The Advanced Practice Nurse will be a member of the MGH Bridge Clinic staff, an outpatient, transitional, urgent access drop-in clinic for patients with substance use disorder. This role will work with an inter-disciplinary team, including collaboration with the MGH inpatient Addiction Consult Team and Emergency Department, to provide compassionate care to those with substance use disorder. Responsibilities will include evaluation, diagnosis, treatment, education, and management of the substance use disorder and co-occurring medical and psychiatric illnesses. The position is per diem.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Clinical Practice
§ Provide addiction care and treatment to patients in a transitional, urgent care setting under the supervision of the Bridge Clinic Medical Director
§ Obtain medical history and pertinent labs, and perform focused physical exams for potential candidates for buprenorphine management
§ Responsible for assessing withdrawal symptoms during buprenorphine induction, before and after buprenorphine dosing for those who receive in office induction
§ Provide patient education related to buprenorphine, including home induction, proper use of the medication, side effects, storage, and medical issues that may be of concern
§ Follow-ups and maintain ongoing contact with the patient (in-person or phone), until the patient is stabilized on medication
§ Maintain regular contact with physician to discuss patient outcomes or other clinical concerns
§ Remain available to patients for questions related to their medication and consult with physician as necessary
§ Assess, diagnose and treat complex, acute, and chronically ill patients for urgent and emergent conditions related to substance use disorder and associated medical conditions
§ Perform medically delegated aspects of patient care as agreed upon by nursing and medical administrators according to practice guidelines and under the supervision of the collaborating physician.
§ Administer Naltrexone ER (Vivitrol) depot injections and injectable buprenorphine (Sublocade) monthly as needed to appropriate candidates
§ Demonstrate critical thinking and diagnostic reasoning skills in clinical decision -making
§ Provide expert consultation to other nursing, physician and hospital staff in order to maximize the opportunity to provide the most appropriate treatment.
§ Engage with and treat patients in all stages of readiness
§ Serv e as a patient and family advocate, and facilitate ethical and patient-centered decision making
§ Attend and contribute to patient care rounds
Education
§ Apply new technology, nursing theories, evidence-based research findings and experiential knowledge to support nursing practice. Promote independent professional nursing practice in the staff nurse group in collaboration with team members, managers and clinical leadership.
§ Participate in activities that promote the education of health care professionals including presenting and publishing when applicable, as opportunity arises.
§ Facilitate the educational experience of medical residents, nurse practitioner students, and fellows working in the Bridge Clinic.
§ Collaborate with Advanced Practice Nursing Training Institutions and Assume Preceptor role for advanced practice nurses with interest in addictions treatment.
Research/Research Utilization
§ Participate in and support research activities that will positively influence patient care and patient care outcomes.
§ Participate in and facilitate quality assurance and performance improvement activities for evaluation of structure, process, and outcome criteria as it relates to clinical practice.
§ Maintain familiarity with current trends in health care and their implications related to the treatment of substance use disorder and psychiatric illness. (This includes: appropriate pharmacologic and non -pharmacologic treatment modalities).
Clinical Leadership
§ Integrate systems thinking, ethical reasoning, and problem solving in identifying interventions that facilitate quality, cost-effective patient care outcomes.
§ Facilitate patient movement through the system and efficient use of resources through interdepartmental collaboration. This includes the triage of patient consults to the appropriate interdisciplinary members of the Bridge Clinic and ACT.
§ Analyze clinical and non-clinical variables to anticipate patient care needs and predict responses.
§ Negotiate conflict to promote collaboration.
Professional Development
§ Engage in self-performance appraisal on an annual basis, identifying areas of strength as well as areas for professional and practice development.
§ Identify individual learning needs and goals and develop a plan to meet them.
§ Maintain clinical knowledge and skills based upon current nursing and health care practices.
§ Maintain membership in professional nursing organizations.
§ Maintain the standards and educational requirements specific to the nurse practitioner role and licensure.
§ Maintain and update clinical knowledge and skills based on current health care practice/research.
SKILLS/ABILITIES/COMPETENCIES REQUIRED:
Relying on advanced training in psychodynamics, pathophysiology, physical assessment, pharmacology, treatment intervention, addiction management, harm reduction, and relapse prevention, the APRN provides an assessment and assistance with establishing comprehensive plans that address a broad range of concerns for the patient with substance use disorder:
1) Complete biopsychosocial and psychopharmacological evaluations
2) Develop treatment plans based on assessments and provide appropriate treatment
3) Maintain working relationship with patient and/or family while maintaining appropriate professional boundaries
4) Maintain effective working relationships with collaborative leadership teams and interdisciplinary health care teams and appropriate community providers
5) Document in the medical record according to departmental policies and procedures
A qualified candidate must demonstrate strong interpersonal communication, conflict resolution and organizational skills.LICENSES, CERTIFICATIONS, and/or REGISTRATIONS (if applicable):
Current licensure as a Nurse Practitioner or Clinical Nurse Specialist in the Commonwealth of Massachusetts, Maintain DEA and Mass Controlled Substances Licensing and X Licensing for Buprenorphine
Certified Addictions Registered Nurse – Advanced Practice (CARN-AP) (preferred) .
Current federal and state-controlled substance certification/registration or eligibility.
EDUCATION:
Master’s degree in nursing
EXPERIENCE:
Previous inpatient or outpatient nursing experience preferred.
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