The nurse in this position provides Tuberculosis Case Management and Public Health Clinic Services. Demonstrates flexibility in adapting as program and/or service needs change.

Tuberculosis (TB) Program Services
Works to prevent and control the spread of tuberculosis. Related duties include but are not limited to:

• Participates in TB surveillance and service activities including, but not limited to reportable TB and outbreak response.
• Participates in weekly case review and documents summary of case review to maintain a basic knowledge of all clients on caseload.
• Identifies needs and makes appropriate timely referrals.
• Develops and implements comprehensive plans of nursing care including:
  • Makes/plans home visits for TB program Directly Observed Therapy (DOT).
  • Routine medication assessment, refill, and monitoring.
  • TB screening
  • Collects sputum specimens, draws blood, and administers tests and vaccinations per the patient treatment plan.
  • Contact investigation and follow-up.
  • Educates, counsels and coaches’ clients regarding disease processes, risk behavior, healthy lifestyles, prophylaxis, medication management and treatment goals.
  • Evaluates and revises treatment goals with clients to assure effective plans.
  • Coordinates and consults on plan of care with MCHHS Health Officer and outside providers/agencies.
  • Evaluation and appropriate follow-up of x-ray/lab/sputum.
  • Drives to client home or other sites to provide services, attend off-site meetings, pick up specimens or conduct field investigation of communicable disease.
  • Maintains open communication with and provides nurse guidance and oversight to Public Health Workers providing TB and sexually transmitted infections services.
  • Utilizes computer and internet to access information and document activities.
  • Performs accurate and timely documentation in ORPHEUS database.
  • Performs accurate and timely documentation in electronic medical record.
  • Provides services to non-English speaking clients via telephonic or in-person interpreter.

• Provides direct service to clients, including administration of injections.
• Follows the policies and procedures specific to the services provided.
• Provides health information and education relevant to the services sought by the individual, per policy. 
• Provide timely, accurate & complete documentation and billing of services. 
• Obtains and transports supplies from refrigerator/freezer, overhead cabinets, and other storage areas.
• Greets client in waiting area, escorts to clinic service area and back to front desk.
• Documents services provided accurately and completely at the time of service.
• Checks and records refrigerator and freezer temperatures each AM and PM and informs Supervisor and/or Coordinator of temperature falling outside the range.
• Participates in returning client calls, signing off on returned labs, follow-up of positive labs, weekly chart audits, drug counts, etc.
• Drives to community sites to provide services and attend meetings and training.

• Administer vaccines as forecasted unless medically contraindicated.
• Provides immunizations in Marion County clinics and special off-site clinics.  
• Assures documentation of services to meet state and local standards.   

• Administration of medications and immunizations
• Provision of current and appropriate medication information verbally and in writing.
• Initiate a plan with client for follow up and treatment.
• Triage walk-in clients and those phoning in with questions or requests for exams.
• Provide accurate and timely documentation in electronic medical record.
• Reviews lab results and processes appropriately.
• Phone in prescriptions as ordered by the Health Officer.

• Conduct Immunity Assessment, TB screening, and provide immunizations to employees per policy.
• Draw blood for post vaccine titer per policy.
• Provide post occupational exposure follow-up for BBP and other communicable diseases as appropriate.
• Provide timely, accurate & complete documentation of services in confidential digital & paper files.
• Maintain PPD, fit test solution and vaccine medication inventory for employees.  
• Ensure OSHA requirements for HBV vaccine are met in concert with Immunization Coordinator.
• Ensure employees who fail to comply with needed services are referred to their supervisor and Clinic supervisor within 1 month of being overdue in concert with Immunization Coordinator.  

• Develop and/or contribute to Team meeting agenda, policies and procedures and other documents.
• Review and provide feedback to Health Officer regarding standing orders.
• Provide services to and communication with community partners, e.g., homeless shelters, school nurses and information and technical assistance to healthcare providers.
• Communicate client and program issues to the Clinic Coordinator and/or Program Manager.
• Participate in planning, implementation, and evaluation of CPS program activities.
• Participates in and may provide evaluation and monitoring of CPS program services and activities including quality improvement initiatives and program performance management measurement and tracking.

EXPERIENCE AND TRAINING

1. Associate degree, or diploma, in nursing and two years of experience as a nurse in a public health, social services, or community health setting; OR
2. Bachelor's degree in nursing; OR
3. Any satisfactory combination of work, education, training, or experience relevant to the position, as determined by Marion County. 

• Possession of a current license to practice as a registered nurse in the State of Oregon at the time of appointment.
• Must have a current CPR certificate.
• Must possess a current driver's license in the applicant's state of residence and an acceptable driving history.  Marion County will obtain a copy of the driving record for all qualified applicants from Driver and Motor Vehicle Services and review the driving record according to the Marion County policy and procedure for Driving on County Business.  The policy can be found at:  http://apps.co.marion.or.us/APAP/.
• The finalist for this position will be required to pass a criminal history background check; however, conviction of a crime may not necessarily disqualify an individual for this position.
• This is a safety sensitive/special needs position. Final candidates selected for this position will be required to pass a pre-employment drug screen, including testing for marijuana. The Marion County Drug and Alcohol Use and Testing Policy can be found at: http://apps.co.marion.or.us/APAP/policy.aspx?p=policy&pid=518.
• This position may be subject to the following:  Must not be excluded from participation in the federal health care programs (Medicaid, Medicare and other federally funded programs that provide health benefits); AND must not be excluded from participating in federal procurement (Federal Acquisition Regulation) and non-procurement activities (Executive Order No. 12549).
• This is a full-time position that is eligible for overtime.
• This position is represented by a union.
• Typical work schedule:  Monday through Friday, 8:00 am - 5:00 pm, with flexibility to meet the needs of the department or program.

• the practice of public health nursing and the use of community resources.
• public health sciences and services.

• in interdisciplinary teamwork.
• make nursing assessments which include environments and systems, in addition to individuals, families and groups.
• accept and abide by supervision received.
• recognize the needs and concerns of people and to maintain constructive and therapeutic relationships.
• provide skilled nursing care.

PUBLIC SERVICE LOAN FORGIVENESS
Marion County is a qualifying public employer for the Public Service Loan Forgiveness Program.  Through the Public Service Loan Forgiveness Program, full-time employees working at the County may qualify for forgiveness of the remaining balance on Direct Loans after 120 qualifying monthly payments under a qualifying repayment plan.  Questions about your loan eligibility should be directed to your loan servicer or the US Department of Education.

VETERANS’ PREFERENCE
Applicants are eligible to use Veterans’ Preference when applying with Marion County in accordance with ORS 408.225, 408.230, and 408.235 and OAR 105-040-0010 and 105-040-0015.  Preference will be awarded only if the applicant meets the minimum requirements of the position and attaches the required documentation at the time of application.

DOCUMENTS REQUIRED FOR VETERANS’ PREFERENCE

• One of the following:
  • MEMBER COPY 4 of the Certificate of Release or Discharge from Active Duty (DD Form 214 or 215); OR
  • Letter from the US Department of Veterans Affairs indicating receipt of a non-service connected pension; OR
  • Certification that discharge or release from active duty under honorable conditions will take place not later than 120 days after the submission of the certificate.

• In addition to one of the above documents, Disabled Veterans must also submit one of the following:
  • A copy of their Veterans disability preference letter from the Department of Veterans Affairs; OR
  • Certification that medical separation from active duty under honorable conditions will take place not later than 120 days after the submission of the certificate.

You can request copies of your military service record through the National Archives website at http://www.archives.gov/veterans/military-service-records/

Marion County is an Equal Opportunity, Affirmative Action, Veteran and Disability employer committed to increasing the diversity of its workforce.