Areas of Practice

Nurses holding babies

Primary Care

We offer primary care — including acute, chronic, and preventive care — in all 25 Kaiser Permanente clinics. Primary care nursing services include adolescent health, behavioral health, family medicine and pediatrics, family practice obstetrics, injection and infusion services, occupational health, and treatment services including complex wound care.

Women's health care services are also available in primary care. This includes reproductive health, gynecological care, maternity care, and general preventive services such as Pap smears and breast exams.

RNs work in roles to support primary care providers or in our treatment and injection rooms by providing wound care, immunotherapy, and a variety of other procedures. RNs are primarily responsible for care coordination, care management of complex patients, and clinical oversight within the team.

Specialty Care

While we offer specialty care at many of our clinics, most specialty services are available at our Capitol Hill, Bellevue, Tacoma, and Olympia clinics. Many specialty areas, such as gastroenterology and cardiology, have a high volume of procedures that may be relevant for clinical experience.

Ambulatory care is an exciting area of practice where multi-disciplinary teams work together to support the patient's goals and experience. In our infusion centers, for example, staff have an opportunity to develop longer term relationships with patients as they receive treatment and support for their cancer and other diagnoses.

Care coordination, guided patient self-management, and patient education are key to meeting the needs of our patients in multiple specialties. In addition, our ARNPs treat patients using evidence-based guidelines and nursing research, and they contribute to nursing research through participation in studies.

Continuing Care

Our Continuing Care department provides home health and hospice services in a patient's home setting. This includes private homes, assisted living, adult family homes, and skilled nursing facilities.

Home health nurses often see patients discharged from a hospital or skilled nursing facility. They make sure patients understand their follow-up plans, medications, and when to call a doctor. Home health requires skills in comprehensive assessment; teaching; and expertise in areas such as chronic disease management, wound care, and IV management.

Hospice nurses work with patients needing end-of-life care. Nurses make sure patients are comfortable at home or other facility. Hospice nursing requires expertise in pain and symptom management as well as an ability to work with patients and families who are facing difficult choices and decisions.

Urgent Care

Kaiser Permanente Washington has six urgent care clinics. Nursing in urgent care is important for clinical quality, access, and patient satisfaction. We are always looking for innovative ways to improve patient care.

In fact, at our Capitol Hill Campus in Seattle, we've developed a Rapid Medical Evaluation team that pairs a RN with a provider in triage. This has led to dramatic reductions in length of stays and improved patient satisfaction. At our Bellevue Urgent Care Center, we implemented a protocol to reduce the number of catheter-associated urinary tract infections. Nursing staff at our Olympia Urgent Care Center have developed a standardized approach to get EKGs for patients with chest pains, and rapid transfer of patients with symptoms of a heart attack. These have led to early detection and improved patient outcomes.

Complex Care Management

Our Complex Care Management Department includes nurses and social work case managers who perform both inpatient and outpatient case management services designed to help patients become more active participants in their health care.

In the inpatient setting, case managers coordinate and monitor care for patients in contracted facilities. The nurse, in partnership with the patient and treating physician, is responsible for assessing the patient's care needs and facilitating transition or discharge planning.

For outpatient situations, case managers provide focused interventions for complex patients who need additional support. They help develop care plans that the patient, a family member, or caregiver can understand and manage to improve the patient's quality of life.

Consulting Nurse Service

Our Consulting Nurse Service (CNS) provides high-quality, telephone-based nursing advice for Kaiser Permanente members 24/7. All medical calls are triaged to RN's who assess a member’s symptoms using established evidence-based protocols.

Consulting nurses offer advice for self-care; when necessary, direct members to a primary care clinic, emergency or urgent care facility; and provide care coordination. Nurses have access to our members’ electronic medical records which helps them assess a patient's care needs and conditions, and document a care plan. CNS nurses can also consult with providers located on site 24/7.

In addition to the consulting nurse helpline, nurses also answer patient questions using secure web-based messaging through Kaiser Permanente's member website.