MHMR Tarrant County
Adv Practice RN
I) Job Purpose
Serves as a member of the Adult Mental Health Outpatient Clinic's multidisciplinary service team. Provides comprehensive psychiatric evaluation, emergency psychiatric assessment and diagnosis, determining a holistic plan of care including pharmacological decisions, psychotherapeutic and other intentions, making appropriate referrals and providing episodic follow-up care for persons served by MHMR of Tarrant County. Works collaboratively with the Medical Director, Director of Nursing, Chief Psychiatrist, staff psychiatrists and the multidisciplinary team. Provides case consultation services to multidisciplinary team. Work requires skilled professional knowledge and advanced education for planning, coordinating and monitoring care. Works within established medical protocols and practices within the scope of advanced nursing practice as established by the Nurse Practice Act (NPA) and the Board of Nurses Examiners.
II) Essential Functions
A. To provide psychiatric services that is consistent with current standards of advanced nursing practice.
Provides outpatient episodic follow-up care for clients on a scheduled basis, including diagnostic and plan of care reviews.
Provides emergency assessments and treatment recommendations for individuals presenting to the clinic in crisis or emergency, on an as needed basis.
Performs complete psychiatric evaluations for new referrals in accordance with clinic/agency protocols.
Orders, conducts and interprets pertinent laboratory and other diagnostic tests as clinically indicated.
Establishes medical diagnoses using DSM-V criteria and determines plan of care for short term and chronic health problems.
Prescribes treatment/medications or psychiatric disorders, as outlined within advanced nurse practice protocol established collaboratively with supervising physician.
Provides crisis intervention, brief counseling and psychotherapy as clinically indicated.
Provides age-appropriate illness prevention and health maintenance counseling.
Makes appropriate and timely referrals to other community health care professionals and community resources as clinically indicated.
Consults with collaborating physician on a regular basis and as needed regarding clinical decision making.
Dispenses sample medication to clients as clinically indicated and according to the labeling guidelines established by the Texas State Board of Pharmacy.
Administers prescribed medications to client as needed, according to minimum standards of nursing practice.
B. To maintain effective communication as a member of the outpatient multidisciplinary team.
Consults with professional and paraprofessional staff as clinically indicated regarding client care/treatment needs.
Consults with the supervising physician on a regular basis, as outlined by established advanced nurse practice protocol and on as needed basis regarding clinical decision-making.
Consults with the supervising physician if client response to treatment tills outside the expected period of time to treatments initiated by the APN, or if chronic stable problems become unstable.
Attends regularly scheduled physician staff meetings, as well as scheduled clinic meetings.
Maintains a collaborative relationship with the Director of Nursing related to nurse practice issues.
C. To maintain documentation according to agency protocols and established policies and procedures, as veil as accepted standards of nursing practice.
Medical record accurately reflects clinical decisions made, pertinent client history (past history and history of present illness), identified problem areas, significant medical problems, drug/alcohol summary, mental status, medication decisions (initiation of medication, ongoing monitoring, discontinuation), referrals, plan of care, counseling, client education, collaboration, etc.
Medication orders are written and signed in a thorough, accurate and timely manner and verbal orders are signed within acceptable agency time frames.
Maintains a log of weekly supervisory meetings with supervising physician, noting pertinent clinical issues discussed.
Signs for samples received, maintaining invoices for a 2-year period on-site.
Documents the date, time and first name of the pharmacist spoken with when calling in prescribed medication orders to the pharmacy.
D. To participate in quality management activities as assigned.
Participates in quality improvement activities as assigned, completing individual assignments if applicable within established time frame.
Offers suggestions for methods to improve the quality/delivery of client care offered.
Participates in "investigative nursing peer review" focused on advanced nurse practice concerns, as requested by agency.
E. Promote excellence of psychiatric nursing knowledge through the presentation of academic linkages.
Provides opportunities to educate, mentor and precept nursing students in accredited nursing programs.
Promotes the healthcare needs of the severely and chronically mentally ill via networking opportunities with the community, to include area universities.
F. To meet continuing education requirements or advanced practice, including Cho pharmacology required in order to maintain prescribing authority.
Maintains national certification.
Maintains a minimum of 400 hours of current practice within the preceding Biennium.
Accrues 20 hours of CE per biennium appropriate to advanced practice role and specialty.
Completes 5 hours of pharma-therapeutics CE in the biennium in addition to the 20 hours in specialty area and role.
G. To perform other related duties as assigned.
Completes assignment, as applicable, within established time frames.
Attends all required training and is able to successfully perform applicable skills (includes CPR, AIDS/HIV Disease/Body Substance Precautions/Infection Control, Client Rights/Preventing Abuse, Confidentiality, and PMAB).
III) Knowledge of Laws, Policies/Procedures, Skills, Education and Abilities
MHMR of Tarrant County policies and procedures
Texas Nurse Practice Act
Texas Mental Health Code
Texas State Pharmacy Laws
Texas Board of Medical Examiner (BME) provisions governing prescriptive authority established by both the BME and the Texas Board of Nurse Examiners (BNE) ANA Standards of Psychiatric-Mental Health Clinical Practice
TXMHMR Nursing Standards of Care and Nursing Standards of Professional Performance
ANA Code of Nursing Ethics
ICD - 10 Codes
Third party medical billing/insurance procedures
Skill, ability and interest in the psychiatric care of persons with mental and addictive disorders
Ability to establish collaborative relationship with clients and families
Ability to make accurate and clinical health assessments
Ability to develop and monitor culturally sensitive individualized plans of care
Ability to accurately and safely prescribe psychoactive medication within established protocol
Knowledge of and ability to apply health promotion/illness prevention strategies. Knowledge of pathophysiology, psychiatric diagnoses using DSM-V, pharmacological and non-pharmacological therapies.
Ability to communicate effectively in both written and oral format
Sensitivity to socioeconomic and cultural groups
Ability to collaborate with professional and other available resources (both in the agency and community)
Skill in psychotherapeutic counseling of individuals, groups and families.
Ability to advocate for quality of care for consumers and families
Critical thinking skills
Ability to organize, analyze and prioritize
Ability to utilize adult learning principles
Ability to utilize tact/diplomacy/negotiation/flexibility
Ability to work autonomously
IV) Internal & External Customer Service
This position requires extensive internal (team members, agency personnel) and external (doctors, ISDs, day care providers, other agencies) contacts. The Advance Practice Nurse will accomplish this with above average written and oral skills.
This position requires driving to and from locations for work and/and may require overnight traveling. Employees are required to have a license in good standing and be able to be covered by agency liability insurance. If personal vehicle is utilized for work travel, then maintaining personal auto insurance coverage is required.
Master's Degree from an Accredited Nursing School
Licensed RN in State of Texas w/recognition as a Psychiatric MH Nurse Practitioner or Clinical Nurse w/limited prescriptive authority by BNE plus proof of liability insurance.
Valid driver’s license with an acceptable driving record.
Must provide license (if applicable) and official documentation of all educational attainment i.e. Transcript/Degree/Certificate
Required Supervisory Experience
Pre-employment tests including drug and TB Screening, Physical Exam including balance and lift test.
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