REGISTERED NURSE 2            L1172

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

An employe in this class performs as a head nurse, charge nurse, or as a staff nurse providing specialized nursing care and services, in a county setting for individuals with a mental or physical injury or illness and/or developmental disability. As head nurse the employe is responsible for directing the 24-hour continuity of the nursing care and treatment for individuals in a single patient care ward or living area or in a patient care ward or living area that provides acute or long-term care, usually on the day shift. The head nurse is responsible for the development, implementation and evaluation of a comprehensive individualized nursing care and treatment plan for each individual. As charge nurse, the employe directs and coordinates the delivery of nursing care and treatment to individuals on a single shift in multiple patient care wards or living areas, usually on the evening or night shift, or in a medical clinic or infirmary setting. Head nurses and charge nurses make assessments and decisions in regard to staff utilization and supplies and equipment needs. The head nurse and charge nurse directs the work efforts of professional nursing staff and supervises non-professional nursing personnel assigned to their patient care ward(s) or living area(s); and ensures that the coordination of services, coverage of services and maintenance of records is accomplished. The staff nurse at this level functions with charge nurse responsibility in a medical clinic or infirmary. Work involves evaluating nursing care and treatment plans; coordinating nursing care and services with members of the nursing staff, the multiple disciplines of the Interdisciplinary Treatment Team (ITT), Individual Habilitation Plan (IHP); and ensuring that individuals with symptomatic or established conditions of mental or physical injury or illness and/or developmental disability are provided nursing diagnosis and nursing care and treatment appropriate for their treatment needs and preferences. Work includes monitoring the physical and mental condition of individuals; assessing their medical charts, records and reports; ensuring that appropriate nursing care and treatment is provided through effective execution of the nursing regimen and the prescribed medical or psychiatric regimen for each individual; and participating in the development, implementation, evaluation and modification of a comprehensive individualized nursing care and treatment plan for each individual. Work also includes identifying learning needs; making training recommendations; providing ongoing orientation and on-the-job training for lower level professional and non-professional nursing personnel; participating in and evaluating staff development programs to further enhance professional nursing skills; and planning for future admissions and pre-discharge planning to maintain continuous and orderly nursing services in the patient care ward(s) or living area(s). Work assignments are received in the form of oral or written instructions and employes exercise independent judgment in the application of professional nursing practices. Work is clinically reviewed and evaluated by a professional Registered Nurse Supervisor or Physician 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: Serves as head nurse by developing, implementing and evaluating the comprehensive individualized nursing care and treatment plan for each assigned individual, and directing the 24-hour continuity of nursing care in a single patient care ward or living area, or in a patient care area that provides acute or long-term care in the health care system.

Serves as charge nurse by directing and coordinating the delivery of nursing care and treatment for individuals on a single shift in multiple patient care wards or living areas, or in an infirmary usually on the evening or night shift.

Assesses individual/patient physical, psychosocial and/or mental health status; determines immediate and long range nursing care and treatment plans, goals, staff utilization, supply and equipment needs; schedules employes, assigns work and directs the work efforts of assigned professional and non-professional nursing personnel; coordinates services, coverage of services and maintenance of records; monitors nursing care through observation and review of nursing charts, records and reports; and develops, recommends and directs changes in the administration of nursing care and treatment methods and plans.

Coordinates services, coverage of services and maintenance of records; monitors nursing care through observation and review of nursing charts, records and reports; and develops, recommends and directs changes in the administration of nursing care and treatment methods and plans.

Compiles, reviews, monitors and interprets nursing data base regarding vital signs, symptoms, and individuals’ physical and mental conditions and evaluates nursing care and treatment plans to ensure appropriate execution of a nursing regimen and the prescribed medical or psychiatric regimen for each assigned individual.

Observes, interprets, records and reports the effects of pharmacological agents and therapeutic treatments administered to individuals, noting deviations or adverse effects in individuals’ physical, behavioral or emotional conditions to supervisor.

Provides guidance to nursing staff in the development, implementation, review and modification of nursing care plans; coordinates nursing infection control and quality assurance procedures and pre-discharge planning.

Functions as a Qualified Mental Retardation Professional (QMRP) in nursing at a county facility for individuals with a developmental disability.

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

Plans and coordinates the activities of the assigned nursing care staff and the resources of other disciplines required to provide individualized care and treatment.

Organizes and conducts or co-conducts with other professional disciplines, various treatment modalities such as individual psychotherapy; group therapy, family therapy, milieu therapy and behavior modification, as credentialed.

Develops and maintains a therapeutic milieu and a safe and sanitary environment for individuals and staff.

Participates in nursing and facility committee activities.

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

Identifies nursing care learning needs; makes staff development and training recommendations; orients new employes to the policies and procedures, rules and regulations of the nursing department and health care facility; provides on-the-job training for professional and non-professional nursing personnel; and participates in and evaluates staff development programs to further enhance professional nursing skills. 

Prepares and submits records and reports as required in accordance with rules and regulations and operating practices.

Performs related work as required.

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

Knowledge of the principles and practices involved in organizing and directing the work of others.

Knowledge of therapeutic and adverse effects of pharmacological agents, medical treatment, hospital dietetics and personnel hygiene.

Knowledge of current professional nursing practices in such specialty care areas 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 direct and instruct professional and non-professional nursing personnel in the application of standard nursing practices and methodology for assessing, diagnosing, treating and evaluating individuals physical and/or mental health status and to develop and implement a nursing care and treatment plan for each individual.

Ability to develop and implement a comprehensive nursing care and treatment plan in accordance with the prescribed medical or psychiatric regimen for each individual.

Ability to promote and maintain continuity of care within the patient care ward(s) or living areas(s).

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

Ability to make independent judgments in resolving life threatening health problems.

Ability to plan and assess immediate and long term nursing care goals and objectives for individuals in patient care ward(s) or living area(s).

Ability to insure that staff utilization is proper for the needs of the individuals.

Ability to plan and coordinate activities of the nursing staff with resources of other disciplines.

Ability to evaluate both the educational needs of staff and staff development programs.

Ability to establish and maintain effective communications with individuals, families and other members of the health care system.

Ability to provide guidance to individuals and families in health promotion and maintenance.

Ability to identify actual or potential health and safety hazards.

Ability to evaluate patterns and trends in the nursing care system.

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, emotional or behavioral needs.

Ability to demonstrate competence in specialty care areas as appropriate.

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 of the health care facility.

Ability to prepare and maintain records and reports, such as nursing care plans; individuals’ charts; and, as appropriate, laboratory reports.

Ability to acquire knowledges, skills and techniques in current nursing theory and practices by participating in staff development, in-service and out-service training courses.

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

Minimum Experience and Training: One year as a Registered Nurse 1;

or

One year of professional nursing experience.

or

Any equivalent combination of experience and training.

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: Employes 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.

Commonwealth Equivalent PSG ST09