Psychiatric Nurse Practitioner - 08032023-48759

Job Information

LOCATION OF (1) POSITION(S) TO BE FILLED: DEPARTMENT OF MENTAL HEALTH & SUBSTANCE ABUSE SERVICES, MIDDLE TENNESSEE MENTAL HEALTH INSTITUTE DIVISION, DAVIDSON COUNTY

NOTICE: This position requires a criminal background check. Therefore, you may be required to provide information about your criminal history in order to be considered for this position.

Qualifications

Education and Experience: Licensed by the State of Tennessee as a Registered Nurse with Advanced Practice certification and certificate of fitness, as well as current American Nursing Credentialing Center (ANCC) certification in a psychiatric/mental health specialty area.

OR

Education and Experience: Licensed by the State of Tennessee as a Registered Nurse with Advanced Practice certification and certificate of fitness and experience equivalent to at least two years of full-time work as a licensed nurse practitioner providing inpatient or outpatient psychiatric care in private practice or in a community mental health, psychiatric hospital, or similar setting.

Necessary Special Qualifications: Licensed or eligible for licensure by the State of Tennessee as a Registered Nurse with Advanced Practice certification and certificate of fitness, as well as current American Nursing Credentialing Center (ANCC) certification in specialty area. If assigned responsibility of conducting forensic evaluations, completion of Forensic Certification Training is also required. Licensure as a Registered Nurse with Advanced Practice Nurse certificate in the State of Tennessee and national certification in the appropriate nursing specialty area are required within 60 days after employment. Completion of Forensic Certification Training is required within 60 days of assignment.

Examination Method: Education and Experience, 100%, for Preferred Service positions.

Summary

Summary: Under direction, is responsible for psychiatric nurse practitioner duties of considerable difficulty; and performs related work as required.

Distinguishing Features: An employee in this class functions as a psychiatric nurse practitioner with responsibilities involving the assessment, examination, diagnosis, and treatment of patients in a state psychiatric hospital. This includes determining diagnosis and plan of care for patients with psychiatric disorders, medical organic brain disorders, or substance abuse problems; monitoring health status, efficacy of care, safety issues, and responses to treatments to ensure patients' progress; prescribing psychotherapy, psychotropic medications and other medications or treatments in accordance with accepted protocols and regulatory authorities; and various other psychiatric nurse practitioner duties. This class differs from Nurse Practitioner in that an incumbent of the latter primarily functions as clinical nurse practitioner in a specialty area providing assessment, diagnosis, and nursing/medical care for patients and families.

Responsibilities

Making Decisions and Solving Problems:

• Evaluates patient's progress based on observations, patient/family communications, re-examination, and review of progress notes to determine any needed changes in plan of care.
• May conduct forensic evaluations to assist in determining patients' competency to stand trial.,
• Analyzes and interprets patients' histories, symptoms, physical and psychosocial findings, and/or diagnostic information to determine diagnosis and plan of care for patients with psychiatric disorders, medical organic brain disorders, or substance abuse problems.

This privilege is subject to completion of Forensic Certification Training.

Analyzing Data or Information:

• Analyzes/interprets findings from physical/psychological examination, laboratory reports, and other diagnostic testing (e.g., psychological tests, blood counts, electrocardiograms, radiographs or other laboratory or diagnostic test results).

Monitor Processes, Materials, or Surroundings:

• Monitors health status, efficacy of care, safety issues, and responses to treatments to ensure patients' progress.

Getting Information:

• Reviews patient history from medical records including lab results, prior medications, past medical and family history, and prior hospitalizations.
• Talks with patients or others to determine the reason for hospitalization, or the patient's chief complaints.
• Performs physical/mental status examinations to gather information needed to determine treatment and care needs.
• Orders or obtains appropriate diagnostic tests to obtain any information needed to determine patient treatment and care needs.

Assisting and Caring for Others:

• Prescribes psychotropic and other medication dosages, routes, and frequencies based on patients' diagnoses and condition and in accordance with accepted protocols and regulatory authorities.
• Responds to medical/psychiatric emergencies by performing cardiopulmonary resuscitation, basic life support, or other needed emergency care.
• Orders diets, privileges, therapeutic furloughs, and other activities and treatments based on patients' diagnoses/condition, and in accordance with accepted protocols.
• Monitors patients for adverse drug reactions and side effects.
• Prescribes psychotherapy for patients based on diagnosis and in accordance with Best Practices Guidelines and Nurse Practitioner protocols.
• Provides psychosocial counseling to help patients with depression, anxiety, and other conditions.
• Completes the Ambulatory Involuntary Movement Scale (AIMS) evaluation by completing checklist and using a 5-point rating scale for recording scores for movement in face, lips, jaw, tongue, upper extremities, lower extremities, and trunk.
• Orders, implements, and modifies or discontinues the seclusion, restraint, and special precautions or observations of patients.
• Teaches families about patients' diagnosis, treatment, expected outcomes, and follow-up care.

Documenting/Recording Information:

• Prepares discharge notes, incorporating the physical findings, laboratory reports, and the patient's course in the hospital, as well as the instructions given to the patient regarding diet, medication, physical activity, and follow-up care.
• Completes patients' discharge orders and associated paperwork, including discharge and aftercare plan.
• Documents psychiatric evaluations/assessments, treatment plans, progress notes, and miscellaneous chart notes by legibly writing patient information consistent with standard of care and which meets utilization review criteria and other applicable standards/requirements.

Thinking Creatively:

• Devises evidence-based treatment strategies to meet needs of patients.
• Develops treatment plans based on scientific rationale, standards of care, and professional practice guidelines.

Selling or Influencing Others:

• Discusses psychiatric diagnosis, medication/treatment, and follow-up care with patients to ensure their cooperation, understanding, and continuing treatment.

Resolving Conflicts and Negotiating with Others:

• Discusses issues in dispute with the parties involved (e.g., family members, patients, co-workers) to facilitate a resolution or negotiate a compromise solution.

Coordinating the Work and Activities of Others:

• Assumes leadership of patient treatment teams as necessary to coordinate patient care.

Communicating with Supervisors, Peers, or Subordinates:

• Collaborates with consulting physician about patients' plan of care.
• Communicates with supervisor or co-workers about policies, procedures, and operations.
• Communicates with supervisor or co-workers about patient care, condition and treatments.

Updating and Using Relevant Knowledge:

• Obtains continuing education units to satisfy licensure and certifications requirements and to ensure optimal patient care.
• Attends mandatory training and meetings per hospital and/or agency requirements.

Interpreting the Meaning of Information for Others:

• Explains information to patient and/or family members or guardians about psychiatric and medical conditions and plan of care, prescribed medications and side effects, diet, exercise/activity, discharge planning, and follow-up care.
• Explains information about a patient's psychiatric and medical condition to other treatment providers involved in that patient's care.

Evaluating Information to Determine Compliance with Standards:

• Reviews patient charts for protocol, standards of care, and compliance with agency and outside accrediting/licensing organizations' guidelines.

Organizing, Planning, and Prioritizing Work:

• On a daily basis, reviews lists of patients in assigned unit to organize and prioritize the patients' plans of care and associated work activities.

Performing Administrative Activities:

• Securely maintains medical records in accordance with agency directives and state and federal law.

Establishing and Maintaining Interpersonal Relationships:

• Establishes and maintains relationships necessary to deliver quality patient care across the spectrum of care.

Communicating with Persons Outside Organization:

• Makes referrals to and collaborates with specialty care personnel as appropriate.
• Educates and collaborates with the public on health care concerns.
• Provides verbal or written responses to requests for information, including consumer complaints and requests for data or other documentation.

Provide Consultation and Advice to Others:

• Participates in staff meetings to provide professional opinion for process improvement.
• Provides consultation and advice to colleagues across the spectrum of care.
• Participates in treatment review committees (TRC) to provide recommendations for treatment of patients who are not competent to provide consent.

Coaching and Developing Others:

• Acts as a preceptor to students in medical, nursing, pharmacy or nurse practitioner programs by serving as a role model and providing support, counseling, coaching, and feedback to aid in the student's socialization and transition to new professional role.
• Provides guidance and instruction to other hospital staff to maintain best practices.
• Conducts orientation for new advanced practice nursing staff.

Interacting With Computers:

• Uses office productivity software, such as word processing, spreadsheet, or email programs, to process information, create documents, and communicate with others.

Competencies

Competencies:

• Strategic Agility
• Approachability
• Intellectual Horsepower
• Ethics and Values
• Timely Decision Making
• Process Management
• Action Oriented
• Decision Quality
• Composure
• Understanding Others
• Command Skills
• Organizing
• Total Work Systems
• Conflict Management
• Self Development

Knowledge:

• Intermediate knowledge of organisms, their tissues, cells, functions, interdependencies, and interactions with each other and the environment
• Basic knowledge of emergency preparedness and response procedures for the protection of people, data, property, and institutions
• Basic knowledge of computer systems such as word processing, email systems, and other production software applications
• Advanced knowledge of principles, methods, and procedures for diagnosis, treatment, and rehabilitation of physical and mental dysfunctions, including counseling and guidance
• Advanced knowledge of the information and techniques needed to diagnose and treat human injuries, diseases, and deformities, including symptoms, treatment alternatives, drug properties and interactions, and preventive health-care measures
• Advanced knowledge of principles and methods for teaching and instruction for individuals and groups, and the measurement of training effects
• Advanced knowledge of principles and processes for providing customer and personal services, including customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction
• Advanced knowledge of psychotropic and other medications, such as drug classifications, dosing, interactions, abbreviations, drug regimens, calculations, brand and generic equivalencies, and formulary status
• Advanced knowledge of human behavior and performance; individual differences in ability, personality, and interests; learning and motivation; psychological research methods; evidence based practices, and the assessment and treatment of behavioral and affective disorders
• Intermediate knowledge of psychiatric and medical conditions impacted by diet (e.g., obesity, diabetes, hypertension, cardiovascular, gastrointestinal disorders), food and medication interactions; impact of psychotropic medications, and other conditions (e.g., dysphagia, renal diseases, multisystem organ failure, cancer, hepatic disease) which may require preventive health-care measures specific to the mental health population
• Intermediate knowledge of the chemical composition, structure, and properties of substances and of the chemical processes and transformations that they undergo, including uses of chemicals and their interactions, danger signs, production techniques, and disposal methods
• Advanced knowledge of different philosophical systems and religions, including their basic principles, values, ethics, ways of thinking, customs, practices, and their impact on human culture
• Advanced knowledge of laws, legal codes, precedents, government regulations, executive orders, and agency rules relevant to the mental health population
• Intermediate knowledge of group behavior and dynamics, societal trends and influences, human migrations, ethnicity, cultures and their history and origins

Skills:

• Advanced skill in understanding the implications of new information for both current and future problem-solving and decision-making
• Intermediate skill in managing one's own time and the time of others
• Intermediate skill in bringing others together and trying to reconcile differences
• Basic skill in using mathematics to solve problems
• Advanced skill in being aware of the reactions and behaviors of the mental health population understanding why they react/behave as they do
• Advanced skill in giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times
• Advanced skill in using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems
• Advanced skill in considering the relative costs and benefits of potential actions to choose the most appropriate one
• Intermediate skill in adjusting actions in relation to others' actions
• Advanced skill in communicating effectively in writing as appropriate for the needs of the audience
• Advanced skill in using scientific rules and methods to solve problems
• Intermediate skill in teaching others how to do something
• Intermediate skill in persuading others to change their minds or behavior
• Advanced skill in monitoring/assessing patients' mental health status to make improvements or take corrective action
• Advanced skill in talking to others to convey information effectively
• Advanced skill in understanding written sentences and paragraphs in work related documents
• Skill in identifying complex problems and reviewing related information to develop and evaluate options and implement solutions
• Intermediate skill in evaluating processes for quality, performance, and/or compliance requirements

Abilities:

• Advanced ability to listen to and understand information and ideas presented through spoken words and sentences
• Ability to generate or use different sets of rules for combining or grouping things in different ways
• Ability to apply general rules to specific problems to produce answers that make sense
• Ability to concentrate on a task over a period of time without being distracted
• Ability to combine pieces of information to form general rules or conclusions (includes finding a relationship among seemingly unrelated events)
• Ability to focus on a single source of sound in the presence of other distracting sounds
• Ability to see details at close range (within a few feet)
• Advanced ability to communicate information and ideas in speaking so others will understand
• Ability to tell when something is wrong or is likely to go wrong (does not involve solving the problem, only recognizing there is a problem)
• Ability to respond timely to an alarm or other emergency situation requiring immediate action
• Ability to speak clearly so others can understand
• Advanced ability to communicate information and ideas in writing so others will understand
• Ability to arrange things or actions in a certain order or pattern according to a specific rule or set of rules (e.g., patterns of numbers, letters, words, pictures, mathematical operations)
• Ability to add, subtract, multiply, or divide quickly and correctly
• Ability to identify and understand the speech of another person
• Advanced ability to read and understand information and ideas presented in writing
• Ability to shift back and forth between two or more activities or sources of information (such as speech, sounds, touch, or other sources)

Tools & Equipment

• Printers, copiers, and other office equipment
• Computer
• Various medical equipment and devices

TN Driver Standards

State of Tennessee positions that may involve driving responsibilities require candidates to meet the following minimum driver qualifications:

• A valid driver's license
• For the past five years, the candidate's driver record must not have record of the following violations: driving under the influence (DUI), reckless driving, license suspension for moving violations, more than 4 moving violations.

Please include your Driver's License Information under the Licenses and Certifications section of your application.

**Agencies may allow an exception based on other factors.