REGISTERED NURSE IV

DEFINITION

This is advanced professional and supervisory, educational or specialized nursing work.

An employee in this class is responsible for coordinating, directing, evaluating and participating in the nursing care of physically or mentally ill or disabled patients or mentally retarded/developmentally disabled clients; or for work of comparable responsibility involving the application of advanced and specialized nursing skills in the performance of duties. Employees in this class normally are responsible for all nursing services in a moderate-sized multi-ward unit or program or serves as the facility-wide nursing supervisor on an assigned shift, depending on the size of the facility and the diversity of nursing services provided. An employee may also function in a specialized clinical, educational or administrative capacity in areas such as psychiatric nursing, nursing staff development, quality assurance, utilization review, employee health, infection control, oncology, endoscopy, etc. Supervision is usually exercised over subordinate professional and paraprofessional nursing staff. The employee is expected to work independently with a minimum of supervision and work is reviewed by superiors for conformance with established policies and effectiveness of nursing procedures.

Any one position may not involve all of the specified duties or knowledges, skills and abilities, nor are the listed examples exhaustive.

EXAMPLES OF WORK

Directs and evaluates the nursing services provided in a moderate-sized multi-ward unit or program; in a smaller facility may function as a facility-wide shift supervisor; directs and supervises the work of subordinate professional and paraprofessional nurses; promotes a therapeutic milieu in assigned area.

Reviews nursing assessments, diagnoses and care plans and evaluates effectiveness of nursing interventions.

Makes rounds of unit and/or facility to inspect patient/client care and treatment, reviews clinical records, charts and progress records and consults with physicians as needed.

Provides specialized clinical nursing services in a specific area; conducts nursing assessments; develops nursing diagnoses and care plans; implements complex therapeutic nursing interventions; provides guidance and consultation to other nurses in the area of expertise.

Plans, directs and evaluates a nursing inservice and training program under the direction of a Staff Development Officer or under the supervision of the Director of Nursing Education; plans and conducts training and orientation sessions for professional and paraprofessional nursing staff.

Serves as a quality assurance monitor; identifies nursing problem areas, devises plans to alleviate these problems, and evaluates results; plans, implements and evaluates peer reviews and nursing audits.

Coordinates and implements a nursing-related program such as infection control, utilization review, employee health, etc.

Performs other related duties as assigned

KNOWLEDGE, SKILLS AND ABILITIES

Thorough knowledge of professional nursing theory, practices and standards.

Thorough knowledge of pharmacology, therapeutic diets and nutrition, aseptic techniques, and other basic natural and social sciences necessary to provide good nursing care.

Considerable knowledge of management principles and techniques as applied to the administration of nursing.

Ability to direct, supervise and evaluate nursing functions related to patient/client care and staff relationships.

Ability to conduct nursing assessments, develop nursing diagnoses and formulate short and long-term objectives and treatment plans.

Ability to administer detailed therapeutic prescriptions.

Ability to implement and evaluate specialized nursing interventions within the area of expertise.

Ability to develop and maintain an empathetic attitude toward and therapeutic relationships with the physically or mentally ill or disabled and their families.

Ability to establish and maintain effective working relationships with peers, superiors, subordinates and students.

EXPERIENCE AND EDUCATION QUALIFICATIONS

(The following entrance requirements are used to admit or reject applicants for merit system examinations, or may be used to evaluate applicants for employment in positions not requiring selection from merit system registers. When applicable, equivalent substitution will be allowed for deficiencies in experience or education.)

One year of professional nursing experience; and possession of a Master's Degree in Nursing from an accredited college or university.

OR

Two years of professional nursing experience including at least one year of supervisory, educational or specialized clinical experience; and graduation from an accredited four-year college or university with a Bachelor's Degree in Nursing. (Applicants with a Nursing Diploma or Associate of Arts Degree in Nursing will be accepted with one additional year of general professional nursing experience.)

OR

One year of experience as a Registered Nurse III under the Missouri Merit System.

SPECIAL NOTE

Certification by the American Nurses' Association (or other comparable body with equivalent certifying requirements) in psychiatric and mental health, medical-surgical, pediatric, gerontological or general nursing practice, nursing administration, or other areas relevant to nursing practices in state agencies may be substituted for one year of the required general experience.

NECESSARY SPECIAL REQUIREMENT

Possession of a current license to practice as a Registered Nurse in the State of Missouri at the time of appointment.

(Rev. 10/1/89)