REGISTERED NURSE 1 L1171

Definition: This is professional nursing work in the psychiatric, psychosocial and/or physical nursing care and treatment for individuals with a mental or physical injury or illness and/or developmental disability in a county setting.

An employee in this class performs as a staff nurse providing professional nursing services in a county setting for individuals with a mental or physical injury or illness and/or developmental disability or performs as a charge nurse over a patient care area in one of the above health care settings usually on the evening or night shift. Employees practice within a variety of settings in the health care delivery system, including a medical clinic or infirmary setting; however, regardless of the setting, work efforts are primarily directed toward the promotion, maintenance and restoration of the physical, psychosocial, or psychiatric health of individuals. Work involves assessing the actual or potential health care needs and the physical, behavioral and mental health status of individuals, providing nursing diagnosis and treatment; developing and implementing a nursing care and treatment plan for each individual; conferring with other health care disciplines; providing nursing expertise to an Interdisciplinary Treatment Team (ITT), Individual Habilitation Plan (IHP), and participating in the development, implementation, evaluation and modification of a comprehensive individualized care and treatment plan for each individual. Work includes selecting, implementing and evaluating therapeutic measures essential to the effective execution of a nursing regimen and the prescribed medical or psychiatric regimen for each individual; providing direct individual/patient nursing care; and taking, administering, assessing, recording, reporting and evaluating vital signs, symptoms and reactions or responses to medication and reporting and evaluating vital signs, symptoms and reactions or responses to medication and treatment. Employees participate in staff development programs and continuing education programs and provide ongoing orientation and on-the-job training and may supervise non-professional nursing personnel. Work assignments are received in the form of oral or written instructions and are performed in accordance with physician prescriptions/orders and the applicable laws, established rules and regulations, and standard practices of the profession. Work is clinically reviewed and evaluated by a professional nurse supervisor or other qualified health care professional through observation, review of reports and conferences for quality and adherence to established standards in the application of professional nursing practices. Work may be administratively reviewed by another professional supervisor.

Examples of Work: Provides direct individual care and treatment, as appropriate, by following standard nursing processes for assessing, diagnosing, treating and evaluating individuals’ physical, psychosocial and/or mental health status in order to maximize the effectiveness of the treatment, rehabilitative or habilitative program for each assigned individual.

Takes vital signs, including pulse, temperature, respiration and blood pressure; obtains sputum, urine, blood and other specimens for laboratory examination; administers oral, eye, ear, nose, rectal, topical, subcutaneous, intra-muscular and intravenous medications as prescribed in the medical or psychiatric regimen; and observes, interprets, records and reports symptoms, vital signs and reaction/response to medication and treatments.

Develops, implements, evaluates and modifies nursing care plans for each individual in cooperation with their family, legal guardian and other members of the ITT or IHP, and/or other appropriate members of the health care system.

Provides nursing expertise to the ITT or IHP, and participates in the development, implementation, evaluation and modification of a comprehensive individualized care and treatment plan for each individual.

Selects, implements and evaluates therapeutic measures essential to the effective execution of a nursing regimen and the prescribed medical or psychiatric regimen for each individual.

Participates in various treatment modalities such as reality orientation, remotivation therapy, psychotherapy, group therapy, milieu therapy and behavior modification.

Provides health promotion and maintenance through teaching, guidance and counseling to individuals, their families and other members of the health care system on habilitative, rehabilitative, behavior modification and/or restorative techniques such as personal hygiene, infection control, techniques of skin care, nutrition, medication, protective devices, social skills and/or adjustments and sensory training and ambulation.

Prepares pre-discharge nursing care plans and discusses plans with members of the post-discharge health care system, individuals and their families or legal guardians to facilitate continuity of care in the community.

Directs the work of non-professional nursing personnel engaged in the direct care and treatment of individuals.

Provides orientation and on-the-job training, guidance and health care education to non-professional personnel engaged in direct individual care and treatment.

Serves as charge nurse over a patient care or living area by directing and coordinating the coverage of nursing care services on an assigned shift.

Ensures a clean and therapeutic environment is maintained in the assigned patient care area and takes appropriate action to eliminate hazardous or unsanitary conditions.

Participates in nursing and facility committee activities.

Participates in nursing service quality assurance/risk management activities within the nursing department.

Functions as a Qualified Mental Retardation Professional (QMRP) in nursing at a facility for individuals/patients with a developmental disability; responsible for directing the delivery of

individual plans of care and the delivery of training and habilitative services; integrating the various aspects of the comprehensive individual program plan; recording individual progress in meeting program objectives and initiating a periodic review of each individuals’ plan of care.

Explains the policies, rules and regulations, procedures, and objectives of the health care system to individuals, their family members and legal guardians and/or others, as appropriate and consistent with confidentiality and health care standards.

Participates and assists other discipline staff in carrying out activities programming for individuals, such as therapeutic exercises, theraapeutic recreational activities, vocational services, educational and activities of daily living.

Participates in formal staff development programs to develop general nursing skills and skills in specialized areas such as geriatrics, mental retardation and psychiatric nursing; and participates in continuing education programs to enhance professional competence.

Performs related work as required.

Required Knowledges, Skills, and Abilities: Knowledge of the theories and practices of professional nursing.

Knowledge of pharmacological agents, hospital dietetics and personal hygiene.

Knowledge of current professional nursing practices in specialty care areas such as, but not limited to, acute care, psychiatric care, geriatrics and habilitative/rehabilitative care and treatment.

Ability to apply professional nursing practices and methodologies.

Ability to assess, diagnose, treat and evaluate an individuals’ physical and/or mental health status and to develop and implement a nursing care and treatment plan for each.

Ability to develop and implement an appropriate nursing regimen in accordance with the prescribed medical or psychiatric regimen for each individual.

Ability to administer prescribed medications and treatment and to observe, interpret, record and report symptoms, vital signs and reactions to medications and treatments.

Ability to establish and maintain a therapeutic attitude and relationship with individuals with a mental or physical injury or illness and/or developmental disability in order to properly treat and care for their physical, mental, emotional or behavioral needs.

Ability to develop knowledge and skill in the application of professional nursing practices and procedures in such specialty care areas as geriatrics, mental retardation or psychiatric care.

Ability to apply professional nursing concepts, techniques, and procedures to the care and treatment of individuals with a mental or physical injury or illness and/or developmental disability.

Ability to develop and maintain effective working relationships with employes in the health care system.

Ability to prepare and maintain records and reports, such as nursing care plans and charts of care and treatment received by each individual.

Ability to acquire new knowledges, skills and techniques to keep abreast of changing nursing theory and practices.

Ability to instruct and direct non-professional nursing care personnel in the care and treatment of individuals.

Ability to develop the capacity to make independent judgments in relation to nursing care of individuals.

Ability to express ideas clearly and concisely, both orally and in writing.

Minimum Experience and Training: Graduation from an approved school of professional nursing.

Necessary Special Requirement: Possession of a current license to practice as a Registered Nurse issued by the Pennsylvania State Board of Nursing; or possession of a non-renewable temporary practice permit issued by the Pennsylvania State Board of Nursing.

Condition of Employment: Employees possessing non-renewable temporary practice permits must obtain licensure as a Registered Nurse within the one (1) year period as defined by the Pennsylvania State Board of Nursing.

Date Established or Last Revised

Class Specification - January 1998

Commonwealth Equivalent PSG ST08