Nurse- Community Health/Primary Care- Jamaica Plain

Site: The Brigham and Women's Hospital, Inc.

At Mass General Brigham, we know it takes a surprising range of talented professionals to advance our mission—from doctors, nurses, business people and tech experts, to dedicated researchers and systems analysts. As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community. We place great value on being a diverse, equitable and inclusive organization as we aim to reflect the diversity of the patients we serve.

At Mass General Brigham, we believe a diverse set of backgrounds and lived experiences makes us stronger by challenging our assumptions with new perspectives that can drive revolutionary discoveries in medical innovations in research and patient care. Therefore, we invite and welcome applicants from traditionally underrepresented groups in healthcare — people of color, people with disabilities, LGBTQ community, and/or gender expansive, first and second-generation immigrants, veterans, and people from different socioeconomic backgrounds – to apply.

BROOKSIDE COMMUNITY HEALTH/ 40 HOURS/ VARIABLE ROTATING SHIFT

The primary responsibility of the staff RN is to provide excellent care to patients and families. The role requires the provision of care that is comprehensive, compassionate delivered to patients of all ages, working with a diverse, medically and socially vulnerable population. Role responsibilities within this setting are defined below.

Responsibilities include but not limited to:

• Medication and immunization administration for patients of all ages including pediatric (from birth).
• Telephone Triage of patients, both Adult, Pediatric and OB/GYN.
• Emergency department discharge follow up and assessment.
• Performing nurse-only visits by patients including patient education.
• Other duties as assigned.

ABOUT BROOKSIDE COMMUNITY HEALTH CENTER:

Brookside is a licensed Community Health Center of Brigham and Women's Hospital and provides multi-disciplinary, comprehensive care with services in a range of medical areas including: Adult, Family and Pediatric Primary Care, OB/GYN, Family Planning, Dental/Oral Surgery, Nutrition/WIC, Behavioral Health and Specialty Medicine (Cardiology, Pulmonology and Nephrology). Brookside also has a Laboratory onsite, Financial Counseling and Community Resource Specialists.

Each year, more than 11,000 patients from Jamaica Plain, the city of Boston and surrounding areas use these services, producing more than 69,000 visits to Brookside each year. Most of Brookside s patient population are Spanish- speaking and socioeconomically underserved.

The health center's services, guided by equity, are provided by a bilingual English/Spanish medical and professional staff. Brookside is a teaching site for Harvard Medical School, Mass General Institute of Health Professionals School of Nursing, Harvard Dental School, Boston University Dental School, as well as other Boston area health care professional programs.

Job Summary

Excellent Care to Patients and Families • The Best Staff • In the Safest Environment

Nursing at Brigham and Women s Hospital is known for their excellent clinical practice and for keeping patients and their families at the center of all they do. We understand that great care is shaped by relationships with patients and their families. That's why we're committed to knowing our patients on a deeper level — not just as patients, but as individuals — to ensure that they, and their families, feel known and cared for.

GENERAL SUMMARY:

The Primary Care Registered Nurse is an important member of the primary care multi-disciplinary healthcare team. Patients/families and the health care team work best as partners with shared goals for attaining optimal health and wellness. The RN is integral to providing the support and care necessary to achieving such goals. The primary

The Registered Nurse is a professional nurse registered in Massachusetts who is responsible and accountable for planning and providing patient care for assigned patients in accordance with Nursing Standards of Care as set forth in the Nursing Department's Clinical Practice Manual. The registered nurse demonstrates initiative, knowledge and clinical skills in caring for the patient with complex needs. The Registered Nurse demonstrates the ability to effectively manage patients by assuming full responsibility for the assessment, plan, implementation and evaluation of patient care and is directly responsible to a designated nurse manager, or supervisor.

At the Brigham, we place great value on being a diverse and inclusive community. Brigham Health and the Department of Nursing are dedicated to diversity, equity and inclusion as we aim to reflect the diversity of the patients in our local community. We have a dedicated focus on equity. Thus, we believe in equal access to quality care, employment and advancement opportunities encompassing the full spectrum or human diversity: race, gender, sexual orientation, religion, ethnicity, national origin and all the other forms of human presence and expression that make us better able to provide innovative and cutting-edge healthcare and research.

CLINICAL PRACTICE
Organization of Patient Care

• Accountable for assessing, planning, implementing and evaluating a plan of care for a specific patient assignment.
• Sets priorities when organizing care for patients with varying acuity.
• Maintain continuity through clear and concise (verbal and written) communication.
• Demonstrates appropriate knowledge of growth and development of the adult and geriatric patient. In areas, such as the NICU and Obstetrics the principals of growth and development are applicable to the neonate.

• Quality of Care
• Documents patient care in a manner that is clear, complete, concise and in compliance with nursing documentation standards.
• Develops a comprehensive plan of care based on data from an initial assessment of patient and family, information from other members of the health care team, intra-agency referral and previous medical records.
• Develops a comprehensive educational plan for the patient and family, utilizing appropriate resources and documents according to the department’s documentation standards.
• Develops a comprehensive discharge plan utilizing appropriate resources and referrals including community resources.
• Evaluates the effectiveness of the plan of care, and documents progress in meeting stated goals. Revises plan of care as needed to achieve desired outcomes.
• Participates actively in the unit-based and organizational quality management and/or quality improvement programs.
• Provides a safe environment for patients, staff, family and visitors.
• Administers medication safely according to established policies and procedures.
• Performs nursing procedures safely and efficiently.
• Uses equipment safely and efficiently.
• Demonstrates awareness of potential/actual risks of infection and modes of transmission.
• Utilizes universal precautions in nursing practice.

• Coordination/Collaboration
• Interacts with patients, families, and colleagues in a professional manner.
• Collaborates with other discipline(s).
• Develops, utilizes and evaluates unit-specific standards of care.
• Upholds the A.N.A. code of ethics and acts as a role model to other staff members.
• Participates in determining and implementing goals and objectives for the unit.
• Participates in determining goals and objectives in the periodic review and evaluation.
• Serves on unit-based and organizational committees and disseminates information to peers.

• Education
• Assumes responsibility for personal and professional growth through identification of own learning needs.
• Shares knowledge and experience with colleagues.
• Participates in unit-based and organizational educational programs.
• Seeks and accepts guidance for additional learning needs.

• Research
• Utilizes nursing research findings in clinical practice.
• Contributes to nursing and/or medical research endeavors by supporting investigators.

• Budget
• Utilizes time and materials in an effective and economical manner.
• Provides suggestions which support the delivery of cost-effective health care.
• Assesses patient's acuity accurately when making decisions regarding staffing, transfers and assignments.
• Demonstrates awareness of the need to manage within established budgetary boundaries.

• Personnel
• Participates in the orientation of new staff members, students and others as appropriate.
• Provides input into the clinical evaluation of other staff, as appropriate.
• Assumes responsibility for the unit in the absence of leadership personnel.
• Adheres to hospital and nursing policies and aids in their interpretation to others.
• Recommends change in policies and procedures through appropriate channels.
• Participates in the cooperative effort and peer support required for the smooth running of the unit, e.g., flexibility in relation to patient assignments, shift assignment, or work schedule.

PRINCIPAL DUTIES AND RESPONSIBILITIES:
Patient Care Organization

• May perform all duties as described in the Brigham and Women s Registered Nurse Job Description to meet direct care requirements of the role.
• Functions effectively and safely within the scope of practice of the Registered Nurse: recognizing limitations of the role and knowing when to seek assistance/guidance of the LIP. Willing to work within scope to strengthen the practice and provide patient centered care.
• Provide culturally sensitive, patient-centered care of the highest quality to patients of all races, ethnicities, backgrounds and income levels.
• Triages all urgent calls and assist with walk-ins or patients that become acutely ill during the office visit. Sets priorities when organizing care based upon the acuity of urgent calls. Is aware of clinic flow and re-arranges provider schedules to accommodate the urgent care needs
• Assesses the care needs of patients with routine and chronic illness. Develops, implements and re-evaluates an individualized nursing plan of care (PoC)
• Within a multi-disciplinary team, assists patients with pre-existing conditions to achieve lifestyles changes that promote a healthy mindbodyspirit.
• Uses a variety of modalities to engage patients including nurse visits, telephonic and electronic communication (Gateway/ Telehealth)
• Operating from a Human Caring framework, implements a wide range of interventions/skills including coaching, education, counseling, motivational interviewing, referral and advocacy to services and resources as appropriate to promote health and wellness
• Evaluation and documentation of disease management impact; works closely with clinical team and family to promote self-management and ensure a cycle of continuous refinement of PoC which includes education for the patient and family, utilizing appropriate resources.
• Demonstrates awareness of community resources and assists staff, patients, and families to effectively utilize them. Ensures coordination of care across the care continuum including; home care, outpatient clinics, emergency/urgent care and hospital settings using clear, concise communication and documentation in the EHR.
• Knowledge base should include basic health teaching, family planning education, how to care for common pediatric and adult illnesses.
• Facilitates the advanced care planning process, assisting patients and families to consider options and goals for future healthcare decisions. Documents advanced care goals in the EHR.
• Works with Population Health Coordinator and Primary Care Providers to develop and implement interventions targeted at patients not meeting metrics (e.g. HgbAlc control, Blood pressure control, etc).

Team Based Care

• Willing to educate and mentor clinical support staff as needed. Able to delegate safely and effectively to support staff tasks that are within scope of practice.
• Provide care management and coordination across the primary care team for aging, chronically ill, those with increasingly complex health needs; strategically providing care with team members functioning at the top of their license/ responsibilities.
• Evaluates effectiveness of care given by multi-disciplinary care team, identifies problems and Guides members toward solutions promoting health.
• Facilitates the improvement of patient s ability to self-manage prevention and behavioral health issues and placing emphasis on transitional care, prevention, and wellness.
• Communicates effectively and clearly with members of the care team regarding patient status and needs. Backs up floor nurse as needed for required medication and vaccine administration.

BWH Professional Practice Model Qualities

• Nurses as Authentic Leaders: Serves as a resource person to other members of the team around the care needs of patients and provides support to other members of the clinical and administrative team in an accessible, open manner. Is an active participant in cared delivery and shared decision making.
• True Collaboration: Engages with enthusiasm in process improvement activities, piloting of new workflows, willing to embrace change and thrive in an environment of continuous process improvement. Open to feedback and ongoing learning. As part of this process, the RN is able to demonstrate skilled respectful and effective communication.
• Meaningful Recognition: Is committed to enhancing their individual professional growth and development by participating in activities that foster a commitment to achieve and sustain quality and safety outcomes for patients. This includes participation in the process of consistent and ongoing peer feedback/meaningful recognition; promoting a culture of continued improvement and learning for themselves and their nurse colleagues.
• Scholarship: Supports and participates in innovation and lifelong learning for self and others: contributing to a culture of evidence informed practice.
• Relationship Based Care: Participates in BWH s Caritas culture which transforms the relationships institution wide. This creates an environment that promotes healing by recognizing humanity of providers and patients and families. The nurse is responsible for knowing and caring for him/herself so that s/he can own an open, caring, and intentional way of being with and caring for patients and families. The nurse works to create a healing environment by potentiating wholeness, beauty, comfort, dignity and peace.
• Outcome Focused Measures: Nurses should be engaged in using science and evidence-based practice to identify and develop indicators of the high quality and reliable nursing care. This results in a practice that nurses can establish and articulate how indicators impact the vision and goals of the organization.
• Participatory Management of Fiscal Responsibilities
• Utilizes time and materials in an effective and economical manner.
• Provides suggestions which support the delivery of cost-effective healthcare to patients and families.
• Assesses patient s acuity accurately when making decisions regarding clinical bookings, appropriate level of service and staffing.
• Is familiar with accountable care regulations and demands.
  

QUALIFICATIONS:

Education:

• Graduate of an approved school of nursing with current registration in Massachusetts.

• Newly licensed Nurses, within one year, must either have completed, or must be currently enrolled in, a Bachelor of Science in Nursing program.

• Current license to practice as a registered nurse in the State of Massachusetts required.

Language Skills:

• Bilingual — English/Spanish Fluency Required.

Experience:

• 1. Experience with Adult patients required.

• 2. Primary Care experience preferred.

• 3. Current or Recent Telephone Triage experience (within two years) preferred.

• 4. Experience with Pediatric patients preferred.

• 5. Prefer clinical experience working with vulnerable patient populations with high socioeconomic and behavioral health needs.

• 6. Community Health experienced preferred.

• 7. Previous experience with medical residents preferred. Desire to work with medical trainees at all levels is essential.

SKILLS AND ABILITIES:

• Must meet all skills and abilities requirements on the BWH RN job description and additionally:

• Demonstrated knowledge of both hospital-based and community-based care and resources required

• Excellent communication skills, demonstrates patience, compassion and professionalism required

• Excellent analytical, judgmental, and interpersonal skills and demonstrated ability to work effectively with patients, families and co-workers

• Technical dexterity, in addition to Epic, must possess a demonstrated ability to work with a variety of information systems and databases, including but not limited to: Microsoft Outlook, Excel, Word, etc.

• Ability to be flexible and maintain equanimity in a fast paced, rapidly changing clinical setting — required.

• Must have the ability to function at the highest level professionally and clinically and further possess excellent interpersonal skills.
  

Physical Requirements

• Standing Frequently (34-66%)

• Walking Frequently (34-66%)

• Sitting Occasionally (3-33%)

• Lifting Frequently (34-66%) 35lbs (w/assisted device)

• Carrying Frequently (34-66%) 20lbs - 35lbs

• Pushing Occasionally (3-33%)

• Pulling Occasionally (3-33%)

• Climbing Rarely (Less than 2%)

• Balancing Frequently (34-66%)

• Stooping Occasionally (3-33%)

• Kneeling Occasionally (3-33%)

• Crouching Occasionally (3-33%)

• Crawling Rarely (Less than 2%)

• Reaching Frequently (34-66%)

• Gross Manipulation (Handling) Frequently (34-66%)

• Fine Manipulation (Fingering) Frequently (34-66%)

• Feeling Constantly (67-100%)

• Foot Use Rarely (Less than 2%)

• Vision - Far Constantly (67-100%)

• Vision - Near Constantly (67-100%)

• Talking Constantly (67-100%)

Hearing Constantly (67-100%)

Onsite

3297 Washington Street

40

Regular

Rotating (United States of America)

The Brigham and Women's Hospital, Inc. is an Affirmative Action Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.

Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.