LICENSED PRACTICAL NURSE at Bethany Children s Home – Womelsdorf, Pennsylvania

BETHANY CHILDREN’S HOME

Program and Position Summary

PROGRAM SUMMARY

Bethany Children’s Home provides individualized services to youth between the ages of 6 and 20 in a residential home setting on our beautiful rural campus located in Womelsdorf. Youth have opportunities to participate in a variety of therapeutic, spiritual, recreational and cultural services while they heal from past traumas.

EXPECTED STANDARDS FOR ALL BETHANY TEAM MEMBERS

All Bethany Team Members must be at least 21 years of age with a high school diploma or equivalent and be prepared to meet the diverse needs, level of care, supervision, safety, and wellbeing of youth in Bethany’s service. All Team Members share in the responsibility of upholding Department of Human Services Regulations and Bethany program expectations including:

a. Adhering to all policies and procedures.

b. Performing all expected work responsibilities in a safe manner.

c. Treating all children, families and Team Members with respect and courtesy.

d. Completing and maintaining all mandated and required training within required agency timeframes.

e. Maintaining timely compliance with all established agency standards and employment documentation.

f. Acting in compliance with Department of Human Services regulations to the highest degree of ethical standards.

g. Maintaining a clean, safe and functional working environment.

h. Providing services in a manner that are sensitive to the age, culture, religion, dietary needs, sexual orientation, gender identity and other important individual needs of those in our service.

i. Ensuring proper physical care is provided to those in our service.

j. Ensuring new clothing and personal grooming items are provided.

k. Implementing strategies to discourage runaways and unauthorized absences.

l. Informing all youth of his/her rights and ensuring that those rights are obtained.

m. Carrying out the program’s rules and conduct standards with a positive, strength-based behavior management approach.

n. Providing transportation to and from campus appointments.

o. Performing additional duties as assigned by supervisor or administrator per operational needs.

ELEMENTS OF PERFORMANCE

Bethany programs serve an at-risk population referred by county Children and Youth Services or Juvenile Probation. Children and youth served may have experienced trauma, abuse, neglect, exposure to addictive substances and trafficking. Team Members, as a collective whole, are expected to have working knowledge of how to address such individuals directly and assist them through treatment, or refer them to someone who is qualified. Team Members are expected to have the knowledge and skills to recognize, treat or refer to appropriate professionals the following:

• Abide by mandated reporting requirements.

• Systematically gather data, determine the readiness of an individual for treatment and change, apply accepted criteria for the diagnosis of substance use disorder or other detrimental addictions or behaviors.

• Recognize when a youth is under the influence of a psychoactive substance, intoxicated, and/or experiencing withdrawal symptoms.

• Monitor for danger to self or others.

• Document mental health concerns.

• Analyze and interpret data to determine treatment recommendations and priorities.

• Form mutually agreed-upon, measurable goals and objectives with the individual being served.

• Demonstrate and adhere to the accepted ethical and behavioral standard of conduct.

• Participate in continuing professional development.

MINIMUM QUALIFICATIONS FOR ALL BETHANY TEAM MEMBERS

• Be 21 years of age or older.

• Be fluent in the language(s) spoken by a majority of the youth in care.

• Have acceptable written and verbal communication skills.

• Have acceptable organizational and computer skills.

• Demonstrate acceptable interpersonal and problem-solving skills.

• Possess a strong commitment to helping youth succeed by helping them reorient their lives, nurture their reunification efforts and enable them to make a successful transition to their next placement.

• Possess ability to establish rapport and relate sensitively with consistency to multiracial and multicultural groups of young adults.

• Demonstrate the ability to organize and prioritize duties and responsibilities efficiently.

• Possess a valid Pennsylvania Driver’s License with a clear 3-year driving history.

• Successfully pass a pre-employment drug screen and background check.

• Submit to a health assessment demonstrating fitness for duty, certified by a physician no more than 30 days prior to commencing employment and comply with a two-year renewal.

• Provide current PA Child Abuse, PA Criminal History and FBI Fingerprinting clearances prior to commencing employment and comply with a two-year renewal.

SAFETY HAZARDS OF THE JOB

• Potential for possible exposure to bloodborne pathogens – universal precautions are to be utilized in all potential exposure situations.

• Potential for emotional stress and vicarious trauma as it relates to working with children and youth.

• Potential for personal injury that may include, but not limited to, bites, kicks, punches and scratches.

HIPAA /CONFIDENTIALITY

As an employee, Bethany Team Members must agree to follow the standards set forth by the Health Information Portability and Accounting Act (HIPAA) as well as the heightened Pennsylvania standards as they apply. Due to the nature of the work environment, Team Members will have direct and/or indirect access to confidential information regarding clients and/or personnel. All confidential information cannot be discussed with, or disclosed to, unauthorized persons.

EMPLOYER'S RIGHTS

The program summary and position description do not list every aspect of program requirements or all duties of all job positions. All Team Members are employees of Bethany Children’s Home—not necessarily to a specific department or program, with the exception of those roles requiring specific credentials to be in compliance with regulations and treatment services. Team Members may be asked by Bethany to perform other duties within those expectations in times of emergency, crisis or busier times based on operational needs in order to safely care for youth. Performance evaluations, in part, will be based upon performance of the tasks and essential functions listed in the position description.

Bethany has the right to revise the program summary and position description at any time. The position description is not a contract for employment. That is, employment with Bethany can be terminated with or without cause, and with or without notice at any time, at the discretion of the employee or that of Bethany.

POSITION DESCRIPTION

Position Title: Licensed Practical Nurse

Classification: Regular, Full-Time, Hourly Non-Exempt

Reports To: Medical Coordinator

Supervises: N/A

Essential Staff? Yes. Essential staff must remain on duty to supervise youth and ensure safe campus operations in the event of call-offs, late arrivals, crises or inclement weather.

POSITION SUMMARY

The Licensed Practical Nurse (“LPN”) assists with all clinical (within scope of practice) and administrative duties as needed to arrange for medical, dental, vision, and mental health services, complete clinic work, and ensure the overall wellbeing of youth.

PRIMARY RESPONSIBILITIES

• Operates within the medical scope of practice in compliance with Pennsylvania licensing requirements and to the highest degree of ethical standards.

• Maintain health clinic sick area for youth when home sick from school or in need of medical quarantine from others. Notify treatment team and school when youth are home sick.

• Collaborates with other health clinic Team Members to provide appropriate clinical interventions and treatment.

• Orders necessary prescriptions and medications from the pharmacy, prepares medication orders for cottage residents.

• Inventories and orders clinic and office supplies.

• Arranges, schedules and confirms medical, dental and mental health appointments.

• Coordinates routine and emergency care.

• Performs administrative duties relative to client’s medical records.

• Administers medications.

• Receives and reroutes messages or documents, such as laboratory results, to appropriate Team Members.

REQUIRED COMPETENCIES

• Certification required: Graduate of an accredited school of nursing and current Pennsylvania Licensed Practical Nurse (LPN), license in good standing required.

• Minimum of one year mental health, pediatric, adolescent or physical health nursing experience preferred.

• Performs primarily light work in a climate-controlled office environment.

• Must be able to perform the physical requirements of the position:

o Remain in a stationary, seated position more than 50% of the time.

o Occasionally perform light work by lifting, carrying, pushing, pulling up to 20 pounds without assistance.

o Move about on foot to complete tasks and move from one location to another.

o Stoop, kneel, crouch, reach, climb stairs, and stand regularly.

o Have close visual acuity to prepare and analyze figures and data, to view a computer monitor and operate typical office equipment.

o Have manual dexterity to grasp and manipulate objects.

o Be subjected to occasional noise that would cause one to shout in order to be heard above ambient noise level.

o Be able to respond to a crisis situation and participate in physical interventions and tolerate prolonged periods of physical exertion which may include exhaustion.

• Demonstrates a commitment to achieving a standard of excellence with procedures and outcomes.

• Communicates effectively by balancing listening and talking, speaking and writing clearly and influencing others.

• Demonstrates excellent teamwork skills by being helpful, accountable, respectful and approachable.

SCOPE OF PRACTICE

LICENSED PRACTICAL NURSE

49 Pa. Code § 21.145

Functions of the LPN

a. The LPN is prepared to function as a member of the health-care team by exercising sound nursing judgment based on preparation, knowledge, experience in nursing and competency. The LPN participates in the planning, implementation and evaluation of nursing care using focused assessment in settings where nursing takes place.

1) An LPN shall communicate with a licensed professional nurse and the patient’s health care team members to seek guidance when:

i) The patient’s care needs exceed the licensed practical nursing scope of practice.

ii) The patient’s care needs surpass the LPN’s knowledge, skill or ability.

iii) The patient’s condition deteriorates or there is a significant change in condition, the patient is not responding to therapy, the patient becomes unstable or the patient needs immediate assistance.

2) An LPN shall obtain instruction and supervision if implementing new or unfamiliar nursing practices or procedures.

3) An LPN shall follow the written, established policies and procedures of the facility that are consistent with the act.

b. The LPN administers medication and carries out the therapeutic treatment ordered for the patient in accordance with the following:

1) The LPN may accept a written order for medication and therapeutic treatment from a practitioner authorized by law and by facility policy to issue orders for medical and therapeutic measures.

2) The LPN may accept an oral order if the following conditions are met:

i) The practitioner issuing the oral order is authorized by law and by facility policy to issue oral orders for medical and therapeutic measures.

ii) The LPN has received instruction and training in accepting an oral order in an approved nursing education program or has received instruction and training in accepting an oral order in accordance with the established policies and protocols of the facility.

iii) The policy of the facility permits an LPN to accept an oral order.

iv) The regulations governing the facility permit an LPN to accept an oral order.

3) The LPN shall question any order which is perceived as unsafe or contraindicated for the patient or which is not clear and shall raise the issue with the ordering practitioner. If the ordering practitioner is not available, the LPN shall raise the issue with a registered nurse or other responsible person in a manner consistent with the protocols or policies of the facility.

4) The LPN may not accept an oral order which is not within the scope of functions permitted by this section or which the LPN does not understand.

5) An oral order accepted by the LPN shall be immediately transcribed by the LPN in the proper place on the medical record of the patient. The transcription shall include the prescriber’s name, the date, the time of acceptance of the oral order and the full signature of the LPN accepting the oral order. The countersignature of the ordering practitioner shall be obtained in accordance with applicable regulations of the Department of Health governing the licensed facility.

c. The LPN participates in the development, revision and implementation of policies and procedures designed to insure comfort and safety of patients in collaboration with other health care personnel.

d. The Board recognizes codes of behavior as developed by appropriate practical nursing associations as the criteria for assuring safe and effective practice.

e. The LPN may administer immunizing agents and do skin testing only if the following conditions are met:

1) The LPN has received and satisfactorily completed a Board approved educational program which requires study and supervised clinical practice intended to provide training necessary for administering immunizing agents and for performing skin testings.

2) A written order has been issued by a licensed physician pertaining to an individual patient or group of patients.

3) Written policies and procedures under which the LPN may administer immunizing agents and do skin testing have been established by a committee representing the nurses, the physicians and the administration of the agency or institution employing or having jurisdiction over the LPN. A current copy of the policies and procedures shall be provided to the LPN at least once every 12 months. The policies and procedures shall provide for:

i) Identification of the immunizing and skin testing agents which the LPN may administer.

ii) Determination of contraindications for the administration of specific immunizing and skin testing agents.

iii) The listing, identification, description and explanation of principles, including technical and clinical indications, necessary for the identification and treatment of possible adverse reactions.

iv) Instruction and supervised practice required to insure competency in administering immunizing and skin testing agents.

f. An LPN may perform only the IV therapy functions for which the LPN possesses the knowledge, skill and ability to perform in a safe manner, except as limited under § 21.145a (relating to prohibited acts), and only under supervision as required under paragraph (1).

1) An LPN may initiate and maintain IV therapy only under the direction and supervision of a licensed professional nurse or health care provider authorized to issue orders for medical therapeutic or corrective measures (such as a CRNP, physician, physician assistant, podiatrist or dentist).

2) Prior to the initiation of IV therapy, an LPN shall:

i) Verify the order and identity of the patient.

ii) Identify allergies, fluid and medication compatibilities.

iii) Monitor the patient’s circulatory system and infusion site.

iv) Inspect all equipment.

v) Instruct the patient regarding the risk and complication of therapy.

3) Maintenance of IV therapy by an LPN shall include ongoing observation and focused assessment of the patient, monitoring the IV site and maintaining the equipment.

4) For a patient whose condition is determined by the LPN’s supervisor to be stable and predictable, and rapid change is not anticipated, the supervisor may supervise the LPN’s provision of IV therapy by physical presence or electronic communication. If supervision is provided by electronic communication, the LPN shall have access to assistance readily available.

5) In the following cases, an LPN may provide IV therapy only when the LPN’s supervisor is physically present in the immediate vicinity of the LPN and immediately available to intervene in the care of the patient:

i) When a patient’s condition is critical, fluctuating, unstable or unpredictable.

ii) When a patient has developed signs and symptoms of an IV catheter-related infection, venous thrombosis or central line catheter occlusion.

iii) When a patient is receiving hemodialysis.

g. An LPN who has met the education and training requirements of § 21.145b (relating to IV therapy curriculum requirements) may perform the following IV therapy functions, except as limited under § 21.145a and only under supervision as required under subsection (f):

1) Adjustment of the flow rate on IV infusions.

2) Observation and reporting of subjective and objective signs of adverse reactions to any IV administration and initiation of appropriate interventions.

3) Administration of IV fluids and medications.

4) Observation of the IV insertion site and performance of insertion site care.

5) Performance of maintenance. Maintenance includes dressing changes, IV tubing changes, and saline or heparin flushes.

6) Discontinuance of a medication or fluid infusion, including infusion devices.

7) Conversion of a continuous infusion to an intermittent infusion.

8) Insertion or removal of a peripheral short catheter.

9) Maintenance, monitoring and discontinuance of blood, blood components and plasma volume expanders.

10) Administration of solutions to maintain patency of an IV access device via direct push or bolus route.

11) Maintenance and discontinuance of IV medications and fluids given via a patient-controlled administration system.

12) Administration, maintenance and discontinuance of parenteral nutrition and fat emulsion solutions.

13) Collection of blood specimens from an IV access device.

Accountability: It is the responsibility of the LPN to operate within the scope of practice to the highest degree of ethical standards and maintain licensure.