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RN Behavioral Decision Unit-PRN

Company: Christus Health
Location: Alexandria
Posted on: July 13, 2019

Job Description:


The Behavioral Health RN plans, implements, evaluates and documents nursing care in accordance with facility and departmental policies and in accordance with standards of professional nursing practice. This position is accountable for the quality of nursing services delivered by self or others under his/her direction.


Action Oriented -- Taking on new opportunities and tough challenges with a sense of urgency, high energy and enthusiasm.

Collaborate -- Building partnerships and working collaboratively with others to meet shared objectives.

Customer Focus -- Building strong customer relationships and delivering customer-centric solutions.

Nimble Learning -- Actively learning through experimentation when tackling new problems, using both successes and failures as learning fodder.

Demonstrates Self-Awareness -- Using a combination of feedback and reflection to gain productive insight into personal strengths and weaknesses.

Communicates Effectively -- Developing and delivering multi-mode communications that convey a clear understanding of the unique needs of different audiences.

Decision Quality -- Making good and timely decisions that keep the organization moving forward.


Standard I. Associate demonstrates competence in the performance of duties and responsibilities related to the application of CHRISTUS St. Frances Cabrini Hospital's Core Values:

Dignity/IntegrityMaintains confidentiality of information as required
Conducts and presents self in a professional manner
Respects the culture and ethnic heritage of others
Demonstrates honesty consistently in all relationships
Follows the CHRISTUS Health Guidelines related to the Health Insurance Portability & Accountability Act (HIPAA)

ExcellenceAccepts constructive criticism and modifies actions accordingly
Seeks opportunity for professional and personal growth
Actively seeks ways to improve level of performance/service

StewardshipFlexible and adaptive to changes in work processes and functions
Supports department objectives and the Strategic Plan of the hospital
Uses resources/assets in a cost-effective manner
Notifies appropriate personnel of facility's needs/issues

CompassionAssists others in completing tasks/duties effectively
Responds to needs/requests of others in a caring and timely manner
Open to different ideas and alternatives to solutions

Standard II. Utilizes the Nursing Process:

Uses critical thinking skills to assess the basic physical, psychosocial, social, cultural, spiritual and development needs of patients/families.
Communicates findings to appropriate healthcare team membersCollects data from all applicable resources; organizes assessment data so that it is complete and accessible; legibly documents in the medical record or other appropriate system.
Recognizes alterations in patients' health status; anticipates onset of patient care crisis situation and communicates findings appropriately
Assesses, reassesses and manages patients' pain
Develops and uses a specific Plan of Care and modifies it to meet the individual patient's needs, using evidence-based practice; implements patient care and therapeutic procedures and monitors/documents progression of treatment and teaching goals:Identifies and prioritizes the patient's present/potential problems; incorporates the patient's cultural, age-specific and developmental needs
Plans appropriate nursing interventions specific to the patient's problems, incorporating the patient's cultural, age specific and developmental needs
Competently performs nursing interventions and procedures for the patient population served consistent with scientific principles of nursing policies and procedures
Provides education to patients and families concerning diagnoses, treatment and hospitalization
Reviews and updates the Plan of Care according to the patient's needs and/or regulatory/agency requirements.
Evaluates the care and treatment(s) provided to the patient and the patient's response to care and treatment(s); performs timely reassessment and documentation:Evaluates patient response to treatment/care and modifies plan of care as needed
Prior to discharge, evaluates patient's and/or family members/significant other's ability to perform self-care/procedures
Records patient's response to prescribed treatment and other significant data

Standard III. Patient Throughput & Patient Flow Process:

Anticipates admission/discharge/transfer needs to facilitate patient flowIdentifies potential/actual discharge/transfer needs of the patient upon admission and as patient condition changes
Identifies need for and/or follows up on referrals to ensure identified problems are addressed
Incorporates other disciplines into Plan of Care according to the patient's needs
Evaluates patient's and/or family member's/significant other's understanding of discharge instructions based on ability to verbalize and/or give return demonstration
Expedites admission/discharge/transfer
Participates in a process of communication with the multidisciplinary team to facilitate the progress of the patient throughout the continuum of care.

Standard IV. Unit Operations:

Demonstrates good stewardship in appropriate use and maintenance of equipment and suppliesCoordinates the selection of supplies and equipment in a cost-effective manner
Charges for supplies/procedures appropriately
Ensures availability and organization of supplies and equipment for patient care use
Performs and documents emergency equipment checks as assigned
Removes/returns discontinued supplies and equipment
Removes broken equipment from area immediately; initiates work order
Ensures and documents that all alarms (patient and equipment) are functional

Standard V. Safe Practice/Quality Care Regulations

Incorporates patient safety practices/guidelines to promote a safe environment resulting in positive patient outcomes:
Demonstrates accountability for nursing research and quality improvement activities
Provides evidence-based nursing careDemonstrates knowledge and skill in administering medications:

Completes medication reconciliation upon admission, transfer and/or discharge
Reviews physician's orders for clarity and accuracy, legibility and appropriate authenticity (name, date, time, title, etc.)
Follows restrictions on abbreviations; does not use abbreviations on the JC "DO NOT USE" list
Transcribes verbal/telephone orders per policy
Administers, documents and evaluates medication(s) according to policy and procedure
Instructs patients on medication(s), including expected effects, possible side effects, possible food/medication interactions; documents instructions
Recognizes, reports and documents medication errors and adverse drug reactions.Uses patient identifiers as defined by policy.
Communicates patient information effectively across the continuum of care:

Uses an approved hand-off communication format consistently
Follows Universal Protocol for "Time Out"
Uses SBAR to communicate changes in patient condition
Follows the chain-of-command
Assures that critical values are reported in a timely manner in accordance with policy
Sets clinical alarms according to equipment parameters and responds to the alarms in a timely mannerInitiates Rapid Response Team in response to deterioration in a patient's condition.
Demonstrates safe patient handling practices.
Promotes a safe patient care environment including compliance with restraint policies and procedures.
Implements processes to reduce risk of/prevent falls, pressure ulcers and other hospital acquired complications.
Assures compliance with Core Measure implementation and documentation, e.g. SCIP, CHF, AMI and PNE.
Maintains a neat, organized and safe environment for patients and staff
Identifies, corrects and/or reports patient safety and/or environmental safety hazards at time of discovery.
Demonstrates proper infection control/isolation techniques including providing appropriate information concerning isolation precautions and patient's status to patient, family members, significant other and other disciplines.
Adheres to CHRISTUS policies and procedures; adheres to standards of JC, OSHA, DHH, HIPAA, and any other state, local or federal regulations.

Standard VI. Leadership:

Serves as a leader of patient care:Guides and supervises other nursing staff in the operational activities in the assigned area
Promptly recognizes and attempts to reinforce appropriate behavior and attempts to correct inappropriate behavior in self and coworkers
Delegates nursing and non-nursing functions according to standards and scope of practice
Participates in leadership activities including community activities, e.g. charge/team leader, council participation, preceptor/coach, unit education and/or staff/council meetings
Assumes responsibility for currency of knowledge and skills including participating in unit-level meetings and all mandatory education activities sponsored by the facility.
Identifies and corrects inconsistencies in nursing procedures/techniques
Participates in implementing performance improvement and changes activities as necessary
Assists in teaching/evaluating other personnel as assigned
Contributes to the learning experience of students/new associates
Acts as a resource person
Communicates the intensity of workload and collaborates with nursing leadership to meet patient care needs and unit activity

Behavioral Health -- General Duties:

To enhance the quality of care provided, the nurse collects and documents patient data:Collects and documents patient data:

1) Interviews patients, family members and significant others and completes the patient's psychiatric/medical profiles

- Establishes a legal status

- Assesses mental status

- Assesses for physical stability

- Assesses for willingness to comply with and participate in/abide by the Unit's policies

- Assesses for high-risk, suicidal, or violent behavior

- Assesses for criteria for admission and follow-up

Documents physical assessment findings and incorporates diagnostic data into the written assignment.
Observes and documents signs and symptoms that indicate actual or potential medical or psychological problems of the psychiatric patient.
Actively seeks and documents information from families, physicians, nurses, and other healthcare team members
Uses information gathered in an assessment to identify problems; documents on the Master Problem List
1) Recognizes, defuses and handles emotional/physical crises

2) Possesses working knowledge of general nursing skills

3) Knowledgeable of Mental health Laws

4) Recognizes abnormal lab values; notifies physician and documents action taken

5) Utilizes resources to assess patients with unfamiliar nursing, psychiatric, and medical diagnoses

6) Recognizes teaching and learning needs of patients and families and assists in the development and implementation of information required to meet those needs

7) Incorporates and addresses appropriate problems into the care of the psychiatric patient

In the spirit of respect for individual dignity, the patient's response to the Plan of Care is evaluated in a non-judgmental manner and is revised appropriately:Evaluates the safety of the patient care environment
Evaluates the patient's status to determine any need for special precautions

1) Fall precautions

2) Suicide precautions

3) Elopement precautions

4) Close observation: 30 minutes/15 minutes/one to one

Evaluates patient's physical status to determine level of care needed (physical or psychiatric)
Evaluates Emergency Department (ED) patients requiring psychiatric assessment for admission, discharge, or referral from ED
Works with the multi-disciplinary team to evaluate the patient care plan on a weekly basis
Contributes to the evaluation and revision of nursing procedures.
In an effort to promote personal and professional growth, we affirm the value of gifts/talents by encouraging the teaching of adult and geriatric patients, their family members, staff and the community at large:Demonstrates knowledge of psychotropic medications
Demonstrates a working knowledge of lab values and notifies the physician of abnormal lab values
Evaluates the teaching needs of the patient, family members and/or significant others
Utilizes, adapts and revises teaching resources to meet the patient's informational needs
Documents responses to teaching
Explains tests, procedures, and disease processes to patient, family members, and significant others to alleviate anxiety
Demonstrates a working knowledge of restraints, policies and suicide precautions
Demonstrates working knowledge of drug and IV therapy
Demonstrates working knowledge of proper body mechanics; evaluates compliance of other team members
Demonstrates working knowledge of CSFCH procedures
Knowledgeable of computer capabilities
Demonstrates knowledge of physiological systems, where applicable
Is a role model for health care students and other health team members
Contributes to the learning experience of health care students in cooperation with the clinical instructor.
Acts as a clinical consultant in different areas of the medical center
Presents a patient care conference or an inservice annually (may be unit based or hospital wide)
Assists in the orientation of new staff by sharing knowledge, experiences and verbal encouragement
Assists in orientation of new staff by functioning as a preceptor as needed


In an effort to provide our patients with the highest level of care, a commitment to professional responsibility and personal growth is desired:Shows evidence of continuing education in the specialty area of:

1) Psychotropic medications

2) Psychiatric disease processes

3) Documentation

4) Legal issues and patient's rights

5) Psychiatric treatment modalities

6) Community resources

Responsible for information communicated through staff meetings.
Demonstrates an understanding of the CSFCH mission, philosophy and the guest relations program
Willingly accepts changes in assignments
Assumes responsibility for initiating and completing assignments in a timely manner
Completes credentialing requirements as designated on the nursing unit:
1) Restraints and seclusion

2) Glucometer

3) Crash cart

4) CPI

Supports unit staff needs by demonstrating schedule flexibility and adhering to the unit scheduling guidelines.
Participates on committees and PI teams
Practices cost effectiveness

In an effort to promote team spirit and the highest level of professional standards, an atmosphere of caring and accountability is displayed:Provides input regarding the need for changes in policies, procedures, and products as identified
Assumes ownership for feelings and responsibilities in problem solving
Recognizes and seeks opportunities to learn from others and their environment
Supports and facilitates group decision-making
Supports and participates in nursing research or data collection activities
Participates in a peer as well as self-evaluation
Acts as role model for nurses in a multidisciplinary environment
Is accountable for own behavior and response to situations arising on the unit

Behavioral Expectations:

Abides by and promotes employee behavioral expectations, including compassion, service, communication, fairness, courtesy, teamwork, stewardship, flexibility, professionalism and concern for the environment:Demonstrates sensitivity for the needs of others by showing appreciation and respect for dignity of all persons. Shows concern for the feelings of others.
Anticipates and responds to the needs of patients, visitors, physicians, employees, volunteers, and the community. Recognizes the needs of others and takes appropriate steps.
Expresses and receives, through work, body language and listening (oral and/or written) in a clear and concise manner that is easy to hear, read and/or understand.
Displays open-mindedness and objectivity in relations with patients, visitors, physicians, employees, volunteers and the community; treats all persons justly, acting without self-centeredness, prejudice and favoritism.
Demonstrates the hospitality of CSFCH through words and behavior; displays friendliness, kindness and appropriate manners in interactions with patients, visitors, physicians, employees, volunteers, and the community.
Promotes a spirit of unity which enables the group to work together to achieve a common goal. Takes initiative to perform job and/or assist co-workers, supporting the work of others in accomplishing the mission of the hospital.
Demonstrates efficient and careful use of materials and human resources to carry out the mission of the department and the hospital in a resourceful and creative manner. Effectively utilizes human and financial resources, equipment, supplies, buildings and property in a manner that is not wasteful.
Displays open-mindedness and adaptability by adjusting to meet the needs of the department and the hospital; receives suggestions for improvement in a positive manner; makes changes in scheduling, procedures, and assignments as necessary and in an appropriate manner.
Presents a positive image of self and the hospital; exhibits behaviors which demonstrate competence, reliability, self-control, honesty and an appropriate overall appearance while rendering service.
Demonstrates responsibility for maintaining a work environment that is conducive to the work of the hospital; takes necessary measures to assure work area and the hospital as a whole are kept safe, neat, quiet and clean.

Leadership Skills:

The Registered Nurse utilizes leadership and management skills to promote the highest level of care to the CSFCH patient through effective utilization of staff and materials.Anticipates the need for prospective patient care conferences.
Identifies and communicates learning needs and follows through as appropriate regarding personnel of other departments.
Encourages direct discussion between staff members when differences occur.
Participates on interdepartmental committees as assigned.
Interprets policies and procedures for others when appropriate.
Assists in altering unproductive group behavior using the principles of group dynamics.
Provides each staff member with a patient care assignment according to job duties and patient acuity.
Provides patient information to the multidisciplinary tam in the regularly scheduled morning report and weekly multidisciplinary staff meetings.
Coordinates team members to achieve maximum productivity with quality care as the objective.
Solves problems effectively when handling patient, visitor, staff or physician complaints.
Communicates with Director regarding any problems related to ethical, legal or standard of practice issues.
Performs counseling of employees, both formal and informal, as the situation arises.
Completes the unit schedule in a timely manner, assuring adequate coverage of shifts involved.
Assists Director with the budget planning and in maintaining the unit within the budget.
Provides input and evaluation of new employees during their orientation and probationary period.
Performs evaluations of staff members assigned and makes recommendations for merit salary increases.
Acts as liaison between patients, physicians, families and staff.
Assists shift supervisors and Director in the provision of adequate staffing for their own as well as the following shifts.
Serves as role model for other members of the team.
Assists Director as requested.


To help geriatric patients live in a state of well-being, we encourage looking for opportunities to foster open and caring communication:Reports and documents the patient's condition in an accurate, concise manner to the appropriate persons:

1) Patient's mental status

2) Behavior

3) Lab values

4) IVs/Cath/Feeding Tubes/Dressing/etc.

5) Restraints/seclusion

6) Legal status

7) Tests/permits/preps

8) Medications

9) Physical changes in status

Maintains patient and medical record confidentiality.
Applies basic verbal and nonverbal skills to maintain open, effective communication among all health team members, patients, and significant others.
Encourages direct discussion between staff members when differences occur and seeks assistance to arbitrate these differences.
Gives and receives constructive feedback appropriately.
Uses positive reinforcement as a means of supporting and rewarding nursing colleagues and other healthcare professionals.
Identifies actual and potentially unsafe patient care practices; reports them in the designated manner and suggests alternate practices/processes.
Willing to attend and conduct lectures/groups.
Maintains working knowledge of computer system
Demonstrates appropriate telephone communication skills.
Implementation Planning:

Concern for appropriate and responsible care for the geriatric patient is reflected in the development of a collaborative patient plan of care:Begins Master Problem List and Treatment Plan on admission; documents obvious patient problems, expected outcomes and interpretation of diagnostic related clinical findings requiring intervention. Addresses medical/psychosocial, management and family problems, including teaching needs and discharge planning.
Provides comprehensive shift report in accordance with unit's guidelines incorporating behavior, affect and one-on-one observations.
Involves patient, significant others, and healthcare team members in the development of the Problem List; works cooperatively with the multidisciplinary team for a comprehensive treatment plan.
In a spirit of respect and compassionate service, holistic patient care is implemented:Provides safe and therapeutic care; seeks resources when appropriate
Sets priorities based on psychiatric and medical patient acuity and potential problems.
Safely performs and documents procedures consistent with CSFCH policies such as:

1) Admits, discharges and transfers

2) Peripheral IV placement and therapy

3) Urinary catheterization

4) Stoma care (GI/Trach)

5) NG tube placement

6) Wound Care

7) Insertion and care of tube feedings

8) Taking and recording vital signs

9) Administering medicines

10) Post-mortem care

11) Familiarizes self with psychiatric procedures

12) Blood administration

Manages geropsychiatric patients with:
1) Physical disabilities

2) Mental disabilities

3) Nausea/vomiting

4) Non-compliance

5) Impaired skin integrity

6) Impaired mobility

7) Confusion

8) Impaired nutrition

9) Impaired coping skills

10) Fluid and electrolyte imbalances

11) Pain

12) Altered thought processes

13) Suicidal ideation

14) Potential for violence

15) Drug and alcohol withdrawal

Demonstrates a working knowledge of all equipment used on the unit, as applicable:
1) Vital signs

2) Infusion pump

3) Thermometer, otoscope, ophthalmoscope

4) Pneumatic tube system

5) Sure Med

6) Routine office equipment: i.e. Computer, copier, telephone system, fax machine, intercom, coffee machine

7) Crash cart

8) Defibrillator

9) Suction machine

10) Glucometer

11) KEO feeder

12) PSCU showers, whirlpool bath

13) Restraints (leather/posey)

14) Fire Extinguisher

15) Wheel chair, chair lift with scale

Implements physicians' orders in a timely manner.
Delegates and monitors quality of care provided by the nursing team.
Implements continued patient care as recommended by the multidisciplinary staffing team.
Monitors patient outcomes by their (verbal/non-verbal) behavioral responses to the treatment program.
Coordinates activities in order to implement CQI/PI.
Records and reports all interventions clearly and accurately and in the designated manner to appropriate multidisciplinary personnel.
Familiarizes self with emergency procedures:
1) Response to ED/crisis call

2) Fire emergency; RACE

3) Activation of pyramid call system

4) Blood spills


6) Water failure, power failure, phone system failure

7) Code Blue-Cardiac Arrest, Code White-Combative Person-Unarmed, Code Silver-Active Shooter/Combative Person With Weapon, Code Yellow-Disaster, Code Black-Bomb Threat, Code Pink -- Child Abduction, Code Grey -- Severe Weather, Code Red - Fire

Maintains a quite therapeutic environment in the immediate patient care area.
Initiates close observation:
1) Notifies physician

2) Maintains observation record

3) Provides safety

Seclusion and restraints according to unit policy.
Knowledgeable regarding patient's legal status:


3) Judicial Commitments

4) 72 Hour Request of Release

5) Mental Health Advocacy Information

Demonstrates the ability to assist physicians with special procedures:
1) Examinations

2) Amytol interviews

3) Lumbar punctures

Is held accountable for own actions.
Documents patient care, patient response, and patient outcomes in a timely manner.
Supervises and assumes responsibility for PCTs, LPNs, MHTs and aides.
Demonstrates initiative with a light workload.
Performance standards for nursing include:
1) Glucometer

2) Seclusion/restraints

3) BLS

4) Code Blue

5) Infection Control


7) OPI

Supervises the administration of medication through daily review of each medication administration record, as assigned


One year recent experience preferred. Excellent written and verbal communication skills. English required, bilingual (English/Spanish; English/French) preferred.
Current Louisiana RN License
Current BLS Card
Current CPI or certification within 90 days of employment

Keywords: Christus Health, Alexandria , RN Behavioral Decision Unit-PRN, Healthcare , Alexandria, Louisiana

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