Licensed Vocational Nurse I/II - Relief

Posting number: 202600114

Department: HHSA - Behavioral Health

Job classification: LICENSED VOCATIONAL NURSE II

Posting type: External - Open

Categories: Mental Health

SummaryUnder general supervision, and in accordance with physicians’, clinicians’, and registered nurses’ instruction, performs nursing duties in the care and treatment of patients according to established standards and practices in an inpatient, outpatient clinic, public health, home health, hospice or mental health setting; performs related duties as assigned. 
 
SUPERVISION RECEIVED AND EXERCISED
 
Receives general supervision from assigned supervisory staff.  Receives lead direction from a physician, clinician or registered nurse. Exercises no supervision of staff.  May provide training to students and interns.

CLASS CHARACTERISTICS
 
Licensed Vocational Nurse (LVN) I: This is the entry-level class in this series. Initially under supervision, incumbents learn and perform a variety of duties in various settings.  As experience is gained, assignments become more varied, complex, and difficult and close supervision and frequent review of work lessen as an incumbent demonstrates skill to perform the work independently.  Positions at this level usually perform most of the duties required of the positions at the II level, but are not expected to function at the same skill level and usually exercise less independent discretion and judgment in matters related to work procedures and methods.  
            
Licensed Vocational Nurse (LVN) II: This is the fully competent-level class in this series.  Under general supervision, incumbents perform the full range of assigned duties. Incumbents have typically developed expertise in a specified area of vocational nursing and may provide leadership and limited supervision of lower-level staff.  This class is distinguished from other nursing classifications in that the latter require certification as a Registered Nurse with the State of California, and provides lead direction to other health care team members, with responsibility for consulting with the other team members and formulating the nursing care plan. In addition, the Registered Nurse has acquired a body of knowledge that enables greater independent judgment and manages a wider variety of nursing care situations. 
 
The positions in the LVN class series are flexibly staffed and positions at the II level are normally filled by advancement from the I level requiring two (2) additional years of experience and after gaining the knowledge, skill, and experience which meet the qualifications for and after demonstrating the ability to perform the work of the higher-level class. Examples of duties(Illustrative Only)
Management reserves the right to add, modify, change, or rescind the work assignments of different positions and to make reasonable accommodations so that qualified employees can perform the essential functions of the job.
 
 
 
When performing all assignments:

• Assesses and monitors patient’s condition; obtains patient histories, and records and conveys information to the physician and other professional and para-professional staff.
• Attends and participates in meetings as scheduled to discuss assignments, patient treatment plans, and changes in conditions; attends in-service and continuing education programs.
• Coordinates medication refills per Medical Doctors’ orders and refill requests from pharmacies.
• Charts, interprets and executes oral and written orders received from physicians; maintains nursing notes of changes in orders and patient progress, condition and response to medications.
• Assists physicians in a variety of examination and treatment procedures as required.
• Administers oral medications and intramuscular and subcutanous injections; may administer intravenous injections.
• Discusses medication effects with patients; assesses response to medications including adverse effects;  effectiveness, etc.
• Performs various clerical tasks as required, including preparing records and reports, entering computer data, copying and filing documents, attending meetings, answering the telephone, ordering supplies and equipment, stocks and inventories; processes patient admissions, status changes and discharges, completing required documentation.
• Operates and assists in testing and maintaining unit equipment; prepares equipment, instruments and supplies for use in treatments, procedures, etc., as directed.
• Cleans and maintains patient, treatment, work and storage areas; changes soiled linens and clothing.
• Assesses patients’ hygiene, feeding and toileting activities, and provides for the comfort of patients as needed.
• Follows safety regulations and takes necessary steps to ensure patient and staff safety.
• May serve as team leader for less experienced staff; provides training and orientation as requested.
• Provides patient and family health/medical instruction and/or counseling as appropriate or directed; schedules appointments and follow-up visits as necessary; contacts community agencies to provide additional care as appropriate.
• Assesses need for and provides coordinated care between primary care physician, specialists and Agency services.
• Remains on call as scheduled.
• Performs other related duties as assigned.

 
 When performing assignments in a public health setting:

• Initiates and/or responds to cardiac and respiratory arrest alerts, administering first aid and nursing care until the arrival of a physician.
• Removes, cleanses, medicates and re-bandages sterile wound dressings.
• Measures and charts vital signs, including blood pressure, pulse, temperature, height and weight, etc., in preparation for examination by physician; measures and charts solid and fluid intake/output.
• Administers enemas and checks patients for stool impactions.
• Inserts, cleanses and changes urinary catheters and colostomy bags.
• Obtains specimens for laboratory analysis.

 
When performing assignments in a mental health setting: 

• Conducts intake interviews of new patients; records emotional health and family history and reasons for referral; determines whether possible admissions are appropriate and refers clients to community agencies or emergency facilities, as necessary. 
• Responds to crisis telephone calls and/or emergency situations by advising, counseling, referring and/or recommending to inpatient or other outpatient crisis/stabilization units; provides crisis referral and intervention. 
• Participates in groups and assists in mental health rehabilitation services for patients on an as needed basis; listens to and converses with patients; encourages patient participation in recreational and other group activities; accompanies patients to designated areas of the facility or to recreational areas away from the treatment facility. 
• Maintain coordination with other treatment providers both within and external to the agency to develop coordinated care planning and whole health care.
• Provide field services and assessment as assigned.
• Reviews lab reports and refers to psychiatrist related to anomalies.

QualificationsKnowledge of:

Licensed Vocational Nurse I:    

• Applicable state and federal laws, regulations and guidelines.
• Principles and practices of licensed vocational nursing.
• First Aid care and treatment.
• Patient hygiene and bedside care.
• Medical terminology.
• Methods, materials, tools and equipment commonly used in a healthcare setting.
• Aseptic techniques and infection control in a healthcare setting and in-patient treatment and care.
• Methods of medical case recording and report preparation.
• Community resources.
• Basic mathematics.
• Modern office practices, methods, and computer equipment and applications related to the work.
• English usage, grammar, spelling, vocabulary, and punctuation. 
• Techniques for providing a high level of customer service by effectively dealing with the public, vendors, contractors, and County staff.

 
Licensed Vocational Nurse II: In addition to the above:

• Operation and maintenance of specialized nursing equipment.
• Policies and procedures specific to the nursing area assigned.

 
and, when performing mental health assignments:

• Applicable federal, state, and local laws, codes, regulations and guidelines governing treatment of involuntary patients including Welfare and Institution Code Section 5328, Code of Federal Regulation Title 42, Health Insurance Portability and Accountability Act (HIPAA) and Code of Conduct requirements related to specific licensing board regulations.
• Principles and practices used in caring for the mentally ill and emotionally disturbed patients.
• Principles and practices of individual and group counseling. 
• Effects and possible side effects of the major psychoactive drugs. 
• Methods and techniques of physical and chemical restraints.

 
Ability to:
 
Licensed Vocational Nurse I:

• Perform procedures and techniques in hospital, clinic or home environment as permitted by vocational nursing certification.
• Recognize critical and significant mental status/physical health changes in patients.
• Administer medications prescribed by physicians.
• Learn to safely and skillfully operate a wide variety of hospital equipment.
• Understand and follow written and oral instructions of a technical nature.
• Work cooperatively as a team member.
• Keep accurate records.
• Follow established policies, procedures, protocols and standards, including safety regulations.
• Operate modern office equipment including computer equipment and specialized software applications programs.
• Use English effectively to communicate in person, over the telephone, and in writing.
• Use tact, initiative, prudence, and independent judgment within general policy and legal guidelines.
• Establish, maintain, and foster positive and effective working relationships with those contacted in the course of work.

 
Licensed Vocational Nurse II: In addition to the above:

• Provide specialized vocational nursing services related to the job assignment.
• Operate and maintain specialized nursing equipment.
• Assist in training and supervising the work of lower-level nursing and support staff.
• Use tact, initiative, prudence, and independent judgment within general policy and legal guidelines.

  
Education and Experience:
Any combination of training and experience that would provide the required knowledge, skills, and abilities is qualifying.  A typical way to obtain the required qualifications would be

Completion of an accredited program of training as a Licensed Vocational Nurse, and;
 
Licensed Vocational Nurse I:
Six (6) months of recent, full-time experience as a Licensed Vocational Nurse in an acute care unit or mental health inpatient or outpatient clinic setting.
 
Licensed Vocational Nurse II: 
Three (3) years of responsible vocational nursing experience; or two (2) years as a Licensed Vocational Nurse I in Tuolumne County.  
 
Licenses and Certifications:

• Possession of, or ability to obtain, a valid California Driver’s License by time of appointment.
• Depending upon area of assignment, requires possession of current, valid license as a Vocational Nurse or license as a Psychiatric Technician, issued by the California State Board of Vocational Nurse or Psychiatric Technician Examiners. 
• Specialty training and certification in a specific function of the unit to which assigned may be required, including CPR, CCU and IV certifications.