Emergency Psychiatric Liaison Nurse

Detailed Overview

The Registered Nurse/Registered Psychiatric Nurse (RN/RPN) acts in accordance with the philosophy, goals and objectives of Fraser Health and the Standards of Practice of the British Columbia College of Nurses and Midwives (BCCNM). As a member of and working in close collaboration with the interdisciplinary health care team, the RN/RPN provides and coordinates the delivery of psychiatric nursing care services primarily to patients treated/admitted to the Pediatric Emergency Department. The RN/RPN demonstrates nursing expertise and provides clinical leadership in evidence based practices through direct care activities including psychiatric nursing assessments, screening of medical conditions and lab values, development and adjustment of nursing care plans, medication administration and monitoring, clear documentation of treatment outcomes, observational and functional feedback to assist in accurate psychiatric diagnosis, maintenance of program based clinical pathways, and participation in group program leadership activities. The RN/RPN provides direction to Health Care Workers and/or Youth Workers, and guidance to team members who assist with seclusion and restraint practices of primary patients. May be assigned to support the Child & Adolescent in-patient units as needed. Responsibilities Receives referrals through the Patient Care Coordinator (PCC) and a variety of internal and external sources, including the general Emergency Department and Pediatric Emergency Department. Evaluates the psychiatric nursing care needs of assigned patients and provides direct psychiatric nursing care. Identifies preventative, therapeutic, and rehabilitative aspects of care, and develops and modifies individualized care plans in consultation with the interprofessional team and family members, with clear attention to treatment and risk management priorities. Carries out selected treatments and procedures as prescribed by physicians and nursing orders, in accordance with hospital policy and procedures. Performs psychosocial assessments and collects collateral related to patients’ primary support group, social environment, occupation, education, housing, finance, health service access, and legal problems. Completes emergency psychiatry patient assessments for patients triaged to psychiatry. Develops care plans with final dispositions authorized by the Emergency Department Physician or consulting Psychiatrist, and provides general and crisis counselling to patients and their families, in accordance with approved treatment plans. Maintains clinical records by collecting and documenting information, including health care information regarding patients and their families, nursing observations, telephone communications, progress notes, interventions, themes worked on during interventions, teaching, care evaluations, patient outcomes and discharge summaries to ensure that patient/family records are current and complete. Collaborates and consults with Emergency Department staff and other allied health department service providers in the hospital and community, and assists in adapting care plans to address psychiatric needs. Liaises and communicates as required to support patient flow of admitted psychiatric patients being transferred to inpatient units in a timely manner. Communicates and shares knowledge and information with Coordinators and other team members of the community mental health team on client care issues, resources and discharge planning process; organizes and participates in interdisciplinary conferences with psychiatrists as required; explains plan of care to patients and their families; refers patient to rehabilitation and other adjunctive services including the acute care site as appropriate. Provides consultation and education to patients, their families and/or care-givers with respect to illness prevention, health maintenance and health promotion strategies and explains the theoretical rationale for nursing decisions. Provides guidance to Emergency Department nursing staff and a variety of internal sources involved in caring for psychiatric patients, and provides leadership for team members actively involved in violence de-escalation, suicide prevention and restraint practices. Ensures safe patient management and adherence to restraint policies and procedures. Participates in the orientation and ongoing education of nursing staff and students by providing information and acting as a preceptor or mentor as appropriate. Liaises with appropriate departments and professionals, and facilitates transition to aftercare by following transition of care processes including provision of discharge plans and referral to community service providers. Acts as a patient advocate by assisting patients and their family members to access appropriate community resources including agencies, services and service providers. Participates in continuous quality improvement and risk management activities by identifying and reporting high risk situations, near-miss incidents, evaluating effect of changes in nursing practice and making recommendations for alternative approaches to nursing practice. Maintains a safe environment for patients, families and staff by adhering to established safety and emergency practices and procedures. Provides input to leadership regarding policies, procedures, operational requirements, program development & delivery of psychiatric services, patient program activities and treatment approaches through methods such as observing service needs, providing spoken or written suggestions, participating in internal conferences, active membership on nursing and hospital committees, and participating in development, implementation and evaluation processes for the improvement of patient care, work processes and promotion of effective use of resources. Identifies own learning needs/goals, reviews these with the Manager or designate, and engages in a variety of activities to meet these needs/goals to maintain and enhance clinical competency. Provides direction and guidance to Health Care Workers/Youth Workers and team members who assist with seclusion and restraint practices. Implements emergency protocols, monitors the condition and presence of resuscitative equipment and other supplies on the unit, and identifies deficiencies to the Manager. Performs other related duties as assigned. Qualifications Education and Experience Graduation from an approved School of Nursing with current practicing registration as a Registered Nurse and/or Registered Psychiatric Nurse with the British Columbia College of Nurses and Midwives (BCCNM). One year's recent, related experience in an acute psychiatric setting, including experience working with an adolescent population, specialty training in adolescent psychiatry or an equivalent combination of education, training and experience. Skills and Abilities Demonstrated knowledge of mental health assessment, psychopharmacology, concurrent disorders, and DSM-V multiaxial diagnoses. Knowledge of crisis intervention and de-escalation strategies, suicide risk assessment, violence management protocols, general counselling and interview techniques and individual and group dynamics. Knowledge of legal and ethical issues related to mental health certification in accordance with the Mental Health Act and other relevant legislation. Knowledge of adolescent development and mental health/psychiatric issues. Demonstrated ability to apply clinical knowledge in practice. Demonstrated ability to determine and deal with emergency situations and make appropriate clinical decisions. Demonstrated ability to deal effectively with patients and their families. Demonstrated ability to communicate effectively and professionally with others, both verbally and in writing. Demonstrated ability to work independently. Demonstrated ability to plan, organize and prioritize work and problem solve. Demonstrated ability to work well under pressure. Demonstrated ability to function effectively and efficiently in an interdisciplinary team setting. Demonstrated ability to operate related equipment including non-invasive blood pressure machines, pulse oximeters, tracheostomy devices and computers and related software. Physical ability to carry out the duties of the position.

---