Provides quality and safe delivery of home care services under the direction of the MEIHSS Program Manager. Registered nurses care for patients who are ill or injured.

Most registered nurses (RNs) work as part of a team that includes doctors and therapists. They write care plans and supervise licensed practical nurses (LPNs) and caregivers. Nurses provide prescribed nursing care to patients in their own homes. They also instruct patients and their families how to perform necessary procedures.

A Registered Nurse administers skilled nursing care to patients on an intermittent basis in their place of residence.  This is performed in accordance with physician orders and plan of care under the direction and supervision of the Nursing Supervisor.

This list is intended only to illustrate the various types of work that may be performed.  The omission of specific statements does not exclude them from the position if the work is similar, related or is a logical assignment to the position.

1. Provides services in accordance with the plan of care.
2. Makes the initial evaluation visit and regularly reevaluates the patient’s nursing needs.
3. Initiates the plan of care and necessary revisions.
4. Provides those services requiring substantial specialized nursing skills.
5. Initiates appropriate preventive and rehabilitative nursing procedures.
6. Prepares clinical and progress notes for each patient visit and summaries of care conferences on his/her patients in a timely manner as per MEIHSS policy.
7. Coordinates services.
8. Informs personnel of changes in the condition and needs of the patient.
9. Counsels the patient and family/significant others in meeting nursing and related needs.
10. Participates in and presents in-service programs.
11. Understands and adheres to established MEIHSS policies and procedures.
12. Processes orders and notifies physician of patient needs and changes in condition. Completes certification/recertification orders and discharge summaries.
13. Determines the amount and type of nursing needed by each individual patient.
14. Refers to Physical Therapist, Speech Language Pathologist, Occupational Therapist and Medical Social Worker those patients requiring their specialized skills.
15. Supervises and teaches other nursing personnel.
16. Participates in the development of standards which ensure safe and therapeutically effective service to patient/family.
17. Ability to supervise, guide and develop nursing skills and performances.
18. Conducts patient care conferences on patients assigned to his/her care.
19. Participates in peer review and performance improvement as assigned.
20. Participates in utilization review of medical records as assigned.
21. Responsible for the orientation of new patient care personnel.
22. Gives total patient care as needed.
23. Takes on-call duty nights, weekends and holidays, as assigned.
24. Completes and submits OASIS assessments, reassessments, transfers, resumptions of care, discharges and significant change in condition in accordance with MEIHSS defined time frames.
25. Appropriately utilizes ICD-9/ICD-10 codes.
26. Because of the Tribe’s commitment to community service and the well being of its members, each employee may be expected to perform a wide range of office and field duties from time to time. Such duties may or may not be related to their regular responsibilities.

Task list

The following list of occupational tasks is specific to registered nurses.

• Maintain accurate reports and records. Audit and review charts.
• Observe patients. Monitor vital signs using computerized equipment.
• Record patients' medical information, vital signs, and progress.
• Write and manage care plans for patients.
• Discuss cases with doctors and other medical staff.
• Supervisory visits to staff and clients.
• Monitor patient's reaction to medications.
• Evaluate tests to assess patient's condition.
• Monitor patient care. Receive and take orders
• Supervise licensed practical nurses and nursing assistants.
• Prepare patients and assist with dr appts if necessary.
• Observe nurses and visit patients. Make sure proper nursing care is provided.
• Give patients treatments and medications.
• Visit patients' home and work to identify health or safety problems.
• Visit clients in the hospital
• Develop health programs. Teach the public about topics such as health education, disease prevention,  and nutrition.
• Perform routine office work.
• Examine patients on the way to the hospital or at disaster sites.
• Prescribe or recommend medications and treatments.
• Follows plan of care for all tasks
• Attend CARE Team Meeting
• Evaluate incident reports.
• Conduct and monitor initial nurse assessments and reassessments

Common work activities

Registered nurses perform the following tasks. These tasks are common to many occupations.

• Assist and care for others
• Document and record information
• Make decisions and solve problems
• Get information needed to do the job
• Update and use job-related knowledge
• Organize, plan, and prioritize work
• Communicate with supervisors, peers, or subordinates
• Identify objects, actions, and events
• Monitor events, materials, and surroundings
• Perform for or work with the public
• Use computers
• Evaluate information against standards
• Explain the meaning of information to others
• Establish and maintain relationships
• Teach others including clients, caregivers, family, and staff
• Process information
• Inspect equipment, structures, or materials
• Judge the value of objects, services, or people
• Develop and build teams
• Coordinate the work and activities of others
• Communicate with people outside the organization
• Coach others
• Resolve conflicts and negotiate with others
• Perform administrative tasks
• Guide, direct, and motivate others
• Think creatively
• Analyze data or information
• Perform activities that use the whole body
• Provide advice and consultation to others
• Estimate sizes, quantities, time, cost, or materials needed
• Handle and move objects
• Develop goals and strategies

Because of the Tribe’s commitment to community service and the well being of its members, each employee may be expected to perform a wide range of office and field duties from time to time. Such duties may or may not be related to their regular responsibilities.

Registered nurses must be licensed by the Washington State Nursing Care Quality Assurance Commission.

Requirements include:

• completion of an approved school of nursing program;
• passing a national exam; and
• seven-clock hours of HIV/AIDS education.
• Two (2) years’ nursing experience, preferred.
• Acceptance of philosophy and goals of this MEIHSS.
• Ability to exercise initiative and independent judgment.
• Must obtain First Aid, CPR, Blood Borne Pathogens, Oxygen certifications within 6 months of hire
• Food Handler’s permit within 30 days of hire.
• Must maintain valid Washington State Driver’s License, own transportation and valid insurance coverage.
• Experience working with Elders and within a native community.

Registered nurses need to:

Communicate

• Understand spoken information.
• Listen to others and ask questions.
• Speak and write  clearly so others can understand information.

Reason and problem solve

• Notice when something is wrong or is likely to go wrong and recognize the nature of the problem
• Use reasoning to discover answers to problems.
• Combine several pieces of information and draw conclusions.
• Analyze ideas and use logic to determine their strengths and weaknesses.
• Follow guidelines to arrange objects or actions in a certain order.
• Judge the costs and benefits of a possible action.
• Understand new information or materials by studying and working with them.
• Develop rules that group items in various ways.
• Concentrate and not be distracted while performing a task.
• Remember information such as words, numbers, pictures, and procedures.
• Think of new ideas about a topic.
• Understanding and aligning care plan with PCP

Manage oneself, people, time, and things

• Check how well one is learning or doing something.
• Manage the time of self and others.
• Go back and forth between two or more activities or sources of information without becoming confused.

Work with people

• Be aware of others’ reactions and understand the possible causes.
• Look for ways to help people.
• Change behavior in relation to others’ actions.
• Teach others how to do something.
• Use several methods to learn or teach new things.
• Persuade others to approach things differently.

Registered nurses frequently:

• Stand for long periods of time.
• Use their hands to handle, control, or feel objects, tools, or controls.
• Walk or run for long periods of time.
• Bend or twist their body.

It is important for registered nurses to be able to:

• Understand the speech of another person.
• Speak clearly so listeners can understand.
• See details of objects that are less than a few feet away.
• Use stomach and lower back muscles to support the body for long periods without getting tired.
• See details of objects that are more than a few feet away.
• Be physically active for long periods without getting tired or out of breath.
• Hold the arm and hand in one position or hold the hand steady while moving the arm.
• Use one or two hands to grasp, move, or assemble objects.
• Use fingers to grasp, move, or assemble very small objects.

It is not as important, but still necessary, for registered nurses to be able to:

• See differences between colors, shades, and brightness.
• Focus on one source of sound and ignore others.
• Move two or more limbs together (for example, two arms, two legs, or one leg and one arm) while remaining in place.
• Bend, stretch, twist, or reach out.
• Use muscles to lift, push, pull, or carry heavy objects.
• Hear sounds and recognize the difference between them.
• Make quick, precise adjustments to machine controls.
• Choose quickly and correctly among various movements when responding to different signals.
• Coordinate movement of several parts of the body, such as arms and legs, while the body is moving.
• Use muscles for extended periods without getting tired.
• React quickly using hands, fingers, or feet.
• Move arms and legs quickly.
• Determine the distance between objects.