Occ. Code 5614500
COMMUNITY MENTAL HEALTH NURSE, GRADE 19
New York State Department of Civil Service
NATURE OF WORK
A Community Mental Health Nurse, as a registered professional nurse, works as a member of a multi-disciplinary clinical treatment team providing a total therapy program tailored to the individual needs of mentally ill or developmentally disabled clients in the community. Incumbents serve as the medical and psychiatric nursing care specialists on such a treatment team in consulting with and advising team members, community groups, and others in areas of the nursing specialty; coordinate treatment efforts with community health and related services; and carry out a treatment plan for a caseload of clients in the community.
All positions in this class are in the Office of Mental Hygiene at various locations in the community.
CLASSIFICATION CRITERIA AND DISTINGUISHING CHARACTERISTICS
A Community Mental Health Nurse provides professional nursing care as described in the classification criteria section of the Nurse I Classification Standard #5500510. The activities of a Community Mental Health Nurse are characterized by a wide range of community relationships with health and related services, with mentally ill and developmentally disabled clients and their families, and with the community in general. Within the community treatment team the Community Mental Health Nurse is the professional nurse providing direction, assistance, consultation and instruction to team members on all aspects of medical and psychiatric nursing care.
Nurse 1, Nurse 2 and Community Mental Health Nurses are registered professional nurse positions. Nurse 1 and Nurse 2 positions provide professional nursing care to patients within hospitals, clinics and infirmaries where comprehensive physical and/or mental care is provided. Community Mental Health Nurse positions are distinguished from Nurse I and II positions by their role as primary therapists to a caseload of mentally ill or developmentally disabled clients and their families in a community setting. Incumbents have close working relationships with community health and related services and are required to have specialized nursing experience providing direct service to clients in a community setting. Community Mental Health Nurse positions do not provide professional nursing services to patients in a hospital ward, clinic or infirmary on a full-time basis.
TYPICAL ACTIVITIES, TASKS AND ASSIGNMENTS
As a registered professional nurse, a Community Mental Health Nurse serves as a member of a multidisciplinary treatment team providing advice and consultation to team members in nursing care components of comprehensive treatment plans.
· Attends regularly held team meetings assisting members by providing clinical interpretations of medical and psychological examinations and diagnoses, medications prescribed and other aspects of the treatment plan concerned with clinical and psychological nursing care.
· Assists team members in assessing the effectiveness of clients' treatment plans with specific focus on the nursing aspects of the plan and in recommending modifications in treatments that will best serve the clients' needs.
· Instructs team members in first aid procedures, possible side effects of medications and treatments and in identifying signs and symptoms indicating possible physical or mental relapse.
· May provide technical direction and instruction to non-licensed para-professional personnel, students and volunteers in community mental health activities and in the performance of routine nursing procedures.
Following the treatment plan, the Community Mental Health Nurse functions as a primary therapist and case manager providing direct medical and psychiatric nursing care to a group of clients in the community.
· Screens prospective clients on a referred or walk-in basis for admission to the program by personal interview and the review of available medical records to obtain a complete medical and psycho-social history and to evaluate the mental and physical status of the person to determine the kind and severity of the physical or emotional complaint.
· Refers the person to a physician for a medical examination.
· Visits the client's home to identify possible physical, psychological, social, economic and environmental factors which may contribute to the person's disability.
· May interview family members to confirm and expand on the knowledge of the client's health history, environmental background and other relevant information.
· Formulates a nursing diagnosis compatible to the medical regimen prescribed by the physician and recommends a treatment plan including short and long-range goals.
· Carries out prescribed treatments, administers and dispenses medications, instructs clients and their families on the proper use, dosages and possible side effects of medications taken and observes the clients' physical and emotional status.
· Conducts individual and group psychotherapy, family therapy and crisis intervention to assist the client in establishing constructive living patterns and to provide basic emotional support and encouragement.
· Teaches and counsels the clients and their families in support of the total treatment plan on how to cope with emergency situations and the availability of medical, mental health and social services in the community.
· Arranges referrals to appropriate community health care providers for the client. Makes appointments, transmits health history and may escort the client to the appointment.
· Records observations and actions taken such as achievement or lack of achievement of treatment objectives, nursing care given, medications and treatments given and reactions to treatments and medications.
· Administers prescribed medications and treatments to clients and observes reactions to such procedures that require the training and skills of a registered professional nurse. Takes and records the client's vital signs to detect deviations from the normal.
· Provides the nursing care component of the client's treatment plan through such services as casefinding, health teaching, health counseling and care supportive to or restorative of life and well-being. Included are areas of personal hygiene, self-care activities, the alleviation of problems dealing with personal care or physical needs and other health and psychological related needs.
· Intervenes in crisis and in emergency situations by administering immediate and appropriate measures to the client. If immediate physician attention is required, reports signs and symptoms to the physician and initiates medical attention.
· May order and maintain an inventory of medications prescribed for client use.
Maintains contact and consults with community agencies as the client's mental health advocate and as a mental health professional on the treatment team.
· Provides consultation for representatives of community agencies on the psychiatric and physical nursing needs of clients and ways in which these agencies can assist in providing the necessary health care services.
· Gives talks to interested community groups providing information on the State's mental health programs and to improve the community's acceptance and understanding of the mentally disabled and of the programs provided on their behalf.
· Through personal contact and written communications, maintains a close relationship with community health services for the purpose of obtaining commitments to provide services for the mentally disabled.
RELATIONSHIPS WITH OTHERS
A Community Mental Health Nurse serves as a nursing specialist on a multidisciplinary treatment team in a community setting involving frequent personal contact with specialists of other disciplines, requiring the coordinated and interdependent planning between all disciplines in the development and implementation of clients' treatment efforts to insure that maximum benefits are being achieved. Incumbents attend team meetings providing consultation and advice to members on the medical and nursing care aspects of the clients' treatment plans. The Community Mental Health Nurse collaborates with the other team members in the development of a treatment plan, the evaluation of its effectiveness, and in coordinating the nursing care service element of the plan with the services provided clients by the other disciplines represented on the team.
As a primary therapist, a Community Mental Health Nurse provides direct medical and psychiatric nursing care to clients in the community. Incumbents teach and counsel clients and their families in understanding, and ways of coping with, mental health problems and medical problems including the proper use, dosages and possible side effects of medications taken.
Incumbents carry out the medical orders of physicians, and provide written and oral observations to the team of the clients' progress and reactions to treatments and recommendations concerning possible changes in the treatment plans that would better serve the clients' needs.
Within the community served, the Community Mental Health Nurse maintains personal contact and counsels with community agencies, groups and individuals in defining the psychiatric and physical nursing needs of clients, the kinds of mental health services provided, and ways such agencies or groups can most effectively assist in the treatment effort.
Incumbents participate in seminars, conferences, institutes and workshops conducted by local and State agencies, professional nursing associations and others, for the purpose of upgrading their nursing skills and learning newly developed nursing skills concerned with the provision of community psychiatric nursing care. As clinical nursing specialists, incumbents may also develop and test relevant theories and evaluate and implement research findings for nursing practice.
NATURE OF SUPERVISION
A Community Mental Health Nurse independently carries out prescribed nursing care and treatment activities within the scope of acceptable professional nursing practices to promote and preserve the mental and physical health of a group of clients in the community.
A Community Mental Health Nurse works under the administrative direction of a Treatment Team Leader (Mental Health) who, typically as a non-medical leader, makes assignments, coordinates the total treatment services provided by the clinical treatment team including those of the nurse, insures that procedures are followed, treatment plans are prepared and carried out, and that service is effectively rendered. The team leader evaluates the treatment care provided clients by incumbents in terms of its effectiveness in achieving stated goals as set forth by the clients' treatment plan.
A Community Mental Health Nurse is typically a non-supervisory class. However, incumbents may provide technical direction and instruction to non-licensed para-professional positions, students and volunteers in community mental health activities and in the performance of routine nursing procedures. A Community Mental Health Nurse may also provide occasional clinical supervision to lower level professional nurses.
Possession of or eligibility for a license to practice as a registered professional nurse in New York State and either: a Bachelor's Degree in nursing or a closely related field and two years of appropriate nursing experience, at least one of which must have been in public health, mental health or psychiatric nursing in a position providing direct services to clients in a community setting; or the satisfactory completion of 30 credit hours beyond the basic RN program in any combination of appropriate course areas and three years of clinical nursing experience with at least one year in public health, mental health or psychiatric nursing in a position providing direct services to clients in a community setting.
NOTE: Classification Standards illustrate the nature, extent and scope of duties and responsibilities of the classes they describe. Standards cannot and do not include all of the work that might be appropriately performed by a class. The minimum qualifications above are those which were required for appointment at the time the Classification Standard was written. Please contact the Division of Staffing Services for current information on minimum qualification requirements for appointment or examination.