Registered Nurse (RN) - ORCA Center, Night Shift

Description

Schedule:

• Before ORCA Center Opens (anticipated in summer-fall 2025): Monday – Friday, 9:00 am – 5:00 pm; clinical care on DESC’s Opioid Treatment Network team.
• After ORCA Center Opens: Planned schedule is three (3) 12-hour shifts with at least two 30-minute breaks, 7:00 pm – 7:30 am, per week, with some weekends required; and one additional 12-hour shift every 4 weeks. Please note that ORCA is a new program, and the schedule is subject to adjustment as necessary to meet operational and clinical needs.

Shift Differential: $3.25 per hour

Supervised by: ORCA RN Supervisor

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

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.

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 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!

The ORCA Center is estimated to start clinical services in mid-2025 (though the RNs will start once hired) and will be open 24 hours per day, 7 days per week, including holidays. It will offer 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 Code of Federal regulations 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, such as hepatitis C testing and treatment and HIV pre-exposure prophylaxis.
• Follow-up care, at the ORCA Center or at times field-based, with individuals who have started MOUD to ensure support in MOUD continuation.  

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. 

Requirements

MINIMUM QUALIFICATIONS:

• Registered Nurse, licensed in the State of Washington, in good standing.
• 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:

• 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.