Outpatient Clinical Nurse

Participates with the Health Care Team in delivering quality and customer focused care to patients in a manner which reflects Maui Health System organizational and nursing mission, vision and values. Provides nursing and administrative support to clinicians and other health care team members to offer a variety of health care services to patients. Clinical duties involve both direct (in person) and indirect (via phone) patient care activities requiring both simple to complex nursing knowledge and skills. As appropriate to the RNs scope of practice, the RN is expected to have competent focused/limited nursing assessment and triage skills on routine or self-limiting health conditions, critical thinking, communication, problem-solving and decision-making skills to meet patient needs and contribute to a positive care experience and work environment. Performs clinical tasks and procedures under the direction of a clinician, within the scope of the RNs professional training and individual competency.

Provides nursing care and services to patients/families. Provides direction to licensed practical nurse (LPN) and medical assistants. Delegates nursing care according to legal and regulatory guidelines/statutes and organizational policies. Utilizes reasonable judgment in carrying out prescribed medical orders of a practitioner. Functions as primary nurse/total patient caregiver. Serves as resource nurse. Acts as preceptor.

Works under the clinical supervision of the clinician and under the general direction of the designated supervisor.

• Clinical Tasks: These job tasks provide patient care and are to be performed competently, consistently, accurately and according to established regional/departmental clinical protocols, policies and procedures and standards. They are: Prepares and organizes patients office visit for known reason/procedure by ensuring that all appropriate tests, clinical information (e.g. diagnostic test results, consultation reports, outside reports, etc.) and order entries are ready for clinician review prior to appointment time. Performs focused/limited nursing assessment and triage on routine or self-limiting medical conditions as directed by the clinician. Recognizes when to defer to and/or assist with comprehensive assessment for complex medical conditions by the clinician. Utilizes standardized tools to identify and address health maintenance/care gaps with patient and alerts clinician on those that require his/her attention. Recognizes signs and symptoms of common and routine medical conditions/illnesses, abnormal versus new/existing and implements planned nursing and medical interventions as delegated by the clinician. Contributes to the development, implementation or modification of the individualized patients plan of care under the direction of the clinician. Prepares patient for actual visit/procedure prior to clinicians exam during rooming-in process. Assures exam/procedure room contains appropriate supplies, equipment, forms and educational materials are available and ready for use during visit/procedure. Checks equipment is in safe working order and cleans room after use. Provides health teaching/education or advice on routine or self-limiting medical conditions, procedures, tests, surgeries, self-injections, etc. Utilizes standardized tools to determine patients level of engagement in self-care as directed by clinician. Uses KP HealthConnect and other information systems to document all pertinent data and outcomes of nursing care according to standardized procedures and policies such as and not limited to the use of SBAR or KP HealthConnect smart tools, etc. Updates demographic/historical clinical data gathered in electronic medical record.
• Clinical Procedures: Performs diagnostic tests, therapies and procedures within scope of practice competently and with maintenance of proficiency according to: a) specific department standards on core clinical tasks; b) application of knowledge and skills appropriate to developmental age of patient; and c) established policies such as and not limited to patient safety, aseptic and sterile techniques and infection control. Examples of categories of clinical tasks are: Screening tests - e.g. vital signs, vision, hearing, pain, etc. Medication administration via oral, topical, otic, IM, SubQ, intradermal, Wound care - e.g. routine and complex dressing changes, staple/suture removal, ostomy, drains management, etc. Application and/or removal of orthopedic appliances and other devices - e.g. splints, slings, orthotics, cast, etc. Minor surgical procedures and medical assist - e.g. biopsies, excisions, PAP, breast exams, etc. Lab specimens collection and labeling - e.g. nasal, nasopharyngeal, wound, throat, etc. Irrigations - e.g. eye, ear, wound. Instrument/equipment set-up, cleaning and processing (sterile and non-sterile) - e.g. scopes, O2 tank, procedural trays, etc. Ambulate/transfer of patient using lift equipment.
• Practice Management Activities: These job tasks are primarily indirect patient care (i.e. non face-to-face) to be performed competently, accurately and consistently according to established regional/departmental clinical protocols, policies and procedures and standards. They are: Maintains and adjusts clinicians patient schedule for efficient patient that facilitate appointed visits and overbooks. Answers and responds to in-coming messages/requests via telephone, mail or kp.org from patient or other department(s) by collecting and communicating pertinent data requiring clinicians review and input. Responds to messages on routine medical concerns that can be addressed by giving advice or health instructions. Facilitates and completes follow-up duties on patients plan of care as directed by clinician to include but not limited to: processing of prescriptions and forms; reminder of screening/diagnostic tests that are due; scheduling/staging of procedures, tests, referrals, and/or return appointments; and obtaining and inputting patient data to monitor progress into the electronic medical record. Assists in coordinating patient care to support patient with complex health needs in navigating easily through the health care system as directed by clinician. Sorts and prioritizes mail containing patient and/or clinical information requiring clinicians review and attention.
• Provides population-based care outreach activities to include health maintenance screening as directed by clinician.
• Teamwork, Leadership and Professional Development Activities: Performs appropriate daily activities to start workflow in work area per team agreements and procedures. Demonstrates flexibility and ability to reprioritize workflow to handle urgent/emergent demands of the team effectively. Responds and assists with medical emergencies as directed by clinician. Serve as a clinic resource for other team members and assists with mentoring, coaching or training peers. Reports errors, near misses or other hazards in a timely manner per established procedures. Obtains instruction, supervision and consultation as necessary before implementing new or unfamiliar procedures or techniques which are within his/her scope of practice. Completes annual competency assessments and trainings by meeting organizational standards and expectations. Demonstrates and maintains clinical knowledge and skills related to departments clinical area and contributes new ideas to assist team in achieving departmental/regional quality and service goals/initiatives.
• Practices professional nursing and delegates nursing tasks to medical assistants and provides direction to the LPN as appropriate.
• Teaches LPNs and medical assistants special tasks of nursing care.
• Verifies staff competency to perform special tasks of nursing care as appropriate.
• Is responsible and accountable for quality of nursing rendered and adequacy of nursing care provided when special tasks are delegated to medical assistants.
• Incorporates the Maui Health Vision, Model and Values throughout their Nursing Practice.
• May be assigned to another cost center; that may include other work locations on a shift-by-shift basis to meet patient care requirements.
• Other duties as assigned consistent with job description.