The Behavioral Health RN plans, implements, evaluates and documents nursing care in accordance with facility and departmental policies and in accordance with standards of professional nursing practice. This position is accountable for the quality of nursing services delivered by self or others under his/her direction.
Action Oriented -- Taking on new opportunities and tough challenges with a sense of urgency, high energy and enthusiasm.
Collaborate -- Building partnerships and working collaboratively with others to meet shared objectives.
Customer Focus -- Building strong customer relationships and delivering customer-centric solutions.
Nimble Learning -- Actively learning through experimentation when tackling new problems, using both successes and failures as learning fodder.
Demonstrates Self-Awareness -- Using a combination of feedback and reflection to gain productive insight into personal strengths and weaknesses.
Communicates Effectively -- Developing and delivering multi-mode communications that convey a clear understanding of the unique needs of different audiences.
Decision Quality -- Making good and timely decisions that keep the organization moving forward.
Standard I. Associate demonstrates competence in the performance of duties and responsibilities related to the application of CHRISTUS St. Frances Cabrini Hospital's Core Values:
- Maintains confidentiality of information as required
- Conducts and presents self in a professional manner
- Respects the culture and ethnic heritage of others
- Demonstrates honesty consistently in all relationships
- Follows the CHRISTUS Health Guidelines related to the Health Insurance Portability & Accountability Act (HIPAA)
- Accepts constructive criticism and modifies actions accordingly
- Seeks opportunity for professional and personal growth
- Actively seeks ways to improve level of performance/service
- Flexible and adaptive to changes in work processes and functions
- Supports department objectives and the Strategic Plan of the hospital
- Uses resources/assets in a cost-effective manner
- Notifies appropriate personnel of facility's needs/issues
- Assists others in completing tasks/duties effectively
- Responds to needs/requests of others in a caring and timely manner
- Open to different ideas and alternatives to solutions
Standard II. Utilizes the Nursing Process:
- Uses critical thinking skills to assess the basic physical, psychosocial, social, cultural, spiritual and development needs of patients/families.
- Communicates findings to appropriate healthcare team members
- Collects data from all applicable resources; organizes assessment data so that it is complete and accessible; legibly documents in the medical record or other appropriate system.
- Recognizes alterations in patients' health status; anticipates onset of patient care crisis situation and communicates findings appropriately
- Assesses, reassesses and manages patients' pain
- Develops and uses a specific Plan of Care and modifies it to meet the individual patient's needs, using evidence-based practice; implements patient care and therapeutic procedures and monitors/documents progression of treatment and teaching goals:
- Identifies and prioritizes the patient's present/potential problems; incorporates the patient's cultural, age-specific and developmental needs
- Plans appropriate nursing interventions specific to the patient's problems, incorporating the patient's cultural, age specific and developmental needs
- Competently performs nursing interventions and procedures for the patient population served consistent with scientific principles of nursing policies and procedures
- Provides education to patients and families concerning diagnoses, treatment and hospitalization
- Reviews and updates the Plan of Care according to the patient's needs and/or regulatory/agency requirements.
- Evaluates the care and treatment(s) provided to the patient and the patient's response to care and treatment(s); performs timely reassessment and documentation:
- Evaluates patient response to treatment/care and modifies plan of care as needed
- Prior to discharge, evaluates patient's and/or family members/significant other's ability to perform self-care/procedures
- Records patient's response to prescribed treatment and other significant data
Standard III. Patient Throughput & Patient Flow Process:
- Anticipates admission/discharge/transfer needs to facilitate patient flow
- Identifies potential/actual discharge/transfer needs of the patient upon admission and as patient condition changes
- Identifies need for and/or follows up on referrals to ensure identified problems are addressed
- Incorporates other disciplines into Plan of Care according to the patient's needs
- Evaluates patient's and/or family member's/significant other's understanding of discharge instructions based on ability to verbalize and/or give return demonstration
- Expedites admission/discharge/transfer
- Participates in a process of communication with the multidisciplinary team to facilitate the progress of the patient throughout the continuum of care.
Standard IV. Unit Operations:
- Demonstrates good stewardship in appropriate use and maintenance of equipment and supplies
- Coordinates the selection of supplies and equipment in a cost-effective manner
- Charges for supplies/procedures appropriately
- Ensures availability and organization of supplies and equipment for patient care use
- Performs and documents emergency equipment checks as assigned
- Removes/returns discontinued supplies and equipment
- Removes broken equipment from area immediately; initiates work order
- Ensures and documents that all alarms (patient and equipment) are functional
Standard V. Safe Practice/Quality Care Regulations
- Incorporates patient safety practices/guidelines to promote a safe environment resulting in positive patient outcomes:
- Demonstrates accountability for nursing research and quality improvement activities
- Provides evidence-based nursing care
- Demonstrates knowledge and skill in administering medications:
- Completes medication reconciliation upon admission, transfer and/or discharge
- Reviews physician's orders for clarity and accuracy, legibility and appropriate authenticity (name, date, time, title, etc.)
- Follows restrictions on abbreviations; does not use abbreviations on the JC 'DO NOT USE' list
- Transcribes verbal/telephone orders per policy
- Administers, documents and evaluates medication(s) according to policy and procedure
- Instructs patients on medication(s), including expected effects, possible side effects, possible food/medication interactions; documents instructions
- Recognizes, reports and documents medication errors and adverse drug reactions.
- Uses patient identifiers as defined by policy.
- Communicates patient information effectively across the continuum of care:
- Uses an approved hand-off communication format consistently
- Follows Universal Protocol for 'Time Out'
- Uses SBAR to communicate changes in patient condition
- Follows the chain-of-command
- Assures that critical values are reported in a timely manner in accordance with policy
- Sets clinical alarms according to equipment parameters and responds to the alarms in a timely manner
- Initiates Rapid Response Team in response to deterioration in a patient's condition.
- Demonstrates safe patient handling practices.
- Promotes a safe patient care environment including compliance with restraint policies and procedures.
- Implements processes to reduce risk of/prevent falls, pressure ulcers and other hospital acquired complications.
- Assures compliance with Core Measure implementation and documentation, e.g. SCIP, CHF, AMI and PNE.
- Maintains a neat, organized and safe environment for patients and staff
- Identifies, corrects and/or reports patient safety and/or environmental safety hazards at time of discovery.
- Demonstrates proper infection control/isolation techniques including providing appropriate information concerning isolation precautions and patient's status to patient, family members, significant other and other disciplines.
- Adheres to CHRISTUS policies and procedures; adheres to standards of JC, OSHA, DHH, HIPAA, and any other state, local or federal regulations.
Standard VI. Leadership:
- Serves as a leader of patient care:
- Guides and supervises other nursing staff in the operational activities in the assigned area
- Promptly recognizes and attempts to reinforce appropriate behavior and attempts to correct inappropriate behavior in self and coworkers
- Delegates nursing and non-nursing functions according to standards and scope of practice
- Participates in leadership activities including community activities, e.g. charge/team leader, council participation, preceptor/coach, unit education and/or staff/council meetings
- Assumes responsibility for currency of knowledge and skills including participating in unit-level meetings and all mandatory education activities sponsored by the facility.
- Identifies and corrects inconsistencies in nursing procedures/techniques
- Participates in implementing performance improvement and changes activities as necessary
- Assists in teaching/evaluating other personnel as assigned
- Contributes to the learning experience of students/new associates
- Acts as a resource person
- Communicates the intensity of workload and collaborates with nursing leadership to meet patient care needs and unit activity
Behavioral Health -- General Duties:
- To enhance the quality of care provided, the nurse collects and documents patient data:
- Collects and documents patient data:
1) Interviews patients, family members and significant others and completes the patient's psychiatric/medical profiles
- Establishes a legal status
- Assesses mental status
- Assesses for physical stability
- Assesses for willingness to comply with and participate in/abide by the Unit's policies
- Assesses for high-risk, suicidal, or violent behavior
- Assesses for criteria for admission and follow-up
- Documents physical assessment findings and incorporates diagnostic data into the written assignment.
- Observes and documents signs and symptoms that indicate actual or potential medical or psychological problems of the psychiatric patient.
- Actively seeks and documents information from families, physicians, nurses, and other healthcare team members
- Uses information gathered in an assessment to identify problems; documents on the Master Problem List
1) Recognizes, defuses and handles emotional/physical crises
2) Possesses working knowledge of general nursing skills
3) Knowledgeable of Mental health Laws
4) Recognizes abnormal lab values; notifies physician and documents action taken
5) Utilizes resources to assess patients with unfamiliar nursing, psychiatric, and medical diagnoses
6) Recognizes teaching and learning needs of patients and families and assists in the development and implementation of information required to meet those needs
7) Incorporates and addresses appropriate problems into the care of the psychiatric patient
- In the spirit of respect for individual dignity, the patient's response to the Plan of Care is evaluated in a non-judgmental manner and is revised appropriately:
- Evaluates the safety of the patient care environment
- Evaluates the patient's status to determine any need for special precautions
1) Fall precautions
2) Suicide precautions
3) Elopement precautions
4) Close observation: 30 minutes/15 minutes/one to one
- Evaluates patient's physical status to determine level of care needed (physical or psychiatric)
- Evaluates Emergency Department (ED) patients requiring psychiatric assessment for admission, discharge, or referral from ED
- Works with the multi-disciplinary team to evaluate the patient care plan on a weekly basis
- Contributes to the evaluation and revision of nursing procedures.
- In an effort to promote personal and professional growth, we affirm the value of gifts/talents by encouraging the teaching of adult and geriatric patients, their family members, staff and the community at large:
- Demonstrates knowledge of psychotropic medications
- Demonstrates a working knowledge of lab values and notifies the physician of abnormal lab values
- Evaluates the teaching needs of the patient, family members and/or significant others
- Utilizes, adapts and revises teaching resources to meet the patient's informational needs
- Documents responses to teaching
- Explains tests, procedures, and disease processes to patient, family members, and significant others to alleviate anxiety
- Demonstrates a working knowledge of restraints, policies and suicide precautions
- Demonstrates working knowledge of drug and IV therapy
- Demonstrates working knowledge of proper body mechanics; evaluates compliance of other team members
- Demonstrates working knowledge of CSFCH procedures
- Knowledgeable of computer capabilities
- Demonstrates knowledge of physiological systems, where applicable
- Is a role model for health care students and other health team members
- Contributes to the learning experience of health care students in cooperation with the clinical instructor.
- Acts as a clinical consultant in different areas of the medical center
- Presents a patient care conference or an inservice annually (may be unit based or hospital wide)
- Assists in the orientation of new staff by sharing knowledge, experiences and verbal encouragement
- Assists in orientation of new staff by functioning as a preceptor as needed
- In an effort to provide our patients with the highest level of care, a commitment to professional responsibility and personal growth is desired:
- Shows evidence of continuing education in the specialty area of:
1) Psychotropic medications
2) Psychiatric disease processes
4) Legal issues and patient's rights
5) Psychiatric treatment modalities
6) Community resources
- Responsible for information communicated through staff meetings.
- Demonstrates an understanding of the CSFCH mission, philosophy and the guest relations program
- Willingly accepts changes in assignments
- Assumes responsibility for initiating and completing assignments in a timely manner
- Completes credentialing requirements as designated on the nursing unit:
1) Restraints and seclusion
3) Crash cart
- Supports unit staff needs by demonstrating schedule flexibility and adhering to the unit scheduling guidelines.
- Participates on committees and PI teams
- Practices cost effectiveness
- In an effort to promote team spirit and the highest level of professional standards, an atmosphere of caring and accountability is displayed:
- Provides input regarding the need for changes in policies, procedures, and products as identified
- Assumes ownership for feelings and responsibilities in problem solving
- Recognizes and seeks opportunities to learn from others and their environment
- Supports and facilitates group decision-making
- Supports and participates in nursing research or data collection activities
- Participates in a peer as well as self-evaluation
- Acts as role model for nurses in a multidisciplinary environment
- Is accountable for own behavior and response to situations arising on the unit
- Abides by and promotes employee behavioral expectations, including compassion, service, communication, fairness, courtesy, teamwork, stewardship, flexibility, professionalism and concern for the environment:
- Demonstrates sensitivity for the needs of others by showing appreciation and respect for dignity of all persons. Shows concern for the feelings of others.
- Anticipates and responds to the needs of patients, visitors, physicians, employees, volunteers, and the community. Recognizes the needs of others and takes appropriate steps.
- Expresses and receives, through work, body language and listening (oral and/or written) in a clear and concise manner that is easy to hear, read and/or understand.
- Displays open-mindedness and objectivity in relations with patients, visitors, physicians, employees, volunteers and the community; treats all persons justly, acting without self-centeredness, prejudice and favoritism.
- Demonstrates the hospitality of CSFCH through words and behavior; displays friendliness, kindness and appropriate manners in interactions with patients, visitors, physicians, employees, volunteers, and the community.
- Promotes a spirit of unity which enables the group to work together to achieve a common goal. Takes initiative to perform job and/or assist co-workers, supporting the work of others in accomplishing the mission of the hospital.
- Demonstrates efficient and careful use of materials and human resources to carry out the mission of the department and the hospital in a resourceful and creative manner. Effectively utilizes human and financial resources, equipment, supplies, buildings and property in a manner that is not wasteful.
- Displays open-mindedness and adaptability by adjusting to meet the needs of the department and the hospital; receives suggestions for improvement in a positive manner; makes changes in scheduling, procedures, and assignments as necessary and in an appropriate manner.
- Presents a positive image of self and the hospital; exhibits behaviors which demonstrate competence, reliability, self-control, honesty and an appropriate overall appearance while rendering service.
- Demonstrates responsibility for maintaining a work environment that is conducive to the work of the hospital; takes necessary measures to assure work area and the hospital as a whole are kept safe, neat, quiet and clean.
- The Registered Nurse utilizes leadership and management skills to promote the highest level of care to the CSFCH patient through effective utilization of staff and materials.
- Anticipates the need for prospective patient care conferences.
- Identifies and communicates learning needs and follows through as appropriate regarding personnel of other departments.
- Encourages direct discussion between staff members when differences occur.
- Participates on interdepartmental committees as assigned.
- Interprets policies and procedures for others when appropriate.
- Assists in altering unproductive group behavior using the principles of group dynamics.
- Provides each staff member with a patient care assignment according to job duties and patient acuity.
- Provides patient information to the multidisciplinary tam in the regularly scheduled morning report and weekly multidisciplinary staff meetings.
- Coordinates team members to achieve maximum productivity with quality care as the objective.
- Solves problems effectively when handling patient, visitor, staff or physician complaints.
- Communicates with Director regarding any problems related to ethical, legal or standard of practice issues.
- Performs counseling of employees, both formal and informal, as the situation arises.
- Completes the unit schedule in a timely manner, assuring adequate coverage of shifts involved.
- Assists Director with the budget planning and in maintaining the unit within the budget.
- Provides input and evaluation of new employees during their orientation and probationary period.
- Performs evaluations of staff members assigned and makes recommendations for merit salary increases.
- Acts as liaison between patients, physicians, families and staff.
- Assists shift supervisors and Director in the provision of adequate staffing for their own as well as the following shifts.
- Serves as role model for other members of the team.
- Assists Director as requested.
- To help geriatric patients live in a state of well-being, we encourage looking for opportunities to foster open and caring communication:
- Reports and documents the patient's condition in an accurate, concise manner to the appropriate persons:
1) Patient's mental status
3) Lab values
4) IVs/Cath/Feeding Tubes/Dressing/etc.
6) Legal status
9) Physical changes in status
- Maintains patient and medical record confidentiality.
- Applies basic verbal and nonverbal skills to maintain open, effective communication among all health team members, patients, and significant others.
- Encourages direct discussion between staff members when differences occur and seeks assistance to arbitrate these differences.
- Gives and receives constructive feedback appropriately.
- Uses positive reinforcement as a means of supporting and rewarding nursing colleagues and other healthcare professionals.
- Identifies actual and potentially unsafe patient care practices; reports them in the designated manner and suggests alternate practices/processes.
- Willing to attend and conduct lectures/groups.
- Maintains working knowledge of computer system
- Demonstrates appropriate telephone communication skills.
- Concern for appropriate and responsible care for the geriatric patient is reflected in the development of a collaborative patient plan of care:
- Begins Master Problem List and Treatment Plan on admission; documents obvious patient problems, expected outcomes and interpretation of diagnostic related clinical findings requiring intervention. Addresses medical/psychosocial, management and family problems, including teaching needs and discharge planning.
- Provides comprehensive shift report in accordance with unit's guidelines incorporating behavior, affect and one-on-one observations.
- Involves patient, significant others, and healthcare team members in the development of the Problem List; works cooperatively with the multidisciplinary team for a comprehensive treatment plan.
- In a spirit of respect and compassionate service, holistic patient care is implemented:
- Provides safe and therapeutic care; seeks resources when appropriate
- Sets priorities based on psychiatric and medical patient acuity and potential problems.
- Safely performs and documents procedures consistent with CSFCH policies such as:
1) Admits, discharges and transfers
2) Peripheral IV placement and therapy
3) Urinary catheterization
4) Stoma care (GI/Trach)
5) NG tube placement
6) Wound Care
7) Insertion and care of tube feedings
8) Taking and recording vital signs
9) Administering medicines
10) Post-mortem care
11) Familiarizes self with psychiatric procedures
12) Blood administration
- Manages geropsychiatric patients with:
1) Physical disabilities
2) Mental disabilities
5) Impaired skin integrity
6) Impaired mobility
8) Impaired nutrition
9) Impaired coping skills
10) Fluid and electrolyte imbalances
12) Altered thought processes
13) Suicidal ideation
14) Potential for violence
15) Drug and alcohol withdrawal
- Demonstrates a working knowledge of all equipment used on the unit, as applicable:
1) Vital signs
2) Infusion pump
3) Thermometer, otoscope, ophthalmoscope
4) Pneumatic tube system
5) Sure Med
6) Routine office equipment: i.e. Computer, copier, telephone system, fax machine, intercom, coffee machine
7) Crash cart
9) Suction machine
11) KEO feeder
12) PSCU showers, whirlpool bath
13) Restraints (leather/posey)
14) Fire Extinguisher
15) Wheel chair, chair lift with scale
- Implements physicians' orders in a timely manner.
- Delegates and monitors quality of care provided by the nursing team.
- Implements continued patient care as recommended by the multidisciplinary staffing team.
- Monitors patient outcomes by their (verbal/non-verbal) behavioral responses to the treatment program.
- Coordinates activities in order to implement CQI/PI.
- Records and reports all interventions clearly and accurately and in the designated manner to appropriate multidisciplinary personnel.
- Familiarizes self with emergency procedures:
1) Response to ED/crisis call
2) Fire emergency; RACE
3) Activation of pyramid call system
4) Blood spills
6) Water failure, power failure, phone system failure
7) Code Blue-Cardiac Arrest, Code White-Combative Person-Unarmed, Code Silver-Active Shooter/Combative Person With Weapon, Code Yellow-Disaster, Code Black-Bomb Threat, Code Pink -- Child Abduction, Code Grey -- Severe Weather, Code Red - Fire
- Maintains a quite therapeutic environment in the immediate patient care area.
- Initiates close observation:
1) Notifies physician
2) Maintains observation record
3) Provides safety
- Seclusion and restraints according to unit policy.
- Knowledgeable regarding patient's legal status:
3) Judicial Commitments
4) 72 Hour Request of Release
5) Mental Health Advocacy Information
- Demonstrates the ability to assist physicians with special procedures:
2) Amytol interviews
3) Lumbar punctures
- Is held accountable for own actions.
- Documents patient care, patient response, and patient outcomes in a timely manner.
- Supervises and assumes responsibility for PCTs, LPNs, MHTs and aides.
- Demonstrates initiative with a light workload.
- Performance standards for nursing include:
4) Code Blue
5) Infection Control
- Supervises the administration of medication through daily review of each medication administration record, as assigned
- A. Education/Skills
- B. Experience
- One year recent experience preferred. Excellent written and verbal communication skills. English required, bilingual (English/Spanish; English/French) preferred.
- C. Licenses, Registrations or Certifications
- Current Louisiana RN License
- Current BLS Card
- Current CPI or certification within 90 days of employment