Registered Nurse – Health through Housing

Downtown Emergency Service Center


Days Off: Saturday, Sunday

Shift: Office Day

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

Other Benefits: Employee Assistance Program (EAP), Flexible Spending Account (FSA), ORCA card subsidy, Paid Time Off (34 days per year), Retirement Plan


The Registered Nurse (RN) acts as a member of a multi-disciplinary team responsible for providing nursing services to adults experiencing homelessness. The DESC emergency housing sites provide 24-hour, low-barrier, enhanced supportive services. Here, the RN will provide in-the-moment, low-threshold medical access to clients who may otherwise not present to more traditional clinics. Work is done under the supervision of the Outpatient Nurse Manager, Nursing Director and Medical Director at DESC’s emergency housing sites.


  • 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.
  • 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.
  • Actively participate in care planning, medication management and discharge planning for clients enrolled in DESC’s Crisis Respite Program (CRP).
  • Oversee on-site medication monitoring services.
  • Work in close collaborative partnership with prescribing providers, verbally share care plan and clearly document and communicate with prescribers. Engage with emergency housing staff, other nurses, behavioral health providers and case managers to provide follow-up care of patients. Manage client registry to proactively identify clients who need follow-up and reach out to them personally and through case managers and outreach staff.
  • 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.
  • Make frequent contact with clients and use motivational interviewing, client-driven goal exploration, and supportive counseling to enhance adherence.
  • Teach clients about safer substance use, overdose prevention and overdose reversal.
  • Provide / coordinate chronic disease management; educate client re: self-care and medication management.
  • Other duties as assigned.


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.



  • 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.
  • Knowledge of Harm Reduction strategies.
  • Ability to relate to a wide range of people, demonstrate highly developed communication skills, and have a desire to serve homeless, mentally ill clients.
  • Ability to remain open and receptive to constructive feedback.
  • Ability to communicate and coordinate with staff from diverse backgrounds.
  • Ability to work effectively with clients displaying a wide range of peculiar or disturbing behavior.
  • Subscribe to the philosophy of cooperation and continuity across programs and of consideration and respect for clients.


  • Knowledge and skill in working with co-occurring mental health and substance abuse disorders; with homeless or formerly homeless individuals; and 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.
  • Bachelor of Nursing degree.
  • Bilingual in Spanish/English.

Strong applicants are able to 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.

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