LVN

Position Summary

The LVN/LPN will provide patient care and assist in the collection of data during the assessment process, within their scope of practice, under the direction of an RN, mid-level practitioner, licensed physician, or supervisor at all times.

Essential Job Functions

• Mets productivity standards and performs duties as workload necessitates.
• Collections relevant medical data within state specific scope of practice utilizing proper grammar, spelling, and complete sentences without using unapproved abbreviations.
• Informs personnel (i.e. UR, psychiatry, dietician) of new admissions when appropriate.
• Administers and documents vital signs, CIWAs, COWS (SUD only), collects data for fall assessments/precautions, seizure precautions, suicidal/homicidal assessments, pain scales, anxiety scales, craving scales, standard and infection control precautions adding co-signers as necessary.
• Observation, documentation, audit functions, education, and record keeping of all observed/inventoried/destroyed/prescribed medications.
• Assessment of patients with addiction and mental health conditions and assisting in ascertaining clinical medication management with Registered Nurses, Nurse Practitioner, Physician Assistant, Psychiatrist, and Medical Doctor.
• Administers medications via oral, sublingual, inhalation, auricular, topical, intramuscular, subcutaneous, vaginal, and rectal routes as ordered.
• Enters medication orders into the electronic medical record.
• Manages the Medication Administration Record, documenting administration, efficacy, and first response.
• Provides direct patient care to a diversified patient population, across continuum of care.
• Collaborates with staff in assessing patient, family age-specific nursing needs and developing plan of care for complex high-risk patients.
• Provides assistance to Utilization Review in communicating pertinent nursing information.
• Designs teaching programs for patients/families and provides assistance to staff in program implementation.
• Works closely with physicians to provide education and counseling for clients and other organizational health care providers on optimal use of medicines (e.g., proper use, avoidance of over medication).
• Provides nursing care adapted to the individual patient needs based on the nursing process, which includes data collection, planning, implementation and evaluation.
• Directs patient care, including the reporting of observed changes in mental status and/or physical condition, response to emergencies, safety risks.
• Documents nursing incidents and medication errors.
• Oversees the medication management system that includes but not limited to, medication planning, storage, ordering and transcribing, administration, monitoring and evaluation.
• Verifies the integrity of and controls medications brought into the organization by the client, their families, and licensed independent practitioners.
• Ensures to use the utmost of care in protecting the confidentiality of client records in accordance with state and federal laws.
• Understands and adheres to DBH compliance standards as they appear in DBH’s Corporate Compliance Policy, Code of Conduct and Conflict of Interest Policy.
• Keeps abreast of all pertinent federal, state and DBH regulations, laws, and policies as they presently exist and as they change or are modified.
• Systematically collects, records and analyzes data and other relevant interactive social systems, including mental status, special precautions (suicidality, homicidally, elopement); physical problems/medical acuity (withdrawal and nutritional needs); and ethnic concerns (social, religious, or cultural needs).
• Uses assessment data to identify problem list and other interactive social systems.
• Maintains NG Tube and administration of bolus feeds, where applicable.
• Intervenes as guided by the treatment plan to implement appropriate interventions that promote, maintain, or restore physical and mental health, prevent illness effect rehabilitation, and restore developmental progression.
• Provides health education for patients through individual and group interactions.
• Recommends special precautions, as needed.
• Evaluates the response of the patients to interventions in order to revise the plan, including discharge criteria.

Knowledge, Education, & Experience

• Must be a graduate of an approved vocational nursing program with a current licensure from an appropriate state licensing board in good standing.
• PREFERRED: Experience as a staff nurse, preferably in the field of chemical dependency and/or behavioral health.
• Knowledge of industry standards: organization, theory, principles, and research processes, accreditation and regulatory standards, ability to assess clinical care requirements based on nursing principles, scope of practice.
• One year experience preferred working in mental health, substance use, or eating disorders field.
• Familiar with behavior change, recovery models, and treatment methods
• Knowledge of medications, indications, dosage ranges, side effects, and potential toxicity.