Street Medicine Nurse Practitioner

We are excited to continue providing care to people experiencing homelessness through our growing Street Medicine team. We are recruiting for a Street Medicine Advanced Registered Nurse Practitioner (ARNP). You’ll work as part of an interdisciplinary outreach team that includes a nurse and a community health worker, with a physician available for consultation.  This role provides the opportunity to care for people in our community who have a great need for compassionate, respectful, and coordinated medical care. From a clinical standpoint, you will provide a broad scope of primary care services in the field, with a substantial focus on substance use care. This is a Project, Full-Time (1.0 FTE) position currently funded through 9/30/2027.

This is an advanced professional classification that works in collaboration with other health care team members to deliver patient-centered, trauma-informed care for people experiencing homelessness. This position involves supervision of other nurses and clinical staff to ensure the delivery of quality health care and health education to those seeking services. In addition, the Advanced Registered Nurse Practitioner (ARNP) provides hands-on care, develops evidence-based treatment plans, performs a variety of diagnostic workups, and prescribes medications.

Distinguishing Characteristics
This is a single-level classification within the nursing services field that is supported by clinic physicians and/or a Medical Director. This role works independently, under the general supervision of a physician. Employees in this classification work with sensitive and confidential information requiring a high level of discretion.

Examples of Key Duties
 The items in this section are the key duties and responsibilities for this job and do not represent an exhaustive list. Our organization is dynamic, and duties may change based on business needs. Any new duties will remain within the scope of the job.

The Street Medicine Nurse Practitioner serves as the primary care provider within the Street Medicine team, and as the day-to-day clinical lead. Our Street Medicine team provides primary and urgent care for people experiencing homelessness in Pierce County. The Street Medicine NP works as part of an interdisciplinary outreach team that includes a nurse and a certified peer navigator to provide compassionate and culturally appropriate medical care for people in our community. From a clinical standpoint, the Street Medicine NP provides a broad scope of primary care services in the field, with a substantial focus on substance use care and mental health. 

•Provide respectful, culturally appropriate outreach and patient care in the field (e.g., at encampments, streetside for people living in cars).-Services include a broad range of primary care and urgent care issues, such as wound care, chronic disease management, mental health care, and substance use care.• Coordinate with local healthcare organizations, including opioid treatment programs, to help people transition into traditional facility-based care, if they are able to do so.
* Work with certified peer navigator and RN to coordinate patient care.
• Build collaborations with community partners and organizations involved in homeless services. 
• Develop and review Street Medicine policies and procedures, including standing orders if needed. 
• Develop training materials and sessions for other Street Medicine staff and volunteers. 
• This work might require you to participate in the Title XIX Medicaid Claiming Program.
• Performs other duties as assigned.

Emergencies:
When public health responds to an emergency you may be assigned duties and responsibilities that are outside your regular job description. This may involve responding at any time and reporting to a location other than the department with different working conditions and physical requirements. You are expected to participate in emergency preparedness activities including our emergency notification system, WA SECURES. Drills and real-world events may take place at any time.

Click here for a detailed Classification Specification. (See Advanced Registered Nurse Practitioner)

Knowledge and skills:

• Knowledge of the patient population and approaches to effective engagement and care for people experiencing homelessness and people with limited access to healthcare services.
• Knowledge of principles, laws, regulations, policies, practices, and guidelines applicable to the body of work, including those governing the prescribing of medications for opioid use disorder and the provision of substance use care more broadly.
• Effective coordination of care and appropriate use of referrals. 
• Understanding of ethical principles and how they apply to public health work. 
• Diagnostic reasoning and clinical decision-making skills. 
• Strong communication, engagement, and de-escalation skills.
• Excellent planning and analytical skills.
• Exhibits dynamic leadership and mentorship skills for fostering a strong team environment.
• Intermediate knowledge of the following software: standard Microsoft Office programs, electronic medical records usage.

Job Specific Skills:

• Knowledge of neurobiology of addiction, pathophysiology of substance use disorders, pharmacology of medications for opioid use disorder (MOUD) and medications for treatment of alcohol use disorder, contingency management for stimulant use disorder, common medication interactions and contraindications, mental status assessment, medical decision making capacity assessment, management of sexually transmitted infections, screening of co-occurring medical and psychiatric conditions like ADHD, withdrawal management, toxicology, screening and diagnostic tests, EKG interpretation, basic life support, and motivational interviewing.
• Ability to work daily with patients who often have extremely difficult life circumstances and collaboratively stigma, discrimination, and marginalization
• Ability to work collaboratively with patients and other health professionals. Exercise independent clinical judgment in determining when to consult other resources for diagnosis management. 
• History taking, physical examination, diagnostic reasoning, and clinical decision-making.
• Knowledge of harm reduction, health promotion, and risk assessment.
• Awareness of community, professional, and educational resources and the ability to direct patients to the appropriate resource.

Competencies:

• Cultural competency: Demonstrates knowledge of the implications for public health of increasingly diverse communities (including racial, ethnic, linguistic, religious, gender diversity and more.)  Understands the impact of decisions on our diverse workforce and community. Adapts public health education practices to the needs of diverse populations.  
• Accountability: Takes personal responsibility for the quality and timeliness of work. Ensures that work is complete and accurate. Independently follows up with others to ensure that agreements and commitments have been fulfilled. Manages own time, priorities, and resources to achieve goals. Accepts responsibility for mistakes. Complies with established control systems and rules.
• Adaptability & Flexibility: Adapts behavior or work methods in response to new information, changing circumstances, changing workload demands, or unexpected obstacles. Adapts to a variety of situations, individuals, and groups.  Is open to change and new information. Effectively deals with uncertainty.
• Communication: Able to communicate effectively and clearly both verbally and in writing to varied audiences, including communicating information of a technical nature. Listens to others, understands and learns from what others say, and asks questions that enhance the clarity, quality, and/or reliability of the information. Grasps the meaning of written information and instructions. Chooses the appropriate method of communication for the given situation.
• Customer Focus: Provides courteous service to internal and external customers. Works with customers to assess their needs, provide information or assistance, and resolve their problems, including complex or sensitive issues. Seeks to improve the quality of services. Knowledgeable about available products, resources, and services.
• Ethics & Integrity: Displays high standards of conduct and understands the impact of violating these standards on the organization, self, and others. Is considered trustworthy by peers and managers. Contributes to maintaining the integrity of the organization.
• Interpersonal Relationship: Develops and maintains constructive working relationships characterized by a high level of acceptance, cooperation, and mutual respect. Gets along and interacts positively with co-workers and others. Shows understanding, friendliness, courtesy, tact, empathy, concern, and politeness to others.  
• Conflict Management: Diplomatically handles challenging or tense interpersonal situations. Maintains composure in highly stressful or adverse situations and works to de-escalate them. Is sensitive to cultural diversity, race, gender, disabilities, and other individual differences.  
• Problem Solving & Decision Making: Recognizes and defines problems. Identifies and evaluates alternative solutions before deciding on or proposing a solution. Makes educated, effective, and timely decisions, at times with limited information in a fast-paced environment. Able to utilize technical information to make effective and timely decisions.
• Confidentiality: Maintains sensitive and confidential data. Demonstrates discretion when sharing information.
• Safety Focus & Emergency Preparedness: Adheres to all workplace and trade safety laws, regulations, standards, and practices. Understands and properly follows established procedures in preventing and responding to unsafe or emergency situations. Identifies and reports potentially unsafe practices or conditions. Operates equipment, tools, machinery, and vehicles safely and understands processes for reporting an accident or injury. Understands and applies knowledge and skills necessary to successfully perform assigned emergency response role during an emergency.

The items below are the requirements for the job and are relevant to this position. The organization values work experience, lived experience, and education and realizes that people take different paths to acquire knowledge.

• Bachelor of Science in Nursing from an accredited school of Nursing. 
• Masters or Doctorate of Science in Nursing from a school accredited by the Commission on Collegiate Nursing Education.
• One year of experience working in a public or community health setting.

Preferred Experience:

• Experience with medical care for people experiencing homelessness. 
• Experience with substance use care.

We will consider any equivalent combination of education and experience that provides the necessary qualifications to successfully perform the duties of the position.  

Professional certifications and licensure we require the below for this role.  

• Current Washington State Advanced Registered Nurse Practitioner (ARNP) License and Washington State Registered Nurse (RN) License. 
• Current Drug Enforcement Administration (DEA) License.   
• Current American Heart Association (AHA) Basic Life Support (BLS) CPR certification.
• Valid Washington driver’s license and willingness to be trained to drive a class B camper van or cargo van.

Physical demands:

• Regularly required to sit or stand continuously.
• Regularly communicate clearly in-person, over the phone, and via written communication, including communicating with dissatisfied or angry individuals.
• Capable of reading physical and electronic documents and working for prolonged periods on a computer monitor.
• Fine motor skills sufficient to grip and manipulate paper and operate a telephone, a computer mouse and keyboard, and use standard medical equipment.
• Reaching and gross manipulation capabilities sufficient to pick up and use standard office supplies and medical equipment.
• Frequently move across various surfaces including unlevel or uneven ground when working in outdoor environments. This work can involve significant walking in all weather conditions, including wet or muddy conditions.
• This position may require lifting, carrying, pulling, or moving objects up to 15 pounds consistently, 30 pounds frequently, and exerting up to 50 pounds of force occasionally.
• Specific vision abilities required by this job include close, color and peripheral vision and the ability to adjust focus. 

Tools and equipment:

• Duties require the use of standard office furniture and equipment (e.g., desk, filing cabinet, computer, printer, telephone, copy machine, etc.)
• Medical equipment.

Travel:

• Frequent travel will be required throughout Pierce County.
• Some additional travel may be required, and is typically local or regional, to conduct business and attend or provide training.

Click Here for more details on reasonable accommodations, safety, risk management and more.