CIWA/COWS

Monitoring — Administer CIWA or COWS at scheduled intervals (e.g., q1h, q2h, q4h) depending on taper protocol or stabilization plan. Score each domain precisely—tremor severity, nausea, anxiety, tactile disturbances, pupil size, bone/joint aches, GI upset, etc. Document scores immediately and notify the physician when thresholds requiring medication intervention are met. Evaluate trends to determine whether withdrawal is escalating, stabilizing, or resolving. Medical Triage Triage Protocols — Assess walk‑in complaints such as headaches, abdominal pain, dizziness, chest tightness, or panic symptoms. Differentiate between minor issues (e.g., mild dehydration, constipation) and urgent conditions (e.g., chest pain, seizures, suspected overdose). Perform focused assessments (lung sounds, neuro checks, blood glucose, orthostatic vitals) when indicated. Communicate findings directly to the physician or Medical Director and obtain orders for labs, medications, or emergency transport. 2. Medication Management & Administration Medication Administration Medication Pass Detail — Prepare and administer scheduled, PRN, and MAT medications following the six rights : right patient, medication, dose, route, time, and documentation. Monitor residents during ingestion to prevent cheeking, pocketing, or diversion. Assess for immediate side effects such as dizziness, nausea, sedation, or allergic reactions. Provide MAT medications (buprenorphine, naltrexone, etc.) according to protocol, verifying identity and monitoring post‑dose stability. Control Count Verification Controlled Substance Protocol — Perform dual‑nurse controlled substance counts at every shift change. If no other nursing staff is available have a clinician of direct care staff present. Verify each dose, reconcile discrepancies, and document counts in the controlled substance log. Investigate and escalate any variance immediately according to diversion‑prevention policy. MAR Accuracy MAR Documentation — Maintain flawless MAR/eMAR records by documenting: Administered doses Refusals Late doses Held medications Adverse reactions Ensure no blank spaces remain; every scheduled dose must be accounted for before shift end. 3. Clinical Collaboration & EHR Documentation Physician Orders Order Management — Receive verbal or written orders, repeat verbal orders back for accuracy, and enter them into the EHR. Execute orders promptly—medication changes, lab draws, vitals frequency adjustments, detox protocol modifications. Interdisciplinary Communication Team Collaboration — Participate in multidisciplinary meetings with therapists, case managers, techs, and physicians. Report medical concerns, withdrawal progression, medication compliance, and barriers to treatment engagement. Provide input for treatment planning and discharge readiness. Regulatory EHR Logging EHR Compliance — Document all nursing interventions, assessments, incident reports, and physician notifications. Chart vital sign trends, CIWA/COWS scores, medication responses, and clinical observations according to LDH standards. Ensure documentation is time‑stamped, objective, and complete before shift end. 4. Patient Health Education & Crisis Intervention Health Education Groups Health Education Detail — Facilitate educational sessions covering: Overdose prevention and naloxone use Nutrition and hydration during recovery Infectious disease prevention (HIV, Hep C, STIs) Medication adherence and MAT expectations Provide handouts, demonstrate naloxone administration, and answer resident questions. Medical Emergency Response Emergency Protocols — Act as first responder for seizures, overdoses, respiratory distress, severe panic attacks, or unresponsiveness.

Initiate emergency protocols:

assess airway/breathing/circulation, prepare naloxone, or begin CPR if needed. Direct support staff, assign tasks (calling 911, retrieving AED, clearing area), and coordinate EMS arrival. Document the event thoroughly and notify the physician immediately. Expanded Day‑to‑Day Nursing Shift Blueprint First 2 Hours — Handovers & Morning Meds Conduct face‑to‑face report with outgoing nurse reviewing unstable clients, detox progression, new admissions, and pending labs. If face-to-face can not be conducted leave detailed documentation for on coming nursing staff. Complete controlled substance count with outgoing nurse, reconciling inventory line‑by‑line. Prepare and administer morning medication pass, verifying identity, monitoring ingestion, and documenting all doses. Assess residents post‑medication for side effects or complications. Mid‑Shift — Assessments, Triage & Documentation Perform scheduled

CIWA/COWS

assessments for residents on tapers or stabilization protocols. Complete head‑to‑toe assessments for new admissions arriving during the shift. Coordinate with pharmacies regarding refills, missing medications, insurance issues, or delivery delays. Address walk‑in medical complaints, perform focused assessments, and obtain physician orders. Draw blood for labs (CBC, CMP, LFTs, etc.) when ordered and prepare specimens for courier pickup. Update EHR with assessment findings, medication responses, and physician communications. End of Shift — Final Rounding & Sign‑Off Conduct afternoon/evening medication pass, documenting all doses and refusals. Audit MAR/eMAR to ensure no missing documentation or unresolved variances. Complete all nursing notes, incident reports, and physician notification logs. Perform final controlled substance count with incoming nurse. Provide structured handoff summarizing medical concerns, withdrawal progression, and residents requiring close monitoring.

Pay:

$21.00 - $28.00 per hour People with a criminal record are encouraged to apply

Work Location:

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