Registered Nurse (RN) - ORCA Center, Day Shift

Description

Schedule:

• Before ORCA Center Opens (anticipated in summer-fall 2025): Monday – Friday, 9:00 am – 5:00 pm; clinical care on DESC’s Opioid Treatment Network team.
• After ORCA Center Opens: Planned schedule is three (3) 12-hour shifts with at least two 30-minute breaks, 7:00 am – 7:30 pm, per week, with some weekends required; and one additional 12-hour shift every 4 weeks. Please note that ORCA is a new program, and the schedule is subject to adjustment as necessary to meet operational and clinical needs.

Supervised by: ORCA RN Supervisor 

The ORCA Center is estimated to start clinical services in mid-2025 (though the RNs will start once hired) and will be open 24 hours per day, 7 days per week, including holidays. It will offer four overlapping types of services:

• Care to individuals in stable condition who have experienced an opioid overdose, brought to the ORCA Center by first responders or transferred from local emergency departments.
• Rapid initiation of medications for opioid use disorder (MOUD), including buprenorphine (sublingual and long-acting injectable) and methadone (under the “72 hour rule”, or Code of Federal regulations Title 21 §1306.07 (b)), for people with OUD, regardless of whether an opioid overdose has recently occurred.
• Harm reduction counseling and OUD-related physical and behavioral health services, such as hepatitis C testing and treatment and HIV pre-exposure prophylaxis.
• Follow-up care, at the ORCA Center or at times field-based, with individuals who have started MOUD to ensure support in MOUD continuation.

The Registered Nurse (RN) acts as a member of a multi-disciplinary team responsible for providing nursing services to adults who have experienced an opioid overdose and/or those with a diagnosis of Opioid Use Disorder. DESC’s ORCA Center provides 24-hour, low-barrier, enhanced supportive services. Here, the RN will provide in-the-moment, low-threshold medical access to clients who may not otherwise present to more traditional clinics. Work is done under the supervision of the ORCA Nurse Supervisor, Senior Nurse Manager, Director of Nursing, and Medical Director. 

MAJOR DUTIES AND RESPONSIBILITIES:

• Provide clinical assessments, RN case management, medical monitoring, wound care and other treatments, intervention in medical emergencies, and linkages to behavioral health treatment and primary care.
• Provide individualized medication management services and education as needed, and ongoing assessment of mental status and the impacts of current treatment.
• Perform initial history and physical of client; documenting any client identified concerns, vital signs, and mental health status exams/AIMs assessments.
• Reconcile medication and medical record with hospitals, other outpatient mental health clinics, and primary care facilities, including collecting appropriate Release of Information requests (ROIs) as needed.
• Provide / coordinate chronic disease management; educate client re: self-care and medication management.
• Administer oral medication, injections, and provide wound care within scope of practice and plan of care or as prescribed by eligible provider.
• Be able to use critical thinking, clinical judgment, patience, and flexibility in frequent contacts with clients. Have strong communication and customer service skills.
• Assess clients for a range of health care needs and facilitate linkage and on-going connection to relevant urgent, primary and specialty health services to ensure continuity of care. Advocate for patients' access to a variety of community resources and services.
• Oversee on-site medication monitoring services.
• Participate in supervision, program meetings and in-service trainings.
• Comply with the agency’s clinical accountability policies and procedures; maintain current and complete clinical records; participate in quality assurance activities.
• Participate in verbal de-escalation and physical interventions in emergent situations and be willing and able to assist other staff as needed to maintain a safe and secure environment.
• Build trusting relationships with clients who may be wary and difficult to engage by employing a warm and accepting approach that includes trauma informed care, harm reduction and motivational interviewing. Demonstrate a commitment to this approach through language and behavior.
• Teach clients about safer substance use, overdose prevention and overdose reversal.
• Other duties as assigned. 

Requirements

MINIMUM QUALIFICATIONS:

• Registered Nurse, licensed in the State of Washington, in good standing.
• Interest or experience in working with clients who are difficult to engage and m