Classes in this series perform a variety of professional
nursing duties including hands-on
care, assessment, testing, and treatment of patients; interviewing patients and
assisting them in follow-up care; maintaining medical and medication supplies; rendering emergency
medical treatment; dispensing and administering medications; and maintaining
charts and records.
The County’s medical care
includes public health centers, public health/field services programs, and
detention/correctional facility health services which are staffed by health managers and various medical
professionals, including registered nurses.
Positions in the Registered
Nurse series may be located in any facility or program requiring registered nursing licensure. Typical assignments are in public health centers which provide
primary medical care or medical services
to targeted client populations; positions may also be assigned to
specific health programs.
All incumbents are expected to
professionally, competently and independently perform all duties within the
department procedures and protocols, and their legal scope of practice as described in the Nurse Practice Act
and other laws, rules and
regulations.
Classes in this series are
distinguished from other nurse classes by the licensure and scope of practice, and by the variety of
possible assignments. Other
registered nurse classes are typically involved in patient care as psychiatric nurses, public health nurses,
nurse practitioners, or medical
case management nurses; registered nurses in some work situations may
perform some duties similar to licensed vocational nurses but are distinguished by
their broader scope of practice and higher level of medical
responsibility.
Supervising Registered Nurse is the
first level supervisory class in this
series. Incumbents work under
general administrative supervision of a higher level health program manager or facility manager, and receive
medical direction as needed from a
physician or higher level professional nurse such as a nurse practitioner.
The focus of duties is on
supervising, planning, organizing and reviewing the operations, program, and
personnel of a medical care unit staffed by registered nurses, licensed vocational nurses, and other
support staff. Positions are
typically limited to facilities where the organizational structure, work shifts, and large number of staff necessitate
a first-line nursing supervisor.
Distinguishing Characteristics: (cont’d)
The Registered Nurse class
has two levels: (Level II) is the full
journey level and (Level I) is designed for recruitment.
Incumbents receive
administrative and clinical supervision from a supervisory level registered
nurse; or, receive administrative supervision from a higher level health program or clinic manager,
with medical direction as needed from
a physician, physician’s assistant, or higher level professional
nurse, depending on job
assignment.
Incumbents may give work
instructions to licensed vocational nurses or other support staff in the normal
course of patient care.
Incumbents may be designated as
nurse-in-charge for specific shifts or clinic assignments and when so
designated may give work direction to other registered nurses and support staff.
The focus of duties is on hands-on medical assessment,
care and treatment.
Note: The following duties are typical of those performed by most
employees in each classification;
however, employees may perform other related duties. Not all duties listed are necessarily performed by each
individual in the classification.
EXAMPLES OF DUTIES:
1. Supervises a staff of registered
nurses, licensed vocational nurses, and support staff, including training,
assigning and reviewing work,
scheduling, evaluating work, and participating as the first-line supervisor in personnel decisions.
2. Prepares reports and makes
recommendations to higher level department management on policies and
procedures involving the services,
priorities, and coordination of services with other health care,
social service, and custodial units.
3. Develops and participates in
developing procedures, policies, and
protocols for nursing staff; and, ensures that subordinates are aware
of and comply with them.
4. Participates in preparing and monitoring
the budget for the unit.
5. Maintains current knowledge of
federal, state and local laws and
regulations which govern the work unit; disseminates this information
to and ensures compliance by subordinates.
6. Ensures that medical equipment is maintained
and operating to meet safety,
security, sanitation and medical requirements.
Examples of Duties: (cont’d)
7. Reviews medical records and case files to
ensure accuracy and completeness,
and adherence to reporting requirements.
8. Ensures that policies,
procedures, protocols, and physicians’ directions are followed in the ordering, storing, dispensing and
administering medications.
9. Observes, reviews and
supervises the medical care of patients to ensure that nursing care is performed appropriately, treatment is
administered in accordance with
physicians’ instructions, and quality assurance standards are met.
10. Conducts and participates in
training and demonstration sessions and in-service education programs for nurses and other staff
members.
11. Investigates complaints
concerning patient medical care; resolves
complaints and advises supervisors, or refers complaint to superiors, as
appropriate.
12. Performs duties of registered
nurse as needed.
KNOWLEDGE OF:
Basic principles and practices
of supervision and personnel management; professional registered nursing
principles, procedures and techniques;
State of California laws and
regulations on nursing practices;
normal course of illnesses and
disabilities, and their treatment;
family planning methods;
pre-natal, pregnancy and
post-natal medical care, infant and child care,
growth, and development, including common illnesses;
substance abuse symptoms and
medical intervention techniques;
mental illness symptoms and
intervention techniques;
symptoms, prevention, reporting
requirements and treatment of child and adult
abuse and neglect;
techniques of planning and
conducting classes and training sessions on a
variety of health subjects;
individual and group counseling
techniques;
common public and community
health care resources;
social and economic factors
influencing individual an community health;
differing cultural, religious
and social attitudes about hygiene, family
planning, child care, and health treatment;
proper handling and
administering of biologicals;
detection and treatment of
common communicable diseases, environmentally
based illnesses, sexually transmitted diseases, and food
and water-borne
illnesses;
standard medical
record-keeping;
common drugs and medications
used for birth control, communicable diseases,
immunizations, allergies, cardio-vascular conditions, and
substance
overdoses,
including their contra-indications and normal and abnormal results.
ABILITY TO:
Supervise and train employees;
effectively recommend employee
selections, promotions, status changes and
other personnel actions;
plan, organize and control work
of staff;
develop and implement policies
and procedures for work unit in accordance
with department goals, policies and procedures;
learn, comply with, and ensure
staff compliance with laws, rules,
regulations,
protocols, and procedures, including security requirements, applicable to the
work unit;
effectively communicate with and
gain the cooperation of patients of various
social, cultural, economic and educational backgrounds;
work cooperatively with other
health and social service providers, and staff
of other work units and departments;
effectively plan, conduct, and participate in in-service education and
training programs;
maintain patient
confidentiality.
REGISTERED NURSE
EXAMPLES OF DUTIES:
1. Interviews and observes patients to
ascertain medical history and
current condition; reviews patients records; takes vital signs, assesses
current condition; and, records and reports all information.
2. Assembles treatment supplies, prepares
patients for examination, and assists
physicians, physician’s assistants, and others in examination and treatment of patient.
3. Performs various tests and treatments
such as hypodermic injections, blood
draws, tubercular skin tests, immunizations, pregnancy tests, EKGs, hearing tests, vision tests, and
inhalation therapy.
4. Administers oral and topical medications,
and observes patients for normal and
abnormal reactions; records results, and takes appropriate action when necessary.
5. Instructs individual patients, and
their parents or custodians, on
follow-up care, birth control, communicable disease prevention,
hygiene, or general health care, as
needed for specific medical condition.
6. Makes appointments and referrals for
patient for other medical care,
social services, and financial assistance; coordinates, consults
with and oversees medical and
non-medical staff regarding patient medical
needs, care and treatment.
7. Maintains records, inventory and
physical security of drugs and medical supplies; sets up and stocks medication
chart, crash chart, and dispensary
medications and supplies; orders and requests supplies to maintain adequate
supply in work unit.
Examples
of Duties, cont’d:
8. Cleans and sterilizes equipment and furniture; ensures that
equipment is maintained and operating properly.
9. Assists in emergency medical
situations, including initial patient
assessment, immediate treatment and/or other action, and cardio-pulmonary
resuscitation.
10. Performs simple laboratory
work; and prepares specimens for delivery to laboratory, obtains tests results,
and notifies patients of test
results.
11. Reports suspected cases of
abuse and neglect of children and adults to
proper authorities, according to procedures and protocols.
12. Responds to inquiries from
patients and the public on the phone and in
person.
13. Keeps accurate records,
charts and case files; distributes copies to
appropriate staff and agencies.
14. Attends and participates in
training and demonstration sessions and in-service education programs to attain and maintain
nursing skills.
15. Provides subpoenaed medical
records and testifies in court on medical test results and treatment.
KNOWLEDGE OF:
Professional registered nursing principles,
procedures and techniques;
State of California laws and regulations on
registered nursing;
proper handling and administering of biologicals;
standard medical record-keeping;
interviewing techniques;
common current medical terminology;
use and care of medical equipment used in clinical
and infirmary settings;
basic medical indications of alcoholism and drug
abuse and their overdoses;
basic behavioral indications of mental
disturbance;
basic laboratory testing procedures;
current standard asepsis protocols;
basic symptoms and treatment of communicable
diseases;
common drugs and medications used for birth
control, communicable diseases, immunizations, allergies, cardio-vascular
conditions, and substance overdoses,
including their contra-indications and normal and abnormal results.
ABILITY TO:
Effectively communicate with and gain the
cooperation of patients of various social, cultural, economic and educational
backgrounds;
accurately follow oral and written instructions,
including standing orders, clinical
protocols, orders for treatment and dispensary orders;
Ability to: (cont’d)
work
cooperatively with other health care providers and other staff;
learn
and comply with laws, rules, regulations, protocols, and procedures,
including security requirements,
applicable to the work unit;
clearly
and accurately chart all patient information and physician’s orders;
gain
cooperation of patients in treatment and follow-up care;
maintain
patient confidentiality.
1. Possession of a current valid Registered Nurse license
issued by the State of California. NOTE:
Failure to maintain such
license may be cause for disciplinary action in accordance with Civil Service Commission Rules.
And
2. Either:
One year of experience in Sacramento County service as a Registered
Nurse or any class requiring registered nurse licensure.
Or: Two years of experience as a registered
nurse.
(LEVEL II): Possession of a current valid Registered Nurse license
issued by the State of
California. NOTE: Failure to maintain such license may be cause for disciplinary
action in accordance with Civil
Service Commission Rules.
(Level I): Possession of a current valid Interim Permit or
Temporary License as a Registered
Nurse, or a current valid license as a Registered Nurse, issued by the State of
California. NOTES: Interim Permittees and Temporary Licensees
are expected to obtain full licensure
within six months of appointment. Failure to obtain and/or maintain the
required
license may
be cause for disciplinary action in accordance with Civil Service Commission Rules.
NOTE: 1) The level at
which initial appointments to this
class are made and 2) advancement from the lower level of
this class to the higher level (Level I
to Level II), are at the
discretion of the appointing authority, providing the minimum qualifications are met.
NOTES:
1. Experience requirements are
stated as full-time work; to convert part-time to full-time equivalency: 173.6 hours = 21.7 days = 1 work month.
2. Required experience may be paid
or unpaid.
SPECIAL REQUIREMENTS:
1. Persons appointed to these
classes may be required to regularly or periodically work evenings, nights, and weekends and holidays.
2. Persons appointed to these
classes may be subject to a confidential criminal history check and fingerprinting.
3. Persons appointed to these
classes will be required to have, or obtain, and maintain a valid CPR certificate.
4. Persons appointed to these
classes may be required to have or obtain a valid hearing testing certificate, emergency first aid
certificate, and/or other
speciality training appropriate to Registered Nurses and necessary in their job
assignment.
5. Some positions in the class
of Registered Nurse may require the ability to communicate fluently in a language other than English,
in addition to English.
When required, the special
skills may be used in the performance of
typical tasks shown in the “Examples of Duties” in this class specification. In addition, incumbents translate and
interpret using standard English and
a language other than standard English; and/or act as a consultant to others regarding the needs and problems
presented by individuals of different languages and cultural backgrounds.
The
Sacramento County Civil Service Commission approved the use of selective certification for special skills
for the class
of
Registered Nurse on May 12,
1989.
PROBATIONARY PERIOD:
Supervising Registered Nurse: Six months.
Registered Nurse:
Six months.
Adopted Revised Retitled Class Schematic EE04 Rep
Code
Code Code Unit
Supervising 9/1/55
5/12/89 5/12/89 4244 57251 02 015
Registered
Nurse
(Previous title: Head Nurse)
Adopted Revised Retitled Class Schematic EE04 Rep
Code
Code Code Unit
Registered 9/1/55 5/12/89 5/12/89 4247 57271 02 016
Nurse
(Previous title:
Staff Nurse)