Provide skilled professional nursing care to patient/family/caregivers as prescribed by the physician and in compliance with regulations by the State Board of Registered Nursing and company policies when called upon after hours. Prioritize calls, and instruct nurses to see patients as needed. Guide after hours staff in assessing and treating physical, psychological, psychosocial and spiritual needs. After clinical and social staffs report findings and interventions, determine appropriateness and if any further instruction is needed.
Work closely with all members of the Interdisciplinary Team to ensure proper patient follow up on previous night after hours calls. Adhere to company policies and procedures and regulatory compliance requirements and directives. Timely documentation of all after-hours calls and visits including problem and intervention. A registered professional nurse with advanced skills, employed with hospice for the purpose of enhancing the quality of care for the entire agency by prioritizing patient calls after hours. Provide leadership and support to the after hours staff. Adhere to company policies and procedures and regulatory compliance requirements and directives. Manage related expenditures in a fiscally responsible manner within the companys budget, and report to case managers any supplies that were ordered previous on call day.
ATTRIBUTES / QUALIFICATIONS
Ability to work within an interdisciplinary setting. Understanding of hospice philosophy, principles of death/dying, and the ability to advise the caregiver and Odyssey staff in proper management of symptoms. Compliance with accepted professional standards and practices. Demonstrate excellent observation, assessment, nursing judgment and communication skills. Ability to provide accurate written documentation in a timely manner. Self-directed with the ability to work with some supervision from the on call administrator.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
REQUIRED EDUCATION / EXPERIENCE
Registered Nurse licensed in the state. Bachelors degree and A.C.R.N.H certification preferred. Minimum of one year of general nursing preferred, with a minimum of six months to one year of experience in hospice or pain and symptom management interventions preferred.
1.Abides by and demonstrates the company Mission Vision Values through both behavior and job performance on a day-to-day basis.
I. Nursing Process
As a member of the Interdisciplinary Team, the On-Call Nurse utilizes the nursing process to assess and provide appropriate interventions for immediate problems.
A. Assessing and Planning
1.Seek and obtain sufficient information necessary to function effectively in the hospice setting where the patient/family/caregiver are requiring care.
2.For after hours concerns, conduct initial nursing assessment, including physical and psychosocial aspects of patient/family/caregiver in a thorough, accurate, compassionate and timely fashion.
3.Utilize own special body of knowledge to provide leadership and guidance to the after hours staff in formulating and individualizing interdisciplinary plan of care to include problem identification, interventions and goals to address palliative comfort measures for the terminally ill patient/family/caregiver.
4.Contribute to identifying both active and potential needs of the patient and his/her family, which may affect the plan of care.
5.Consistently collaborate with the physician to plan and implement the medical and nursing plan of care of any after hours problems.
6.Review the comprehensive interdisciplinary plan of care with the IDG Team. Communicate in writing in the chart and verbally with report on the previous nights problems to coordinate interventions and ensure continuity of care.
B. Implementing and Evaluating
1.Facilitate the implementation of nursing interventions and appropriate preventative and therapeutic nursing procedures for problems that occur after hours. Provide direct patient care as necessary.
2.Collaborate with after hours staff members to provide continuous assessment of immediate problems, interpret findings, initiate appropriate therapeutic actions, and evaluate the results of these actions.
3.Accept responsibility of assignment to perform a specialized procedure only when qualified with specialty training, proven competency, clinical background, and expertise in the specialty area.
4.Work in cooperation with family/caregiver and interdisciplinary team members to meet the emotional needs of the patient/family/caregiver.
5.Provide appropriate information and explanation to the patients families. Facilitate patient and family education to promote continuity of care and optimal patient/family outcome for a quality death as defined by the patient/family/caregiver.
6.Demonstrate expertise in the utilization of all after hours staff, including volunteers and community resources.
7.Submit accurate, relevant clinical notes regarding patients condition and care given for problems that occur after hours.
8.Assist in the investigation and resolution of quality issues in conjunction with the Continuous Quality Improvement Committee.
9.Complete and maintain all patient records at patients residence, maintain chart and submit accurate and relevant clinical notes regarding patients condition and care given.
The On-Call Nurse is a mentor who demonstrates an ability in providing educational experiences and communicating knowledge of patient care to members of the Interdisciplinary Team including, but not limited to: volunteers, patient and families/caregivers, health care professionals, and the general community.
A. Act as a mentor who facilitates individual staff development from novice to expert. Participate in the orientation of new personnel and assist with field training as needed.
B. Identify the learning needs of the hospice staff and other health care professionals, and facilitate formal and informal in-services to promote professional growth of all Interdisciplinary Team members.
C. Teach patient/family/caregiver disease process and self-care techniques when requested by caregivers after hours. Provide medication, diet and other instructions as ordered by physician and recognize and utilize opportunities for health counseling with patients/families/caregivers.
D. Facilitate the development of teaching aids to promote patient/family/caregiver learning.
E. Evaluate effectiveness of educational experiences in order to promote ongoing professional development of staff and quality patient/family/caregiver outcomes.
F. Attend monthly nursing meeting as required.
The On-Call Nurse provides leadership and support to encourage optimum development and performance of each after hours hospice staff member and provides an atmosphere that is compatible with team building.
1.Assume leadership role to facilitate interdisciplinary coordination and collaboration.
2.Demonstrate behavior appropriate to role model and leader.
3.Demonstrate creativity and critical thinking ability in the development of patient care plans or projects.
4.Assume leadership role to facilitate interdisciplinary coordination and collaboration.
5.Function without supervision, utilizing time constructively and organizing assignments for maximum productivity.
6.Function as a change agent, facilitating change by utilizing a constructive approach.
Identify self and clarify role to patient/family/caregiver, physicians, nursing facility staff and other referral sources.
Recognize and respond appropriately to PCG and after hours staffs concerns.
Communicate effectively with all members of Interdisciplinary Team by:
Defending and supporting after hours staffs decisions and actions.
Asserting self with tact.
Supporting collaboration by encouraging communication between after hours social support and after hours clinical staff.
Maintaining open communication.
Offering suggestions and criticisms constructively.
Maintaining confidentiality in all areas.
Obtaining report from PCMs and admissions staff prior to start of shift.
Reporting to individual PCM regarding assessment and intervention for problems related to their assigned patient.
Notify team of deaths and admissions.
Coordinating visit nurses visits with newly admitted patients and patients that are immediate or require immediate symptom management as required.
4.Relates complete and pertinent information in verbal and written communication. Maintains clinical records, statistics, reports as prescribed and in compliance with local, state and federal laws
5.Initiates and maintains open and effective communication with Patient Care Manager and General Manager as well as members of the Interdisciplinary Team as evidenced by improved patient outcomes.
C. Quality Improvement
1.Facilitate the quality improvement process.
2.Facilitate active, ongoing problem solving, which reflects Interdisciplinary Team participation.
3.Pursue after hours problems to resolution, and/or refer them through the appropriate chain of command.
4.Assume responsibility for personal growth and maintain and upgrade professional knowledge and practice skills through attendance and participation in continuing education and in-service classes.
5.Assure compliance with local, state, and federal laws, Medicare regulations, and establish personnel policies and procedures.
6.Maintain all appropriate state nursing licensing requirements.
1.Strengthen problem solving ability of staff through periodic review of patient outcomes and facilitates implementation of peer review.
2.Maintain confidentiality in matters relating to co-workers.
2.Adheres to and participates in Companys mandatory HIPAA privacy program / practices, Business Ethics and Compliance programs / practices, and all Company policies and procedures.
3.Participates in special projects and performs other duties as assigned.
Kindred is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.
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