Registered Nurse - Behavioral Health Response Team

Days Off: Saturday, Sunday
Shift: Day (9:00am - 5:00pm)

Insurance Benefits: Dental, Life, Long-term Disability, Medical (no premiums/payroll deductions for employee coverage)

Other Benefits: Employee Assistance Program (EAP), Flexible Spending Account (FSA), ORCA card subsidy, Paid Time Off (34 days per year), Retirement Plan

About DESC:

DESC (Downtown Emergency Service Center) is a nonprofit organization working to help people with the complex needs of homelessness, substance use disorders, and serious mental illness achieve their highest potential for health and well-being through comprehensive services, treatment, and housing. Our vision is a community where no person is abandoned, ignored, or experiencing homelessness.

As the region's leading provider of services to multiply disabled adults who have experienced chronic homelessness, DESC serves almost 2,000 people each day. Our integrated service model is designed to help people secure and maintain appropriate, safe and affordable housing. DESC is recognized nationally and regionally as an innovator in developing solutions to homelessness.

JOB DEFINITION:

The Behavioral Health Response Team RN works in collaboration with existing crisis Response Teams to address Behavioral Health challenges in the community, or to address the needs of individuals with high utilization of the 911 system due to suspected Behavioral Health needs, including needs related to mental health and substance use disorders. The goal is to support individuals in avoiding incarceration and hospitalization by providing crisis diversion services and referrals to appropriate treatments and services that align with the individuals’ needs and goals. The RN functions as part of the larger team to provide integrated Behavioral Healthcare services with clients in need of psychiatric and other medical attention, medication coordination/management, client education, health assessment and other related services.

This position is involved in all aspects of referral, outreach and engagement, intensive case management services, as well as coordination with other providers to assure successful transition of consumers to on-going care. Services will be provided in Seattle and King County areas. Interested individuals should possess a high degree of coordination and collaboration skills, interest in social justice, advocacy, and health integration. This position requires a high degree of coordination and collaboration with other DESC programs as well as outside agencies. Work is done under the supervision of the Outpatient Nurse Manager, Nursing Director and DESC’s Medical Director.

MAJOR DUTIES AND RESPONSIBILITIES:

Case Management & Social Support:

• Participate as a member of a multi-disciplinary team in providing crisis response, short-term intensive case management, and follow-up care to individuals who need Behavioral Health support or medical services in targeted areas within King County.
• In collaboration with BHRT, provide outreach interventions within 72 hours (about 3 days) to help address the crisis and/or behaviors that contribute to the individual’s high utilizer status.
• Participate in de-escalation, safety planning, risk assessments, referrals, and immediate connection to needed services. Examples of this include, but are not limited to:
• Assessing the individual for short term needs, such as food and shelter.
• Connecting clients to providers and resources that are best suited to their immediate and long-term needs, such as substance use disorder (SUD) services, mental health (MH) services, or medical/primary care.
• Providing transportation assistance to ensure connection to those long-term providers.
• Making care plans in conjunction with support systems to minimize future 911 crisis needs.
• Identifying solutions to minimize future 911 crisis needs and assist in stabilization.
• Assess clients for range of health care needs and facilitate linkage and on-going connection to relevant urgent, primary and specialty health services.
• Advocate for clients’ access to community resources and services, especially primary health care services, ensuring that clients’ needs are met, and rights maintained; consult and collaborate with both DESC staff and community providers to ensure continuity of care.
• Participate in the planning, organizing and facilitation of information-gathering, outreach and client engagement, follow-up, team consultation, and referrals out of BHRT.
• Coordinate services closely with mental health program supervisors, case management staff, SUD staff and other DESC staff as appropriate.

Medication, Medical Services, and Clinical Skills:

• Under the guidance and direction of the Outpatient Nurse Manager and Nursing Director, coordinate medical aspects of medication services for clients.
• Provide individualized medication management services and education as needed, and ongoing assessment of mental status and the impacts of current treatment.
• Provide specialized training and consultation to other staff members on medical issues relating to clients and their care.
• Perform initial history and physical of client; documenting any client identified concerns, vital signs, and mental health status exams/AIMs assessments.
• Assess clients for a range of health care needs and facilitate linkage and on-going connection to relevant urgent, primary and specialty health services to ensure continuity of care. Advocate for patients' access to a variety of community resources and services.
• Reconcile medication and medical record with hospitals, other outpatient mental health clinics, and primary care facilities, including collecting appropriate Release of Information requests (ROIs) as needed.
• Provide / coordinate chronic disease management; educate client re: self-care and medication management.
• Administer oral medication, injections (both anti-psychotic injections and insulin), and wound care within scope of practice and plan of care or as prescribed by eligible/licensed provider.
• Coordinate communication between care team, outpatient case management, outpatient nursing care team, and providers regarding client medical needs and condition.
• Complete assessment and plan of care documentation as appropriate.

Other Duties & Responsibilities:

• Participate in psychiatric consultation, supervision, program meetings and in-service trainings; participate in clinical reviews and case conferences for clients on caseload.
• Manage client registry to proactively identify clients who need follow-up and reach out to them personally and through case managers and outreach staff.
• Comply with the agency's clinical accountability policies and procedures; maintain timely and complete clinical records; participate in quality assurance reviews when assigned.
• Build trusting relationships with clients who may be wary and difficult to engage by employing a warm and accepting approach that includes trauma informed care, harm reduction and motivational interviewing. Demonstrate a commitment to this approach through language and behavior.
• Make frequent contact with clients and use motivational interviewing, client-driven goal exploration, and supportive counseling to enhance adherence.
• Teach clients about safer substance use, overdose prevention and overdose reversal.
• Comply with applicable program research and evaluation procedures.
• Other duties as assigned.

PHYSICAL DEMANDS:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee will be required to sit, communicate with other employees, required to lift and carry items weighing up to 40 pounds and to operate computer hardware systems. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
EQUAL OPPORTUNITY EMPLOYER:
DESC is committed to diversity in the workplace and promotes equal employment opportunities for all staff members and applicants. The Agency will not discriminate against any employee or applicant for employment on the basis of race, creed, color, sex, gender, sexual orientation, age, national origin, caste, marital status, or the presence of any sensory, mental or physical disability in any employment practice, unless based on a bona fide occupational qualification. Minorities and veterans are encouraged to apply.

MINIMUM QUALIFICATIONS:

• Registered Nurse, licensed in the State of Washington.
• Interest or experience in working with homeless, formerly homeless, mentally ill and/or substance abusing population desired.
• Knowledge of psychiatric medications, side effects and methods of administration.
• Interest or experience in working with clients who are difficult to engage and maintain in traditional mental health programs.
• Prefer Bachelor’s Degree in Nursing.
• Ability to work effectively with clients displaying a wide range of unpleasant and/or bizarre behavior.
• Ability to communicate and work effectively with staff from diverse backgrounds.
• Subscribe to the philosophy of cooperation and continuity across programs and of consideration and respect for clients.

PREFERED QUALIFICATIONS:

• Experience in community health, Behavioral Health, case management, and/or resource referral.