Registered Nurse (RN) - Day Shift, ORCA Center

Schedule:

Three (3) 12-hour shifts with at least two 30-minute lunch break, 7:00 am – 7:30 pm, per week, with some weekends required; and one additional 12-hour shift every 4 weeks.

Insurance Benefits: Dental, Life, Long-term Disability, Medical (no premiums/payroll deductions for employee coverage)

Other Benefits: Employee Assistance Program (EAP), Flexible Spending Account (FSA), ORCA card subsidy, Paid Time Off (34 days per year), Retirement Plan

Union Representation: This position is a part of a union and is represented by SEIU Healthcare 1199NW.

Supervised by: ORCA RN Supervisor 

A cover letter is required as part of your application to be considered for this role. 

About DESC:

DESC (Downtown Emergency Service Center) is a nonprofit organization working to help people with the complex needs of homelessness, substance use disorders, and serious mental illness achieve their highest potential for health and well-being through comprehensive services, treatment, and housing. Our vision is a community where no person is abandoned, ignored, or experiencing homelessness.

As the region's leading provider of services to multiply disabled adults who have experienced chronic homelessness, DESC serves almost 3,000 people each day. Our integrated service model is designed to help people secure and maintain appropriate, safe and affordable housing. DESC is recognized nationally and regionally as an innovator in developing solutions to homelessness.

Come work for us! 

About the Opioid Recovery & Care Access (ORCA) program 

DESC’s  ORCA program provides compassionate, low-barrier, and evidence-based  care to individuals who are recovering from opioid overdose and those  seeking treatment for opioid use disorder (OUD). The ORCA Center, our brick-and-mortar location, provides post-overdose subacute stabilization services and provides walk-in access to medications for opioid use disorder (MOUD). The ORCA Patient Outreach Division (POD) delivers field-based MOUD care – meeting people where they literally are in the community. 

ORCA Center 

The ORCA Center is open 24 hours per day, 7 days per week, including holidays. It is  staffed by a multidisciplinary team, including providers, nurses,  medical assistants, peers, and milieu specialists. The ORCA Center offers 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 CFR 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. 
• Follow-up care for individuals who have started MOUD to ensure support in MOUD continuation. 

ORCA POD 

ORCA POD is ORCA’s field-based care team, bringing MOUD induction, stabilization, and maintenance services as well as education and other supports directly to patients in the community. ORCA POD operates during business hours (Monday through Friday, 9 a.m. to 5 p.m.). ORCA POD is a multidisciplinary team, including providers, nurses, and peers, operating across several geographic areas throughout the greater Seattle region including: 

• Permanent Supportive Housing (PSH) sites 
• Emergency shelters 
• Encampments or unsanctioned sites 
• High-need geographic zones identified in collaboration with DESC and community partners 
• Areas without easy access to low-barrier MOUD services 

JOB DESCRIPTION:

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. 

MINIMUM QUALIFICATIONS:

• Registered Nurse licensed in the State of Washington, OR Registered Nurse licensed under Nurse Licensure Compact (NLC) and will apply for Washington State endorsement within 60 days of hire.
• Knowledge of psychiatric medications, side effects and methods of administration. 
• Interest or experience in working with clients who are difficult to engage and maintain in traditional behavioral health programs.
• Be able to pass a Washington State Criminal background check.
• Experience or training in addiction medicine and harm reduction.
• Ability to relate to a wide range of people, demonstrate highly developed communication skills, and have a desire to serve people with Opioid Use Disorder. 
• Ability to remain open and receptive to constructive feedback.
• Ability to communicate and coordinate with staff from diverse backgrounds.
• Strong commitment to serving individuals with complex needs, including homelessness and co-occurring behavioral health conditions.
• Familiarity with trauma-informed care, harm reduction principles, and equity frameworks.
• Ability to work collaboratively in a multidisciplinary team environment.
• Proficiency with electronic health records and clinical documentation. 

PREFERRED QUALIFICATIONS:

• Bachelor of Nursing degree.
• Nursing certifications.
• Experience in low-barrier buprenorphine programs or Federal Opioid Treatment Programs.
• Experience in an acute care setting (e.g., emergency department or overdose prevention center).
• Knowledge and skill in working with co-occurring mental health and substance abuse disorders; with homeless or formerly homeless individuals.
• Crisis intervention and stabilization experience.
• Familiarity with Recovery Principles, Crisis Intervention and Stabilization, Integrated Treatment of Co-occurring Disorders, Intensive Case Management, Illness Management, and relevant Evidenced based/Emerging best practices.
• Bilingual in Spanish/English.

Strong applicants can demonstrate the ability to be positive in their empathetic responses to all persons; understand the value of meaningful and deep client engagement; and value a non-judgmental response to sensitive issues. Candidates should be able to accept feedback and work in a highly collaborative and sometimes stressful environment. 

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee will be required sit for long periods of time, communicate with other persons by talking and hearing, required to lift and carry items weighing up to 25 pounds and to operate computer hardware systems. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

EQUAL OPPORTUNITY EMPLOYER:

DESC is committed to diversity in the workplace and promotes equal employment opportunities for all staff members and applicants. The Agency will not discriminate against any employee or applicant for employment on the basis of race, creed, color, sex, gender, sexual orientation, age, national origin, caste, marital status, or the presence of any sensory, mental or physical disability in any employment practice, unless based on a bona fide occupational qualification. Minorities and veterans are encouraged to apply.