I. DIFFICULTY OF WORK

Variety and Scope

Employees assigned to clinics will work in the same roles as the Public Health Nurse I and in addition assume varying assignments in team leading and clinic management. Alternatively, employees will work independently in outreach settings such as homes, schools, child care centers, or community settings. Intricacy
Work involves developing patient care plans with assigned clients.

In clinic settings, the employee functions as a charge nurse and will be responsible for planning and reviewing the work of other nurses. This requires more independent judgment and application of professional knowledge, skills, and abilities than the Public Health Nurse I. Nurses in other outreach settings often review and assess complex or potentially complex conditions, taking into account both the physical aspects of the issue and the impact of other factors such as patient or family strengths and resources, income, culture, and family dynamics in order to help families develop and implement a usable plan of care. Subject Matter Complexity

Work requires a strong understanding of public health concepts, nursing theory and practice. Guidelines
The North Carolina Nurse Practice Act, public health nursing standards, clinic protocols, agency work standards and program protocols.

Work requires more independent judgment in applying the professional standards and guidelines.

II. RESPONSIBILITY

Nature of Instructions

Daily and weekly work is usually self-planned and coordinated with the team. Agency goals and patient care goals are understood. Employees will frequently have to make short-range plans and changes to meet client and program needs. Nature of Review
Work is reviewed periodically for adherence to established public health nursing standards by a nurse supervisor through review of written reports and oral conferences. Employees refer less to the supervisor than the Public Health Nurse I and make more independent clinical and program decisions. Scope of Decisions
Employees' work and decision-making have a substantial direct effect on the client population served. Consequence of Decisions
Employees' work and decision-making could have a substantial impact on the client population served, especially since this nurse is overseeing (when serving as clinic charge nurse) the work of others and may be the only health professional to come in contact with clients in the field when providing advanced nursing services.

III. INTERPERSONAL COMMUNICATIONS

Scope of Contacts

Employees have contact with a patient population in an assigned area which might not be familiar with public health standards and programs. Communication with patients must demonstrate sensitivity to the person's culture, economic challenges, and other vulnerabilities, and must also recognize each patient's strengths and abilities. Nature and Purpose
Work requires that employees work in cooperation with the patient, patient's family (particularly in homes, schools, and other community settings) and other clinic staff to assess the patient's health status and needs and assist in providing the services needed in order to maintain or improve their health.

Patient education and counseling are important components of this service delivery. The employee must also be aware of health trends and practices that are pertinent to the population of patients served.

IV. OTHER WORK DEMANDS

Hazard

Employees will have periodic exposure to hazards in the field (driving, rural or inner-city settings, inclement weather, clients) and to a lesser degree in clinic settings. They might be exposed to bloodborne pathogens, infectious diseases, or angry or disruptive patients. Work Conditions
These may be mildly disagreeable if working in poor home environments or with difficult clients.

Clinics are often over-crowded and noisy.

V. RECRUITMENT STANDARDS

Knowledge, Skills, and Abilities

Considerable knowledge of, and skill in, the application of nursing theory, practice, principles, and techniques employed in the field of public health and related programs; considerable knowledge of and ability to apply the principles and practices of public health; knowledge of available resources and organizations and the ability to coordinate these as needed; general knowledge of current social and economic problems relating to public health, including health disparities; ability to plan, coordinate, and oversee the work of others; ability to deal tactfully with others and to exercise good judgment in appraising situations and making decisions; ability to work in partnership with patients and with other service providers to elicit needed information and to maintain effective working relationships; ability to record accurately services rendered and to interpret and explain records, reports, and medical instructions; adequate computer skills to allow communication, patient record documentation, and accessing of information.

Minimum Education and Experience

Graduation from an accredited school of professional nursing and one year of professional nursing experience. Necessary Special Qualifications
A current license to practice as a Registered Nurse in North Carolina by the N. C. Board of Nursing. Administering the Class
Individuals employed in a local Health Department without a B.S. Degree which includes a Public Health Nursing rotation or a Master's in Public Health, will be required to complete the \"Introduction to Principles and Practices of Public Health Nursing\" course within one year of employment as a condition of continued employment in accordance with Health Services Commission Rule. Special Note
This is a generalized representation of positions in this class and is not intended to identify essential functions per ADA.

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