Registered Nurse (RN) - HOST

Description

Days Off: Saturday, Sunday

Shift: Day (9:00am -5:00pm)

Insurance Benefits: Dental, Life, Long-term Disability, Medical (no premiums/payroll deductions for employee coverage)

Other Benefits: Employee Assistance Program (EAP), Flexible Spending Account (FSA), ORCA card subsidy, Paid Time Off (34 days per year), Retirement Plan

Union Representation: This position is a part of a union and is represented by SEIU Healthcare 1199NW.

About DESC:

Recognized nationally as an innovator and leader in developing solutions to homelessness, DESC is a social services organization, supportive housing operator, and licensed behavioral health treatment provider focused on meeting the needs of people experiencing long-term homelessness and living with complex behavioral health and other medical conditions. Approximately 3,000 people are actively receiving services from DESC at any given point in time. Our vision is a community where all people are shown compassion, treated with dignity, and everyone has a safe, stable, and affordable place to call home.

DESC operates five shelter/emergency housing programs,19 permanent supportive housing facilities with over 1,750 units, several hundred additional scattered site apartments, and a range of behavioral health services including outpatient mental health and substance use disorder treatment, residential crisis stabilization, street outreach, mobile crisis response, and treatment for opioid use disorder.

JOB DEFINITION

Homeless Outreach Stabilization and Transition (HOST) is a multi-disciplinary team serving homeless adults experiencing severe and persistent mental illness, co-occurring disorders, and substance use dependency. HOST prioritizes services to those who are highly vulnerable, lack service connections or other support, and are unwilling or unable to engage in traditional service models. The HOST team works throughout Seattle and parts of King County to provide critical survival services and engagement with the ultimate goal of addressing acute mental and physical health needs, increasing stability, obtaining housing, and transitioning to long-term services.

The HOST RN functions as part of the larger HOST team to provide integrated behavioral healthcare services to clients in need of psychiatric care, substance use dependency support, medication coordination/management, medical/hospital advocacy needs, wound care, and other nursing needs. The HOST RN will often provide in-the-moment, low-threshold medical services to clients who may otherwise not present to more traditional clinics. Services will be provided on the streets, in encampments, in shelters, in many of DESC’s Permanent Supportive Housing, and other service centers as assigned. Interested individuals should possess a high degree of autonomy, coordination and collaboration skills, interest in social justice, advocacy, and health integration. Work is done under the supervision of the RN Outreach Supervisor and Outpatient Nurse Manager. Most days will be spent out in the community but also have office hours in the clinic on a rotating weekly basis.

MAJOR DUTIES AND RESPONSIBILITIES:

Case Management & Social Support

• •Participate as a member of a multi-disciplinary team providing some components of on-going case management services to homeless and formerly homeless adults.
• •Assess clients for a range of health care needs and facilitate linkage and on-going connection to relevant urgent, primary, and specialty health services.
• •Advocate for clients’ access to community resources and services, especially primary health care services, ensuring that clients’ needs are met, and rights are maintained; consult and collaborate with community providers to ensure continuity of care.
• •Provide outreach and engagement on the streets, shelters, encampments, and other community areas.
• •Participate in verbal de-escalation and physical interventions in emergent situations and be willing and able to assist other staff as needed to maintain a safe and secure environment.
• •Build trusting relationships with clients who may be wary and difficult to engage by employing a warm and accepting approach that includes trauma informed care, harm reduction and motivational interviewing. Demonstrate a commitment to this approach through language and behavior.
• •Coordinate services closely with mental health program supervisors, case management staff, chemical dependency treatment staff and other DESC staff.

Medication, Medical Services, and Clinical Skills

• •Under the guidance and direction of the RN Outreach Supervisor, coordinate medical support and medication services for clients by collaborating closely with pharmacies, hospitals, outside providers, and facilities.
• •Provide individualized medication management services and education as needed, and ongoing assessment of mental status and the impacts of current treatment.
• •Reconcile medication and medical records with hospitals, pharmacies, other outpatient mental health clinics, and primary care facilities, including collecting appropriate Release of Information requests (ROIs). Ensure that client spaces and clinical spaces are clean, stocked, and appropriate medical equipment is in working order.
• •Perform client assessments on a walk-in and as-needed basis, in the clinic on a rotating weekly schedule, utilizing pre-established guidelines and guidance from the Outreach RN supervisor and medical providers.
• •Administer oral medication, injections (both anti-psychotic injections and insulin), provide wound care, foot care, lice, and scabies treatment, within RN scope of practice, in non-traditional spaces including shelters, encampments, on the streets, and other areas within King County.
• •Perform initial intake [medical, behavioral and substance use disorder history] with clients and then determine if there is interest in Buprenorphine or intramuscular naltrexone. Gather vital signs and any required lab work, such as pregnancy tests and urine toxicology screens. Counsel clients on test results.
• •Provide clients counseling about their medication assisted treatment (MAT) options and collaborate with them to set personally meaningful goals for treatment of opioid use disorder.
• •Provide intervention in the case of overdose, administer naloxone to reverse overdose when needed, and linkages to addiction treatment and primary care.
• •Teach clients about safer substance use, overdose prevention and overdose reversal.
• •Coordinate communication between care teams, outpatient case management, outpatient nursing care teams, and providers regarding client medical needs and condition.
• •Complete assessment and plan of care documentation in a timely manner.

OTHER DUTIES AND RESPONSIBILITIES:

• •Participate in required psychiatric consultation, supervision, program meetings and in-service trainings; participate in clinical reviews and case conferences for clients on caseload.
• •Comply with the agency's clinical accountability policies and procedures; maintain timely and complete clinical records; participate in quality assurance reviews when assigned.
• •Comply with applicable program research and evaluation procedures.
• •Other duties as assigned.

Requirements

MINIMUM QUALIFICATIONS:

• •Registered Nurse, licensed in the State of Washington, in good standing. If licensed under the Nurse Licensure Compact Multistate License (NLC MSL), compliance with RCW 71.12.740 and NLC MSL Rule 402.2 is a condition of employment.
• •Be able to pass a Washington State Criminal background check.
• •A Valid Washington State Driver’s License is required
• •Candidates must be able to independently transport themselves via public transportation, personal vehicle (mileage reimbursements will apply), or work vehicle, throughout King County on every working day, as required.
• •Knowledge of Harm Reduction strategies and trauma informed care
• •Experience working with homeless, mentally ill and/or substance abusing population
• •Knowledge of