DIRECTOR OF NURSING (#PD9 )

$68.21-$90.66 hourly / $11,823.00-$15,714.00 monthly / $141,876.80-$188,572.80 yearly

Under general direction, to plan, organize, coordinate, direct and supervise various medical services within the County's Health Services Agency across a major division such as Public Health, Detention or other major division of health; to assist in program planning for the Agency; to plan, organize and coordinate medical services in a major division of the Health Services Agency and to perform other work as required.

This classification is responsible for planning, organizing and coordinating medical and program services associated with a major division of the Health Services Agency such as Detention Health and Public Health. The position is responsible for hiring and training key nursing staff on all appropriate shifts and developing policies and procedures that keep the program in compliance with state and federal requirements.  Additionally the position may be responsible for co-supervising mental health and other personnel assigned to detention facilities and public health.  The position is responsible for assuring that the Public Health component in the programs of Disease Control, Maternal Child Health, HIV Treatment, CCS is fully staffed and that medical services are provided consistently on all shifts.   The incumbent is also responsible for supervising the Managers assigned to the above Public Health and Detention Programs.  

This class has the overall assignment of managing the Detention Nursing program, and is differentiated from the next lower class of Assistant Director of Nursing, which has direct responsibility for medical services in the County Juvenile Hall and Sheriff's Rehabilitation Center and assists in the day-to-day operations of the main detention facilities. Detention Nursing operates 24 hours per day, 7 days per week.

Plans, organizes and directs through subordinate managers and supervisors the work of staff in Family Health, Public Health Nursing Services, Detention Medical Services, and other health divisions. Position engages in a variety of community programs; evaluates policies, procedures, programs, organization and rules and formulates improvements; analyzes workloads and develops criteria for determining personnel needs; prepares preliminary budget expenditure and staff allocations; consults with the senior management on work programs, schedules and departmental policy; works with the staff of other divisions, departments and agencies in the development of joint procedures, program planning, and resolution of administrative problems; initiates, develops, recommends and implements policies and procedures; ensures that federal, state and local regulations and the programs and policies of the department are effectively implemented; develops  position statements for presentations to the Board of Supervisors and other agencies; promotes desirable community health actions based on departmental objectives, and provides technical advice and consultation to other County departments, partner agencies, committees, school personnel, and community groups; selects, assigns, trains and evaluates subordinate supervisors;  participates in departmental policy and program development with other top management staff; keeps senior management informed of changes and problems; monitors budget, grant and contract administration activities; prepares reports and correspondence; directs staff orientation and in-service training activities; directs or participates in the collection and analysis of program data;  develops and implements treatment and disease surveillance programs; evaluates and prepares recommendations for improvements in nursing and related medical services;  develops and maintains manuals of policies and procedures; orients newly hired physicians and mid-level practitioners to the Detention process and procedures for medical and health related issues; coordinates case management of difficult medical/psychiatric inmate cases; discusses medical case management of difficult cases with other health care professionals and private physicians/psychiatrists; coordinates and oversees institutional medical and related services with other community services to ensure proper follow-up care; participates in on-call duties after regular hours; responds in emergency situations; authorizes orders for medical supplies and equipment and assures proper care and security; directs the maintenance of medical and administrative records; acts as the official custodian of medical records; develops and implements budgets; acts as an official witness in court cases requiring interpretation of medical records; acts as a liaison between Health Services and the Sheriff's Office; coordinates conferences and staff meetings; attends meetings and conferences; and may input, access, and analyze data using a computer terminal.

Knowledge:

Thorough knowledge of:

• Principles of Public Health and nursing practices and methods. 
• Public health, clinic and common special nursing programs. 
• Federal and state laws and regulations governing public health and detention health. 
• Professional nursing theory, methods and practices.  

Working knowledge of:

• The principles and effective practices of supervision, training, organization and administration.
• The principles of personnel management.
• The causes, treatment and prevention of communicable disease.
• The procedures involved in promoting maternal and child health and providing for health needs of children.
• The sociological problems involved in public health and health systems.
• Laws pertaining to the practice of nursing.
• Medical case management. 
• Medical/psychological assessment techniques.

Some knowledge of: 

• Community resources available for assistance in public health programs. 
• Nursing administration. 
• Principles and practices of treatment and surveillance programs for communicable diseases.
• Governmental budgetary procedures and finance.
• Use and effect of, and adverse reactions to, medications and controlled substances. 
• Emergency response systems. 
• Nursing principles and practices in an acute care facility.

Abilities:

Ability to: 

• Plan, implement and direct through managers and supervisors a broad range of community health and nursing services.
• Exercise initiative, ingenuity and sound judgement in solving difficult administrative, technical and personnel problems.
• Evaluate policy and program practices, define problem areas, develop and direct the implementation of policy decisions and practices to improve operations.
• Understand and interpret to others the aims, concepts, principles and practices of the Health Services Agency.
• Coordinate operational activities with other divisions, departments and agencies.
• Establish and maintain effective working relationships with administrative, medical and non-medical staff, personnel from other agencies and departments and the general public.
• Prepare clear and concise administrative and technical reports.
• Express ideas effectively in oral and written form.
• Provide after hours, on-call response services to health programs.
• Collect and analyze demographic and other data as required.
• Participate effectively in budget development and analysis.
• Devise and adapt work procedures to meet changing program needs.
• Establish and maintain a cooperative working relationship with others. 
• Coordinate treatment and in-service training programs.
• Prepare and present clear and concise reports, instructions and correspondence.
• Develop and evaluate program policies and procedures and implement them as they are approved.
• Work in an institutional setting and apply institutional rules, policies and procedures.
• Use a computer for general business functions. 
• Deal effectively with manipulative, hostile and antisocial behaviors.
• Respond effectively in emergency and stressful situations.
• Make effective, reasonable and responsible decisions in emergencies and take appropriate action.
• Deal firmly and fairly with patients and demonstrate tact and diplomacy.
• Identify alcohol, drug and street drug related symptoms and behaviors.
• Oversee the maintenance of medical records and legally interpret medical records.
• Apply first aid and CPR which requires stamina and coordination.
• Push heavy objects such as Medcarts, or an occupied wheelchair.
• Distinguish colors of uniforms and armbands to identify inmate access to restricted areas.
• Distinguish verbal and nonverbal sounds in a noisy environment.
• Stand and walk for long periods of time.
• Lift objects weighing up to 16 pounds, such as an emergency bag, portable oxygen tank, and medical cardex files. 

Education and Experience:

Possession of a valid Registered Nurse License issued by the State of California.

Possession of a California Public Health Certificate if the position oversees public health.

Three years of supervisory or administrative experience in nursing, including one year of experience in program development and evaluation and for the position managing Public Health these three years must be in a public health setting. A Master's degree in nursing administration or public health administration may substitute for one of the three years of required supervisory or administrative experience.  Possession of one of these Master's degrees is highly desirable.

Special Requirements/Conditions:

License/Certificate: Possession of a valid California Registered Nurse License, a current CPR certificate, and a valid California Class C driver's license. 

Background Investigation: Fingerprinting and a background investigation are required.

Special Working Conditions: Exposure to: Odors such as vomitus, feces, urine and draining abscesses; fumes from cleaning supplies and solvents; noise such as shouting inmates and constant radio communications; hostile individuals; and infections which might cause chronic disease or death.

PREVIOUS CLASS TITLES: Detention Nurse – Program Manager Director of Nursing Services Director of Nursing  
Bargaining Unit: 11
EEOC Job Category: 02
Occupational Grouping: 56
Worker's Comp Code: 0290
Analyst:  RRP/KT/JS/LM
Revised Date(s):4/87, 3/90, 3/93, 9/95