COMMUNITY HEALTH NURSE I

DEFINITION OF CLASS:
This is entry level professional staff community health nursing work which applies the nursing process (assessment, planning, implementation, and evaluation) to provide comprehensive nursing services that incorporate health promotion and disease prevention to individuals, families and the community in homes, clinics, schools, offices and other community locations. An employee in this class serves as a member of one or more interdisciplinary teams to meet community health and social needs. Clients served are of all ages from diverse cultural backgrounds. Contacts are with clients and their families; school personnel; physicians; and other departmental, public and private health care and social service agency staff to provide nursing care, exchange work information, coordinate actions of mutual concern, and provide health education in order to improve the County population's health status. Public service/assistance is provided through lengthy and/or detailed questioning to obtain clients' significant health and social history in order to determine and provide appropriate health care services.

An employee in this class performs work under the supervision of a professional nursing supervisor who provides technical and professional guidance. The employee works with relative independence in handling routine tasks, and after initial orientation and on-the-job training, assumes progressively more independence in handling new and more difficult assignments. Work is performed in accordance with guidelines, including but not limited to the Maryland Nurse Practice Act and established departmental and program policies, procedures, practices and priorities. Work performance is reviewed and evaluated through records, reports, conferences and observation for desired results, adherence to professional standards and established policies, and contribution to the goals of the community health program. Complexity of the work is derived from the need to gather and categorize information such as client medical/social history and medical test results; ascertain their significance; and determine, implement, and monitor an appropriate health treatment plan. Work has an impact on the outcome of the health program and an effect on the health of individuals, families and the community. Important aspects of the work involve establishing a client/provider relationship in order to assist clients with health matters, identifying client health problems and collaborating with interdisciplinary team members to decrease/eliminate these health problems. The employee's work involves some unpleasantness resulting from exposure to human body fluids. Work requires some exposure to infection and contagious disease, and involves some risk resulting from visits to clients' homes, where clients or members of their households may react violently. Performance of this work involves occasional long periods standing or walking, and employees in this class occasionally lift and carry or move objects weighing up to fifty pounds; but obtain assistance when lifting or moving more than fifty pounds or applying equivalent forces.

EXAMPLES OF DUTIES: (Illustrative Only)
Provides community health nursing services in all phases of health throughout the life cycle to individuals and their families, in order to meet community health and social needs.
Provides client health supervision, counseling, guidance and teaching directed toward health promotion and maintenance, disease prevention, and alleviation of specific health problems.
Conducts health assessments of the newborn, infants, children, adolescents, adults and the elderly in order to provide for early detection of health needs and physical and mental handicapping conditions; assists individuals and families to plan and obtain appropriate health care; and develops and makes recommendations for long term care plans for clients seeking to remain independent in the community, and who are not at immediate risk for hospitalization or institutionalization.
Provides emergency nursing services/crisis intervention including such life-saving procedures as CPR.
Refers individuals and families to available health and community services and provides follow-up services.
Provides consultation, instruction and guidance to County school staff and the school community concerning specific health problems and school health programs.
Provides case management services and coordinates client care.
Conducts group education classes for clients in clinics, offices, schools and/or other community locations.
Maintains clinical records and prepares written and statistical reports.
Evaluates the effect of care on client health.
Coordinates and implements health screening programs for clients.
Serves as a member of interdisciplinary team to meet the health and social needs of individuals, families and the community.
Interprets guidelines and assists the community in implementation of Federal, State and County regulations including communicable disease control and emergency and disaster plans.
May provide guidance for health room technicians, health clinic technicians, home health aides, student interns and/or volunteers.
Prepares and maintains nursing records and reports.
Performs related duties as required.

MINIMUM QUALIFICATIONS:
Experience: None.
Education: Graduation from a National League for Nursing accredited college or university or an equivalent program as determined by the Maryland Board of Examiners with a Bachelor's Degree in nursing.
Equivalency: An equivalent combination of education and experience may be substituted.
Knowledge, Skills, and Abilities:
Knowledge of nursing and public health theories and practices required to provide community health nursing care to individuals, families and the community.
Knowledge of human growth and development throughout the life cycle.
Knowledge of selected pharmaceuticals, their desired effects, side effects, and complications which may arise from their use.
Knowledge of available community resources for referral or the ability to rapidly acquire such knowledge.
Knowledge of applicable Federal, State and County laws and regulations or the ability to rapidly acquire such knowledge.
Knowledge of demographic and data collection methods.
Skill in applying technical nursing procedures; e.g., injections, catheterization.
Skill in operating medical and nursing equipment; e.g., stethoscope, blood pressure apparatus, audiometer.
Ability to provide health counseling to clients and families with multiple health problems.
Ability to provide emergency treatment for life-threatening conditions; e.g., cardiac arrest, shock, hemorrhage.
Ability to gain the cooperation of individuals and their families.
Ability to maintain complete client records.
Ability to communicate effectively, both orally and in writing.
Ability to attend meetings or perform other assignments at locations outside the office as necessary.

LICENSE:
Possession of a current license to practice as a Registered Nurse in the State of Maryland* issued by the Maryland Board of Examiners is required at the time of appointment. If the license is temporary, a regular Maryland RN license must be obtained within ninety (90) days of appointment.
*The State of Maryland accepts as valid the current RN licensure from a candidate's primary state of residence if that state has an interstate compact with Maryland. The states having this interstate compact are Arizona, Arkansas, Delaware, Idaho, Iowa, Maine, Mississippi, Nebraska, New Mexico, North Carolina, North Dakota, South Dakota, Tennessee, Texas, Utah, Virginia, and Wisconsin. (This equivalency only applies to candidates whose primary residence is not Maryland).

PROBATIONARY PERIOD:
Individuals appointed or promoted to a bargaining unit position in this class will be required to serve a probationary period of six months. Individuals appointed to a non-bargaining unit position in this class will be required to serve a probationary period of twelve months, or if promoted to a non-bargaining unit position, will be required to serve a probationary period of six months. Performance will be carefully evaluated during the probationary period. Continuation in this class will be contingent upon successful completion of the probationary period.

MEDICAL PROTOCOL: Limited Core Exam

Class Established: July 1975
Revised: May 1985
May 1993 (M)
April, 2002(M)
November, 2005