PRIMARY JOB DUTIES

Complete ongoing assessments of patient and family/caregiver needs, identifying the physical, psychosocial, emotional, bereavement, environmental, safety, and developmental needs related to the patient's terminal illness and provide direct or supervised nursing services in accordance with the developed Plan of Care.

Assist in the development of an individualized plan of care through collaboration with the hospice interdisciplinary team, patient, and family/caregiver that incorporates palliative nursing interventions by providing accurate and appropriate data based on assessment findings, identification of needs, and patient and family/caregiver goals and preference.

Communicate with the physician (Attending and Hospice) and RN Case Manager regarding the patient’s needs, response to treatment, and changes in the patient’s condition; obtain/receive physician orders as required.

Under the supervision of a Registered Nurse, serve as a collaborative member of the IDG and in cooperation with family/caregiver to provide holistic physical, psychosocial, emotional, and spiritual services, including bereavement support to the patient and family to achieve the highest quality of care.

Organizes and performs work effectively and efficiently, maintaining and adjusting schedule to ensure patient care needs are met and to enhance agency performance.

Demonstrates positive interpersonal relations in dealing with all members of the agency.

Communicates with courtesy and compassion to agency customers and employees, conducting self in a professional manner.

Effectively demonstrates the mission, vision, and values of the agency and a commitment to Well Care Health’s Guiding Principles.

1.0 45% QUALITY OF WORK

1.1 15%

Utilizing all aspects of the Nursing Process (assessment, planning, implementation, evaluation) with appropriate skill to effectively carry out the Plan of Care for each patient as evidenced by:

• Assessing the patients’ and family/caregivers’ physical, psychosocial, bereavement, environmental, safety, and developmental needs.
• Implementing the Hospice Plan of Care as prescribed by the physician and in conjunction with the other members of the interdisciplinary group.
• Providing care to patients and families through the utilization of interventions and evaluation of outcomes of care.
• Assisting the RN Case Manager and other interdisciplinary team members in the revision of the plan of care, based on the changing needs of the patient and family/caregiver, to anticipate, prevent, treat, and manage pain and other undesirable symptoms through ongoing communication of collected data and assessment findings.
• Provide support, instruction, and education of the patient, family and other caregivers who participate in the care of the patient in relation to needs identified on the plan of care, including, but not limited to, disease process and progression, medications, pain, symptoms associated with disease, oxygen safety, Hospice philosophy, and care of the terminally ill.

1.2 15%

Effectively and efficiently assists in the care of hospice patients and assists in the coordinating care with the interdisciplinary team.

• Maintains open communication and coordination of care, acting as a liaison between physician, patient/family, and hospice team.
• Performs ongoing assessment of the patient based on the Plan of Care and communicates findings to the RN Case Manager and other interdisciplinary team members as appropriate.
• Performs and reports assessment findings of the patient’s pain and other undesirable symptoms to the RN Case Manager and physician in a timely manner.
• Maintains an accurate and updated medical record, including all coordination of care notes, on-going assessments, communications with others involved in patient’s care, and any other information pertinent to the care of the patient.
• Attends and participates in regularly scheduled interdisciplinary group meetings.
• Ensures that arrangements for equipment and other necessary items and services are available.
• Reports abuse and neglect in accordance with state laws and regulations as well as organization policy and procedure.

1.3 10%

Appropriately communicates information in accordance with agency policies and procedures and discipline specific guidelines.

• Documents nursing assessments, identified problems, measurable goals of care, and limitations to provision of care, care interventions, and response to care in the electronic medical record.
• Documents all patient related visits and phone calls within the EMR and ensures documentation is completed and synchronized after visit completion.
• Completes, maintains, and submits accurate and relevant notes regarding patient’s condition and care given. Records pain/symptom management changes/outcomes as appropriate.
• Documents all physician orders received within the EMR.
• Consults and collaborates with the hospice interdisciplinary team and others involved in the patient’s care.
• Maintains close contact with the patient’s family/caregiver to provide information, support, and continuity of care.
• Maintains collaborative relationships with long-term care facility personnel to support patient care and ensure quality symptom management.

1.4 5%

Contributes to program effectiveness as evidenced by:

• Provides holistic, patient/family-centered care across treatment settings to ensure continuity of care and facilitate attainment of goals of care.
• Provides medication review and reconciliation of medication list within the EMR. Ensures medications necessary to ensure patient comfort are available.
• Maintains a high level of knowledge pertaining to the management of pain and symptoms in the dying process.
• Participates in the provision of 24/7 on-call nursing services.
• Assumes responsibility for personal growth and development and maintain and upgrade professional knowledge and practice skills through attendance and participation in continuing education and in-service classes and completion of required annual training.
• Actively participates in quality assessment performance improvement teams and activities.

2.0 30% EFFECIENCY AND EFFECTIVENESS

2.1 20%

Organizes and performs work effectively and efficiently as evidenced by:

• Scheduling self to reduce drive time and mileage and utilizing resources to prevent duplicate driving or trips by determining if others are in the area.
• Taking only supplies that are needed and is conscientious of minimizing on-hand inventory.
• Ensuring Durable Medical Equipment (DME) is ordered in bulk to reduce delivery cost.
• Ensuring provision of medical supplies is limited to only what is needed in the home.
• Assessing and cleaning medical supply care box, bag, and electronic devices every month, maintaining appropriate documentation.
• Practicing personal cost containment by responsible use of equipment, supplies, and resources.

2.2 10%

Maintains and adjusts schedule to enhance team performance as evidenced by:

• Reporting to work on time and returning promptly from errands, breaks, and meals.
• Managing personal work schedule and time off to promote smooth agency operations.
• Assisting other team members to ensure completion of all work assignments.
• Demonstrating flexibility with changing workload/assignments.
• Does not exceed accrued PTO or qualified leave of absence(s).*

3.0 25% TEAMWORK, MISSION, VISION, AND VALUES

3.1 25%

Demonstrates positive interpersonal relations in dealing with all members of the team (i.e. co-workers, supervisors, physicians, etc.) as evidenced by:

• Responding to and communicating with all customers in a courteous, sensitive, and respectful manner.
• Demonstrating respect for team members and working collaboratively and cooperatively with others (i.e. departments, divisions, employees, etc.) throughout the agency.
• Managing stress and personal feelings without a negative impact on the team.
• Maintaining a positive attitude about assignments, team members, and agency and industry changes.
• Maintaining patient and agency confidentiality.
• Performing job duties in accordance with documented procedures/processes established to maintain the safety and health of patients, employees, and visitors and demonstrating compliance with Infection Control policies and procedures, including the proper use of Personal Protective Equipment, to prevent the spread of communicable illnesses.

*Cannot Exceed

JOB SPECIFICATIONS

Education/Training: Graduate of NLN accredited school of nursing and holds current license to practice nursing as a Licensed Practical Nurse in the state in which providing care. Understands hospice philosophy, and issues of death/dying.

Licensure/Certification: Licensed as a Licensed Practical Nurse by the NC Board of Nursing; Complies with accepted professional standards and practice. Valid NC driver’s license with an automobile that is insured in accordance with state or organization. Current American Heart Association Healthcare Worker CPR Certification.

Experience: Minimum of one-year clinical experience required; hospice experience preferred. Excellent nursing assessment and problem-solving skills.

Essential Technical/Motor Skills: Working knowledge of Microsoft Office products, typing of 30 wpm, basic technical or medical knowledge of nursing documentation requirements. Advanced customer service skills to respond with simple answers, etc.

Interpersonal Skills: Excellent interpersonal communication skills, both oral and written; ability to work independently as well as collaboratively within an interdisciplinary team.

Essential Physical Requirements: Regular physical activity including sitting, using hands to finger, handle, or eel objects, tools, or controls, reaching with hands and arms, and talking or hearing. Occasionally requires standing, walking, climbing, balancing, stooping, kneeling, crouching, crawling, and smelling. Occasionally requires lifting, pushing, pulling, and supporting patients.

Essential Mental Abilities: Ability to concentrate with large volumes of paperwork and data entry, handle pressure of deadlines, good judgement, emotional/mental stability, and stamina; Demonstrates autonomy, organization, assertiveness, flexibility, and cooperation in performing job responsibilities.

Exposure to Hazards: May be exposed to noise, allergens, viruses, diseases, and infection from patients and working environments. May be exposed to animals (domestic and wild) and rapidly changing traffic and weather conditions.

Organization: Excellent organizational skills with the ability to handle a variety of tasks and to assign priorities to those tasks.

Hours of Work: Monday – Friday, flexible schedule that includes on-call, weekends, nights, and holidays