Walking into the Washington County Mental Health Heaton Street building, one might notice a series of old photographs dotting the wall. Black and white images of the nurses that worked, trained, and slept within these walls are available for all to admire. The smiling faces of dozens of hardworking women are captured between shifts at the hospital across the street. Fast forward more than half a century and the rooms that were once designated as nursing dorms now house the offices of many of our nurses. Gone are the days of nursing caps and freshly pressed crisp cotton uniforms. What is here to stay is our unwavering nursing commitment to the care of our clients. We work hard and we love what we do.
Nursing services are embedded in all divisions at Washington County Mental Health Services providing nursing expertise and perspective; we pride ourselves in having a talented and highly skilled staff of 15 nurses. There are approximately 40 different agency programs that benefit directly from nursing involvement in a variety of ways.
Washington County Mental Health’s nursing team strives to provide the highest level of compassionate and quality care for clients of all ages and backgrounds. We serve as examples of professional nursing excellence by focusing on the unique and sometimes challenging medical and psychological needs of our clients. We use evidence based practices, education and research to utilize therapeutic techniques that are the most appropriate to our clients’ needs; whether it be based in biology, psychology, sociology or a combination and mixture of all disciplines. We are committed to fostering an environment that promotes respect, positive communication, and collaboration with all members of the family and healthcare team. We believe that healthcare is a basic human right and that our clients have the right to dignity, respect and the ability to make autonomous decisions about their plan of care.
To administer medications within WCMHS programs, staff are trained, delegated, supervised, monitored, and evaluated by nurses. The nurse retains accountability for all delegations. WCMH nurses are available to delegated staff as a medical resource for any question or concern that arises around medication administration. Nurses are also responsible for performing and documenting assessments regarding consumers’ ability to self-manage and/or self-administer medications independently.
With the recent adaptation of RBA statistical collection within the nursing department, we have been able to more accurately track the number of staff delegations. For the 2014 calendar year there was an average of 273 individual staff delegated under WCMH nursing licenses to perform nursing tasks such as medication administration. In the same time period, there was an average of 9,621 medication passes that occurred under our nursing licenses in any given month.
Our Children and Family Services nursing care has expanded with our school nurse filling a health teaching role in addition to day to day medication management and student evaluations. We have added a second dedicated nurse to work specifically with our CDS residential programs providing nursing interventions, assessments, and delegations to target medical conditions and provide services where gaps existed before.
For 4 years, the nursing department has had a nurse working with clients at the Sunrise House program. The nurse works with participating wellness clients to address co-morbidities through monthly goals and one on one meetings and support. In an effort to expand these areas of wellness support, the nursing department has begun a discussion with other wellness initiatives around the agency and actively participates in the agency’s Wellness Collaborative.
At Heaton Street, the Assist Team nursing role has expanded and is working with outside providers on improving the flow of information regarding medication orders and instructions, hospital discharges, pharmacy coordination and other important details. Also at Heaton Street, two nursing roles have been streamlined into one position in an effort to improve communication and provide more continuity of care for clients in the areas of phone triage and residential support.
Continuity of care and access to care is an area we continue to improve and expand upon. Our Nursing Department is pleased to continue our participation in the Community Support Program’s impact group, which brings together health care, substance abuse, and mental health community partners to discuss problems and engage in problem solving regarding the needs and challenges for CSP clients served by multiple providers. The nursing department is also involved in the strategic planning and implementation of our Health Home service soon to be available in Building C. And those bundles of flowers that appear in your building for no apparent reason? Those are brought to you by a nurse whose only goal is to brighten your day and bring a smile to your face, we call that our staff wellness initiative.
A short list of what nurses do at Washington County Mental Health Agency for clients and staff would be: administering injectable medications, including WCMHS annual staff flu clinics; wound assessments and direct wound care; drawing blood at program site locations; establishing and evaluating special care procedures and treatment protocols; generating and evaluating care plans; reviewing and acting on laboratory data; medication reconciliation for program admissions and as an ongoing process; supporting and educating clients around smoking cessation, weight loss, diabetes control, and increased mobility; staff education, staff support; admission nursing systems review and wellness checks; supporting our prescribers through medication refills and problem solving with pharmacies and consumers; providing ongoing trainings and guidance to staff regarding seizure disorders, rule 4500 injury assessments, lice checks, vision and hearing screenings; med training and annual recertification, vital sign assessments and AIMS scoring. There is always a nurse available on-call 24 hours a day, 7 days a week at pager #250-6709 to handle emergent questions and concerns that develop when the assigned program nurse is not available.
Great effort has been put into identifying each nurse’s individual strengths and then restructuring their job assignments around development and utilization of those specific strengths. The Washington County Mental Health Agency’s nursing team is a dynamic, dedicated and resilient group of professionals that genuinely care about the clients in their care and work very hard to exceed state and national standards for excellence. From the nursing services at Heaton Street many years ago to the daily commitment demonstrated by the current WCMHS nursing team, a timeless quality endures indeed.
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