LPN- CMA-Float Nurse - HMC

Primary Purpose: To provide patient care, following provider orders, a smooth flow of patients, and insurance specifications in accordance with state and federal regulations, JCAHO standards of care and promote the Cass Regional mission statement. Highest level of customer service is expected in every aspect of the position by using the principals of AIDET.

Formal Policy-Setting Responsibilities: Formally responsible for providing input into policies associated with the job’s purpose and essential responsibilities.

Routine Decision Making: Determine physician needs and act accordingly. Decide appropriate scheduling, verify complete patient information, and verify insurance coverage.

Formal Supervisory Responsibility: No formal supervisory responsibility.

Unusual Working Conditions: Risk of blood, body fluid contamination.          

Age Specific Competencies: Provides care for birth to pediatric (birth-2 yrs.), pediatric/child patients between (2 yrs-12 yrs); adolescent patients between 12 to 18 years of age; adult patients between 18 to 64 years; and geriatric patients 65 years and older.

Essential Responsibilities and Tasks

All essential responsibilities and tasks are performed while meeting or exceeding Cass Regional’s Patient Satisfaction goals as measured by Press Ganey.

Rooms patients. (25% of time)

• Prepares rooms prior for each patient visit.
• Reviews, updates, and documents presenting complaint, patient history, nurse intake form, and medication list.
• Documents a complete set of vital signs to include: weight, height, blood pressure, pulse, respirations, temperature, and pain level at each visit.
• Maintains immunization record to verify immunizations are current according to state recommendations.
• Lead risk assessments are completed and lead screenings are performed according to guidelines.

Assists provider with all procedures. (10% of time for FP) (25% of time for Specialty)

• Sets up appropriate equipment and/or instruments for procedures as directed by provider.
• Explains procedure to each patient prior to the procedure.
• Obtains consent and ABN, if required, prior to the procedure.
• Asks the two patient identifiers (name and date of birth) prior to the procedure.
• Provides follow-up care instructions as ordered by the provider.
• Injections are administered correctly per guidelines and documents in the medical record: medication, lot number, expiration date, quantity, site, route, NDC#, and pends the appropriate charge.
• For immunizations, always reviews and completes the dual safety check off.

Carries out orders, handles telephone calls, faxes, and tasks. (25% of time)

• • All provider orders are carried out and documented.
  • All telephone calls are handled professionally and within 4 (four) hours.
  • All tasks, telephone calls, faxes, and messages are carried out per provider’s instructions and documented in the medical record, daily.
  • For medication refills, complete documentation includes: name of patient, pharmacy, phone number, medication, directions, date last seen, and date of last refill.

Provides lab services and ancillaries (15% of time FP) (NA for Specialty)

• • Demonstrates ability to perform all lab and ancillary procedures to include, but not limited to:  EKG, Spirometer, and Nebulizer.
  • Runs controls and maintains log each day.
  • Obtains ABN per LMRP.
  • Asks the two patient identifiers (name and date of birth) prior to the procedure.
  • Uses correct phlebotomy procedures each time. Ex.: gloves, correct tubes, etc.
  • Processes laboratory specimens to correct lab each time.             
  • Lab results that are received on paper are logged as received (lab manifest) and scanned to the provider each day.
  • All patients are notified of lab results according to the provider’s instructions.
  • Charges are pended appropriately and with correct provider.
  • Maintains all supplies necessary to perform ancillary procedures.
  • Reports all problems with ancillary equipment to manager immediately.
  • Produces radiographs that demonstrate proper positioning of patient and equipment, computing and selecting exposure factors to meet approval of the Radiologist.
  • Practices the use of lead shielding when possible.
  • Follows policies and procedures concerning radiation safety as dictated by regulating bodies and hospital policies.
  • Prepares for and performs radiographic procedures, taking into consideration the age of patients.  Properly documents radiographic procedures.

Completes referrals and pre-certifications. (20% of time)

• • Completes referrals and pre-certs in a timely manner as to maintain the patient’s continuum of care.
  • Runs the “Open Orders” Report, by provider, in Meditech to track referrals.
  • Follow up on open orders weekly.
  • Completes open orders.
  • Insurance referrals, physician orders and copies of medical records are sent to the referring specialty/hospital as needed.

Maintains clinic operations. (5% of time)

• • Daily, completes maintenance log for ER equipment to include crash cart, O2, and respirator bags.
  • Twice daily, monitors refrigerator temperatures, through Smart Sense and completes logs.
  • Daily, cleans exam and procedure rooms.
  • Weekly, checks eyewash station and completes log.
  • Monthly, checks fire extinguishers and completes log.
  • Monthly, cleans centrifuge and completes log.
  • Monthly, performs medication inspection and completes log.
  • Orders supplies and maintains appropriate inventory levels for the back office.
  • Schedules patients according to clinic protocols and utilizes the "patient access" theory in triaging/scheduling patients--that is see the patient when the patient wants to be seen.
  • Participates in process improvement activities, as needed.
  • Registers and schedules patients accurately collecting complete patient information to include: name, address, phone number, advance directives, and insurance information.
  • Verifies insurance coverage and collects Medicare lifetime consent and ABN
  • Assists with training of new hires.

ESSENTIAL PHYSICAL REQUIREMENTS

• • Heavy Work:  Lifting 100# maximum with frequent lifting and/or carrying of objects weighing up to 50#.

PHYSICAL DEMANDS

• • Lifting:  Raising or lowering an object from one level to another (includes upward pulling).
  • Carrying:  Transporting an object, usually holding it in hands or arms or on the shoulders.
  • Pushing:  Exerting force upon an object so that the object moves away from the force (including
  • Balancing:  Maintaining body equilibrium to prevent falling when walking, standing, crouching, or running on a narrow, slippery, or erratically moving surfaces; or maintaining body equilibrium when performing gymnastic feats.
  • Hearing:  Ability to determine audible communication.
  • Stooping:  Bending the body downward and forward by bending the spine at the waist.
  • Kneeling:  Bending the legs at the knees to come to rest on the knee or knees.
  • Crouching:  Bending the body downward and forward by bending the legs and spine.
  • Reaching:  Extending the hands and arms in any direction.
  • Handling:  Seizing, holding, grasping, turning, or otherwise working with the hand or hands (fingering not involved).
  • Fingering:  Picking, pinching, or otherwise working with the fingers primarily (rather than with the whole hand or arms as in handling).
  • Repetitive Motions:  Substantial movements (motions) of the wrist, hands, and/or fingers.
  • Feeling:  Perceiving such attributes of objects and materials as size, shape, temperature, or texture by means of receptors in the skin, particularly those of the fingertips.
  • Speaking: Expressing or exchanging ideas by means of the spoken word.  Those activities in which they must convey detailed or important spoken instructions to other workers accurately, loudly, or quickly.
  • Seeing:  Obtaining impressions through the eyes of the shape, size, distance, motion, color or other characteristics of objects.
  • Acuity, far - clarity of vision at 20 feet or more.
  • Acuity, near - clarity of vision at 20 inches or less.
  • Depth perception - ability to judge distance and space relationships so as to see objects where and as they actually are.
  • Field of vision - area seen up and down or to the right or left while eyes are fixed.
  • Accommodations - adjustment of the lens of the eye to bring an object into sharp focus.
  • Color vision- the ability to identify and distinguish colors.

WORKING CONDITIONS

• Inside:  Worker spends approximately 75% or more of time inside.
• Wet:  Contact with water or other liquids.
• Noise and Vibration:  Sufficient noise, either constant or intermittent to cause marked distraction or possible injury to the sense of hearing and /or sufficient vibration (production of an oscillating movement or strain on the body or its extremities from repeated motion or shock) to cause bodily harm if endured day after day.
• Hazards:  Situations in which the individual is exposed to the definite risk of the bodily injury.
• Odor:  Noxious smells, either toxic dust, fumes, gases, vapors, mists or liquids which cause general or localized disabling conditions as a result of inhalation or action to the skin.
• Infectious Disease:  Risk of exposure to biohazardous materials, blood, body fluid contamination.

Education and Certification/Registration required for the Position: Current LPN license in the State of Missouri; BLS required.  

Required Knowledge: Knowledge of nursing skills; venipuncture; patient triage; pharmaceuticals; operation of equipment; insurance company requirements.  Knowledge of insurance contracts, CPT, and ICD-10 coding.

Required Skills and Ability: Good communication skills; ability to multi-task; ability to act independently.