Position Summary

The Night Shift Registered Nurse (RN) provides direct nursing care and medical oversight to individuals admitted for withdrawal management and behavioral health crisis stabilization.

This role ensures adherence to all Oregon Administrative Rules ? OAR 309-018 for Detoxification Services and OAR 309-035-0217 for Crisis Respite ? as well as OSBN, OHA, and BOLI standards.

The RN performs comprehensive nursing assessments, medication administration, and client monitoring while maintaining a trauma-informed, person-centered approach to care.

Essential Duties and Responsibilities

1. Admissions, Assessments & Eligibility

• Conduct timely nursing assessments and admissions upon client arrival in accordance with OAR 309-018-0110 and OAR 309-035-0217(10).


• Utilize the ASAM Criteria to assess withdrawal severity and determine medical detox eligibility and appropriate level of care.


• Document all nursing assessments, vital signs, and withdrawal scales accurately and promptly.


• Obtain and verify medication history, allergies, and relevant medical/psychiatric information.

2. Client Monitoring & Safety

• Monitor and document client condition, withdrawal progression, and response to medications throughout each shift.


• Recognize signs of medical distress, overdose, or psychiatric crisis and respond immediately following emergency protocols.


• Maintain a clean, safe, and therapeutic environment per OAR 309-018-0200.


• Conduct regular safety and wellness checks in compliance with facility policy.

3. Medication Administration & Pharmacological Care

• Administer medications safely and in accordance with OAR 309-018-0170, OSBN standards, and physician orders.


• Maintain accurate and timely Medication Administration Records (MARs).


• Perform and document controlled substance counts at shift change, reporting any discrepancies immediately.


• Report and document medication errors, adverse reactions, and near misses in compliance with OHA policy.


• Understand and appropriately use medications for withdrawal management (e.g., benzodiazepines, buprenorphine, clonidine, anti-nausea, and anti-convulsant agents).


• Demonstrate working knowledge of pharmacology, potential drug interactions, and contraindications.

4. Communication & Collaboration

• Communicate effectively with prescribers, medical providers, behavioral health staff, and community partners.


• Participate in interdisciplinary treatment planning, case reviews, and handoff reports.


• Maintain timely communication with referral sources and outside medical providers regarding client needs or transitions.


• Provide comprehensive shift-to-shift handoff reports ensuring continuity of care and medication accuracy.

5. Documentation & Confidentiality

• Complete all nursing documentation in accordance with OAR 309-018-0105, OAR 309-035-0217(9), and agency policy.


• Ensure entries are timely, legible, and clinically relevant. All documentation completed by end of shift.


• Uphold all confidentiality standards under HIPAA, 42 CFR Part 2, and OAR 309-019-0115.


• Maintain secure storage of medical and medication records.

6. Emergency & Crisis Response

• Respond rapidly to medical or psychiatric emergencies, including overdose, withdrawal seizure, or suicidal ideation.


• Follow facility protocols for emergency transfer or coordination with external medical providers.


• Administer emergency medications (e.g., naloxone) and perform CPR or first aid as needed.


• Maintain current CPR, First Aid, and Basic Life Support (BLS) certification.

7. Professional Conduct & Regulatory Compliance

• Practice within the Oregon State Board of Nursing (OSBN) scope of practice (OAR 851-045 & 851-050).


• Demonstrate ethical and professional behavior consistent with the MHACBO Code of Conduct.


• Report suspected abuse or neglect immediately in compliance with ORS 419B.010 and 430.765.


• Attend required trainings on infection control, de-escalation, trauma-informed care, and medication safety.


• Maintain accurate reporting for incidents, errors, and quality improvement activities.

8. Facility Safety & Infection Control

• Follow OSHA and OHA infection control and sanitation procedures.


• Ensure proper use of Personal Protective Equipment (PPE).


• Assist with room and unit readiness, cleanliness, and safety checks.


• Participate in incident reporting and follow-up documentation when directed.

9. Attendance, Scheduling & Workplace Standards

• Maintain regular, in-person attendance as an essential job function.


• Adhere to assigned shifts and complete scheduled handoffs before leaving duty.


• Follow BOLI OAR 839-020 requirements for rest and meal periods.


• Submit vacation and personal time off requests at least 30 days in advance for scheduling coordination.


• Participate in team meetings, trainings, and supervisory check-ins as scheduled.

Minimum Qualifications

• Current, unencumbered Oregon Registered Nurse (RN) license.


• Two (2) years of experience in behavioral health, detoxification, or medical-surgical settings.


• Knowledge of OAR 309-018, OAR 309-035-0217, and OHA Behavioral Health licensing standards.


• Demonstrated understanding of ASAM Criteria, pharmacology, and detox protocols.


• Ability to work with individuals in withdrawal or acute psychiatric distress.


• Excellent communication, documentation, and teamwork skills.


• Must pass background check under OAR 407-007-0200 to 407-007-0370

Preferred Qualifications

• Experience with co-occurring disorders or residential behavioral health.


• Familiarity with EHR systems and medication reconciliation workflows.


• Certification in Addiction Nursing (CARN) or similar specialty.

Working Conditions

• Work performed on-site in detox and crisis respite facilities.


• May involve standing, walking, lifting up to 25 lbs, and exposure to biohazard materials.


• Requires flexible scheduling, including nights, weekends, and holidays.

Supervision

Reports To: Nurse Supervisor / Clinical Director

Supervises: None (provides clinical coordination with nursing peers and behavioral health staff)