same professional standards as the Public Health Nurse II and a complete understanding of the expanded nursing role function, knowledge, and skills if in this role. Guidelines - The North Carolina Nurse Practice Act, public health nursing standards, clinic protocols, agency work standards and program protocols. Work requires more independent judgment in applying the professional standards and guidelines. Work requires significant independent judgment in applying specialized expanded role or project administration guidelines. II. RESPONSIBILITY: Nature of Instructions - Daily and weekly work is usually self-planned and coordinated with the team. The agency goals and patient care goals are understood. Employees will frequently have to make short-range plans and change to meet client and program needs. Nature of Review - Work is reviewed occasionally for adherence to established public health nursing standards by a nurse supervisor through written reports and oral conferences. Employees refer little to the supervisor and make more independent administrative, program, and/or technical decisions. Scope of Decisions - Employees' work and decision-making have a direct effect on the patient population served. Consequence of Decisions - Employees' work and decision-making could have a substantial impact on the client population, especially since employee is directly overseeing and coordinating the work of others or making in-depth nursing and physical assessments. III. INTERPERSONAL COMMUNICATIONS: Scope of Contacts - Employees have contact with a patient population in an assigned area which might not be familiar with public health standards and programs. Communication with patients must demonstrate sensitivity to the person's culture, economic challenges, and other vulnerabilities, and must also recognize each patient's strengths and abilities. Staff in a Project Manager role will also generally work in collaboration with other community professionals to devise strategies to meet program goals. Nature and Purpose - Work requires that employees work in cooperation with the patient, patient's family (particularly in homes, schools, and other, community settings), community groups and other clinic or project staff to assess the patient's or community's health status and needs and assist in providing the services needed to maintain or improve health. Health education and counseling are important components of this service delivery. The employee must also be aware of health trends and practices that are pertinent to the population of patients served. Work involves teaching, supportive counseling, and supervision of others. IV. OTHER WORK DEMANDS: Hazards - Employees will have periodic exposure to hazards in the field (driving, rural or inner city settings, inclement weather, clients) and to a lesser degree in clinic settings. They might be exposed to bloodborne pathogens, infectious diseases, or angry or disruptive patients. Work Conditions - These may be mildly disagreeable if working in poor home environments or with difficult clients. Clinics are often over-crowded and noisy. Knowledge, Skills, and Abilities - Thorough knowledge of and skill in the application of nursing theory, practice, principles, and techniques employed in the field of public health and related programs; for employees in expanded role positions, considerable knowledge of, and skill in obtaining a health history and performing physical examinations sufficient enough to determine if there is any deviation from normal; considerable knowledge of available resources and organizations and the ability to coordinate these as needed; general knowledge of current social and economic problems relating to public health, including health disparities; ability to plan, coordinate, and oversee the work of others; ability to deal tactfully with others and to exercise good judgment in appraising situations and make decisions; ability to work in partnership with patients and with other service providers 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; considerable knowledge of and ability to apply the principles and practices of public health; adequate computer skills to allow communication, patient record documentation, and accessing of information. Minimum Education and Experience for Expanded Role - Completion of approximately three months of training that includes both a didactic and on-the-job supervision phase in the expanded role specialty to which assigned AND graduation from a four-year college or university with a B.S. in Nursing which includes a Public Health Nursing rotation and two years of Public Health nursing experience; or a Master's in Public Health and graduation from a school of professional nursing and two years of professional nursing experience; or graduation from a school of professional nursing and three years of professional nursing experience including two years of Public Health nursing experience; or an equivalent combination of training and experience [Note: three months training can be obtained concurrently with other experience required for position ]. Minimum Education and Experience for Program Manager, Clinic Coordinator, or Home Health Role - Graduation from a four-year college or university with a B.S. in Nursing which includes a Public Health Nursing rotation and two years of Public Health nursing experience; or a Master's in Public Health and graduation from a school of professional nursing and two years of professional nursing experience; or graduation from a school of professional nursing and three years of professional nursing experience including two years of Public Health nursing experience; or an equivalent combination of training and experience. Necessary Special Qualifications – A current license to practice as a Registered Nurse in North Carolina by the N. C. Board of Nursing.

Administering the Class - Individuals employed in a local Health Department without a B.S. Degree which includes a Public Health Nursing rotation or a Master's in Public Health, will be required to complete the Introduction to Principles and Practices of Public Health Nursing course within one year of employment as a condition of continued employment in accordance with Health Services Commission Rule. Experience in a field of nursing that is closely related to the anticipated work assignment can be substituted for Public Health experience for hiring purposes; however, the employee will also be required to complete the Introduction to Principles and Practices of Public Health Nursing course or objectively demonstrate an adequate understanding of Public Health practice within 1 year of employment.

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