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Description
Job Objective: Under the administrative direction and supervision of the Director of Behavioral Health Services (BHS), and/or designee, the Psychiatric Liaison Nurse, guided by the policies and procedures of the Medical Center and the BHU Charge Nurse is responsible for the coordination of care and treatment of patients requiring psychiatric services, including those currently admitted to the Medical Center, the Women's and Infant Pavilion and those presenting to the Emergency Department with psychiatric complaints; Lanterman-Petris-Short (LPS) assessments, provides pre-admission psychiatric nursing assessments, interventions and aftercare planning.
Duties and Responsibilities:
A Psychiatric Liaison Nurse meets all essential duties and responsibilities of a Registered Nurse for BHS.
A. Assessment -
1. Performs initial patient assessments as ordered to determine the appropriate behavioral health care needs.
2. Obtains patient's medical history.
3. Provides psychiatric nursing assessment for patients who have Behavioral Health Evaluations (BHE) ordered hospital-wide.
4. Assesses patients outside of the Behavioral Health Unit (BHU) for a potential legal Hold per Medical Center policy and procedures.
5. Completes Psychiatric Screening, and/or Admission Assessment, and LPS Assessments on appropriate patients within an established one-hour goal after notification of order for a patient.
6. Reviews laboratory and radiological results on patients in the ED in addition to completing Pre-Admission Assessments.
7. Completes reassessment per WIC Code (5151) of patients when necessary and required by Medical Center policy/procedure.
8. Completes the initial Suicide Assessment Tool on all patients; completes the Suicide Assessment Tool prior to release of patient from the ED.
B. Interventions -
1. Provides appropriate interventions for patients who have any orders initiated by the ED provider.
2. Coordinates medical transfer/transport of patients in the ED and completes necessary duties when needed, facilitates transitions of patients to the most appropriate level of care by providing pertinent clinical information to other health care providers as requested/required.
C. Planning -
1. Provides appropriate aftercare planning and referrals for behavioral health patients who have orders by the ED provider and are not being admitted to the Medical Center.
2. Develops and maintains knowledge and understanding of Medical Center and community resources available to patients and their families.
3. Supports social services as needed with providing patients with referrals to and education of community resources.
4. Follow-up with facilities and coordinate obtaining any additional information required for patients to be accepted for transfer.
D. Evaluation -
1. Evaluates results of interventions.
2. Evaluates the plan(s) of care developed and makes revisions as needed based on patient current condition.
3. Evaluates documentation of other Registered Nurses and patient care teams and provides peer review as assigned.
4. Evaluates the medical record for documentation that supports the services provided to the patient.
E. Documentation -
1. Completes LPS Assessments accordingly to their authorization and Medical Center policy and/or protocols to its entirety.
2. Maintains an accurate medical record for each patient seen.
3. Documents in the medical record to facilitate the completion of arrangements to other acute or post-acute care facilities.
4. Document all patient teaching on established hospital form(s) or in the electronic health record.
6. Documents review of plan(s) of care and any revisions in the patient's medical record.
7. Maintain all LPS Assessments completed, and Advisements completed hospital-wide to include the Emergency Department and provide data to BHS Director and/or Designee.
F. Patient Education -
1. Provides patient education on a routine basis.
G. Reporting -
1. Provides Administrative Director, Behavioral Health Services, with an end of shift report.
2. Completes electronic event reporting system for an adverse or unusual event that occurs in a timely manner.
3. Aware of all Behavioral Health admissions, transfers and discharges that are occurring/expected to occur during the assigned shift or those after the assigned shift and reports this information to the ED Charge Nurse and the, BHU Charge Nurse and House Supervisor when appropriate, using the report format established in Medical Center policy.
H. Quality Management -
1. Participates in the Performance Improvement program of the BHS Department, which includes quarterly peer-review.
2. Assists with emergency room throughput, by facilitating patient transfers from the ER to acute and non-acute placements/settings.
I. Collaboration -
1. Confers with on-call Psychiatrist for patient disposition.
2. Accepts responsibility for communicating with referral sources, third party payers, consultants, and other departments that patients may be referred to for care as needed.
3. Responsible for understanding the Admission and Continued Care Criteria for the BHS Department, including knowledge and ability to review Interqual™ criteria.
4. Acts as a liaison with the other floors and the ED for any difficult patients, patients needing special observations and/or restraint use.
5. Collaborates with medical staff to ensure accuracy and completion of necessary documentation; interacts with medical staff on a professional level and assists in troubleshooting in relation to admission, placement or release of designated patients.
6. Involves the Patient Care Coordination Social Worker with patients and families including bereavement counseling.
7. Assists and functions as a Behavioral Health Staff Nurse in emergency situations, as competency allows.
8. Presents patient via verbal report for all potential admissions to on-call Psychiatrist for admitting orders or disposition.
9. Coordinates face-to-face assessments for Providers as needed.
Non-Essential Duties:

• Submits a written report via e-mail system to the Director of Behavioral Health Services and/or designee, Behavioral Health Charge Nurse, and House Supervisor/Nursing Administration at the end of one's shift on requested information.
• Participates in self-scheduling.
• Assists in special projects and assignments.
• Assists in orienting new employees to the Behavioral Health Services Department as assigned.
• Utilizes proper use of supplies, time, resources, and equipment.

Knowledge, Skills and Abilities:
Knowledge
• Knowledge of all legal aspects of psychiatric behavioral health nursing.
• Knowledge of current nursing practice and procedures including, but not limited to, the specific needs of psychiatric patients as generally acquired through the completion of a formalized nursing program culminating in the award of either an associate or baccalaureate degree in nursing.
• Knowledge of the practical workings of behavioral health programs, as generally acquired through at least one (1) year of experience in a formalized inpatient behavioral health setting.
• Knowledge of psychiatric emergencies, including assessment and intervention, treatment, and community resources, as generally acquired through at least six (6) months' experience in a psychiatric emergency setting.
• Thorough knowledge of behavioral health disorders and psychiatric nursing diagnoses.
• Knowledge and familiarity of regulatory body requirements regarding behavioral health including state and county laws, CMS, and Joint Commission standards. This includes reporting requirements, such as, Department of Justice Firearms Prohibition reporting and Los Angeles County Superior Court Reporting processes for involuntary committed patients (probable cause hearings, writ hearings, etc.)
Skills
• Meets all skill sets of a Psychiatric Registered Nurse.
• Meets all Behavioral Health RN competencies.
Abilities
• Meets all abilities of a Behavioral Health Registered Nurse.
• Ability to assess the individual needs of each patient, and plan for appropriate care.
• Ability to assess crises, and provide intervention and communication
• Ability to assess and care for the psychosocial, cultural, spiritual and learning needs of patients and their significant others.
• Ability to interpret laboratory and radiology findings and act appropriately on any abnormal finding(s)
• Ability to be flexible in meeting the staffing requirements of the team as well as the needs of the Emergency and Behavioral Health Services Departments on an as needed or scheduled basis.
• Ability to maintain the highly confidential nature of the work of Behavioral Health Services.
• Ability to adhere to the Staff Code of Ethics of the Medical Center in Behavioral Health Services.
AVMC Values: All AVMC employees will effectively demonstrate these values:

• Patients Come First - We listen actively and communicate with our patients and families, placing safety as a top priority.
• Accountability & Ownership - We fully complete tasks, are transparent, effectively communicate, and recognize that what we do reflects on us.
• Teamwork - We build trusting relationships, promote a sense of community, and are respectful of everyone. Success is about the whole team.
• Integrity & Honesty - We tell the truth at all times, speak up when something is wrong, and do the right thing when no one is looking.
• Excellence - We take pride in our work, are goal-oriented, and on a never-ending quest for top tier quality.
• Initiative & Innovation - Our can-do attitudes, creativity, and resourcefulness empower us to improve the patient's experience, solve our own problems, make timely decisions, and look for opportunities to add value.
• Tenderness & Compassion - We have genuine empathy, show kindness, and encourage and advocate for each other.

Requirements
Education and Experience:
Education
• Completion of an associate or higher degree program in nursing.
Experience
• A minimum of one (1) year of experience in a formalized behavioral health setting.
• A minimum of six (6) months' experience in a psychiatric emergency or urgent care setting.
Required Licensure and/or Certifications:
• Meets all required California licensure and/or certification necessary for a Psychiatric Registered Nurse.
• Restraint Certification within six (6) months of hire date and annually thereafter.
• Non-Violent Crisis Intervention Certification within six (6) months of hire date and annually thereafter.
• Current BLS required upon hire and biannually thereafter.
• ACLS (within 3 months of hire)
• PALS (within 3 months of hire)
• Become LPS Authorized by the Los Angeles County Department of Mental Health after six (6) months of hire date and renew every three (3) years thereafter.
• Participate in LA County Department of Mental Health's mandatory Annual LPS Refresher Training provided by the Medical Center.
AVMC Conduct/Compliance Expectations:
• Ability to adhere with AVMC Attendance and Punctuality Policy.
• Ability to adhere with AVMC Leaves of Absence Policy.
• Ability to adhere with AVMC Paid Time Off (PTO) Policy.
• Ability to adhere to the department dress code.
• Ability to organize work and establish priorities.
• Ability to expand on own initiative in performance of duties.
• Skill and ability to follow the telephone etiquette/standards.
• Ability to function effectively under pressure and meet time parameters.
• Ability to communicate effectively while maintaining good working relationships with co-workers, managers and other hospital staff.
• Ability to adhere to the normal standards of courtesy and conduct as defined under the rules of hospitality at AVMC.
• Ability to maintain the confidentiality of patients, hospital and department information.
• Ability to adhere to safety rules and regulations.
• Safely and effectively use all the equipment necessary to carry out duties.
• Ability to interpret and function under hospital and department policies and procedures.
• Conforms with required and appropriate accreditation and regulatory requirements.
• Conforms with and supports hospital quality assurance and improvement guidelines.
• Ability to participate effectively in department and hospital staff education.
• Display a willingness to work as a team player.
• Ability to give and support the highest level of patient/customer satisfaction at all times.
• Supports and adheres to the values and mission statement established by the AVMC Board of Directors.
• Ability to demonstrate knowledge and understanding of the Compliance & Integrity Program and its established policies.
• Ability to follow the Code of Conduct.
Physical Requirements and Working Conditions:

• Work is performed in the sometimes hectic and changeable atmosphere throughout the hospital, especially in the Emergency and Behavioral Health Services Departments. On occasion, it may be called upon to assist in the physical management of violent and/or self-destructive behavior. Workload may occur during times of unexpected circumstances, e.g., high activity, high acuity, high census, and sudden emergencies relating to behavioral health patients.

A detailed description of the physical requirements of this job is maintained in the Employee Health Department.
NOTE: THE ABOVE STATEMENTS ARE INTENDED TO DESCRIBE THE GENERAL NATURE AND LEVEL OF WORK PERFORMED BY PEOPLE ASSIGNED TO THIS JOB. THIS DOCUMENT IS NOT INTENDED TO BE AN EXHAUSTIVE LIST OF ALL RESPONSIBILITIES, SKILLS, AND WORKING CONDITIONS FOR THE PERSONNEL SO CLASSIFIED.