Affinity Hospice
Job Title: Registered Nurse On Call
Division: Hospice
Report to: Clinical Director
Classification: Non-Exempt
Position Overview
This is an On Call position. Sunday-Saturday. Weekday hours are 5pm-8am and Weekend hours you field calls during day and make visits from 5pm-8am.
The registered nurse plans, organizes and directs hospice services and is experienced in nursing, with emphasis on community health education/experience. The professional nurse builds from the resources of the community to plan and direct services to meet the needs of individuals and families within their homes and communities.
Essential Job Functions
Must be able to read, write, speak, and understand the English language
Must have reliable transportation to travel to patient homes per patient schedule and agency needs, as appropriate
Using effective body mechanics, must be able to lift 20 lbs. floor to waist; lift 10 lbs. waist to shoulder; lift and carry 20 lbs. and push/pull 40 lbs.
Must be able to ensure agency is in compliance with all applicable federal, state, and local regulatory agencies
Must practice regular and dependable attendance per company policy and procedure
Must be able to ensure qualified staffing is appropriate to meet the needs of the patients served
Must be able to interview, hire, train, evaluate, counsel, and supervise agency staff
Must be able to meet budgeted goals in all areas, including admissions, revenue, cost, and profitability
Must be able to develop and implement the Performance Improvement program, including the agency annual evaluation for the global region
Must be able to effectively implement all company programs
Must be able to develop a business plan to address opportunities for improvement, growth, and expansion, including staff for expansion
Must be able to sit, stand, bend, lift, and move intermittently throughout the work day
Must be able to communicate and function in an interdisciplinary team
Must be able to document and chart appropriately and within specific time frames
Must be able to follow physician orders and nursing treatment plans for patients
Must be able to (or assist with) lift, turn, move and position patients
Must be able to knowledgeably and competently deliver nursing care to patients
Must be able to evaluate patient needs through ongoing assessment and revise care plans based on changes in patient condition
Must be able to oversee and evaluate care given by LPN and HA
Specific Requirements
Must be able to read, write, speak, and understand the English language
Must have excellent verbal and written communication, organizational, problem solving, and basic math skills
Must be competent in standard Microsoft Office applications
Must comply with accepted professional standards and practice
Must have excellent observation and good nursing judgment
Must be able to concentrate and use reasoning skills
Must be able to interact professionally with the community
Must possess the ability to work harmoniously with professional and non-professional personnel
Must be knowledgeable of nursing practices and procedures based on state practice acts
Must be self-directed and possess leadership and supervisory skills
Must understand and follow company policies and procedures
Must possess the ability to make independent decisions when circumstances warrant such actions
Must have a valid driver’s license and auto liability insurance with automobile being in good working condition
Must be able to multi-task and accept additional duties as assigned
Must present a professional image
Must practice regular and dependable attendance
Education and Experience
Graduate of an accredited school of nursing. One (1) to two (2) years of recent acute care experience in an institutional setting
Current licensure in state and CPR certification
Bachelor’s degree, with one (1) year of hospice experience preferred
Management experience not required. Responsible for supervising hospice aides
Excellent observation, verbal and written communication skills, problem solving skills, basic math skills; nursing skills per competency checklist
Prolonged or considerable walking or standing. Able to lift, position or transfer patients. Able to lift supplies and equipment. Considerable reaching, stooping, bending, kneeling or crouching. Visual acuity and hearing to perform required nursing skills
Licensed driver with automobile that is in good working order and insured in accordance with the organization requirements
Working Conditions
Will work in and travel to patient homes as well as agency office
Sits, stands, bends, lifts, and moves intermittently during working hours
Subject to frequent interruptions
Attends and participates in continuing education programs
Possible exposure to infectious waste, diseases, conditions, etc. including exposure to the AIDS and Hepatitis B viruses
Subject to hostile and emotionally upset patients, family members, caregivers, etc.
May work beyond normal working hours, weekends, and holidays as needed and in other positions temporarily as necessary
Involved with patients, associates, caregivers, government agencies/personnel, etc. under various circumstances
General Responsibilities
Completes an initial, comprehensive and ongoing comprehensive assessment of patient and family to determine hospice needs. Provides a complete physical assessment and history of current and previous illness(es)
Provides professional nursing care by utilizing all elements of nursing process and as defined in the state Nurse Practice Act
Assesses and evaluates patient’s status by:
Writing and initiating plan of care
Regularly re-evaluating patient and family/caregiver needs
Participating in revising the plan of care as necessary
Initiates the plan of care and makes necessary revisions as patient status and needs change
Uses health assessment data to determine nursing diagnosis
Develops a care plan that establishes goals, based on nursing diagnosis and incorporates palliative nursing actions. Includes the patient and the family in the planning process
Initiates appropriate preventive and rehabilitative nursing procedures. Administers medications and treatments as prescribed by the physician in the physician’s plan of care
Counsels the patient and family in meeting nursing and related need
Provides health care instructions to the patient as appropriate per assessment and plan
Assists the patient with the activities of daily living and facilitates the patient’s efforts toward self-sufficiency and optional comfort care
Acts as Case Manager when assigned by Clinical Director and assumes responsibility to coordinate patient care for assigned caseload
Completes, maintains and submits accurate and relevant clinical notes regarding patient’s condition and care given. Records pain/symptom management changes/outcomes as appropriate
Communicates with the physician regarding the patient’s needs and reports changes in the patient’s condition; obtains/receives physicians’ orders as required
Communicates with community health related persons to coordinate the care plan
Teaches the patient and family/caregiver self-care techniques as appropriate. Provides medication, diet and other instructions as ordered by the physician and recognizes and utilizes opportunities for health counseling with patients and families/caregivers. Works in concert with the interdisciplinary group
Provides and maintains a safe environment for the patient
Assists the patient and family/caregiver and other team members in providing continuity of care
Works in cooperation with the family/caregiver and hospice interdisciplinary group to meet the emotional needs of the patient and family/caregiver
Attends interdisciplinary group meetings
Participates in on-call duties as defined by the on-call policy
Ensures that arrangements for equipment and other necessary items and servicesare available
Supervises ancillary associate and delegates responsibilities when required
Assumes responsibility for personal growth and development and maintains and upgrades professional knowledge and practice skills through attendance and participation in continuing education and in-service classes
Fulfills the obligation of requested and/or accepted case assignments
Actively participates in quality assessment performance improvement teams and activities
Instructs, supervises and evaluates hospice aide care provided every two (2) weeks
Performs comprehensive physical and psychosocial assessment on patients accurately and completely, including OASIS assessment, according to direction. Utilizes assessment information to establish appropriate plan of care, clinical goals and discharge plans for patients in collaboration with physician and patient/family/caregiver
Reassesses patient status and revises plan of care as indicated throughout episode.
Performs admission visit and completes all associated paperwork accurately and completely. Explains all patient rights and responsibilities to patients/families/caregivers per regulatory requirements. Verifies payer and advance directive information on admission visit. Coordinates necessary activity to satisfy Medicare and other payer regulations. Submits admission paperwork within 48 hours
Regularly promotes interdisciplinary communication and coordination of care by communicating and documenting pertinent findings to Clinical Director, care team members and physician. Requests changes in physician orders and adds disciplines as needed
Accurately and safely performs all infection control procedures and adheres to standard precautions and principles of safe body mechanics
Performs nursing interventions, including technical skills, wound care management, pain management and clinical program management accurately as ordered
Performs and documents routine daily visits, transfers of care, resumptions of care, recertification, discipline discharges and agency discharges according to regulatory/payer requirements and agency policy
Regularly re-evaluates patients to identify progress toward goal achievement. Reviews OASIS answers, coding and sequencing of diagnoses to ensure accuracy. Obtains orders and updates plans of care as needed throughout the episode of care
Participates in care conferences and mandatory staff meetings. Initiates conferences with patient/family/caregivers and physician as needed to ensure effective coordination of care provided
Identifies and documents changes in patient needs throughout episode of care. Communicates with physician and patient/family/caregivers. Provides written Notice of Medicare Non-Coverage and Hospice Advance Beneficiary Notice per regulatory requirements
Supervises care provided to assigned patients by LPN/LVNs and hospice aides. Provides accurate and complete written instructions and care plans as required. Ensures appropriate assignment and instruction of paraprofessionals by skill level and patient need
Performs supervisory visits for hospice aides per regulation to ensure safe and appropriate care (at least every 14 days for Medicare)
Handles patient complaints as appropriate and/or refers complaint to supervisor for appropriate resolution
Maintains knowledge of community resources and appropriately refers patients to resources as needed
Identifies medical supply needs of patient and ensures patient has adequate supplies to meet care needs without wasting resources
Submits DARS, clinical notes, reassessment visit forms as indicated by payer, and OASIS documents timely and per agency requirements
Meets productivity expectations and communicates change in schedule to Clinical Director /office
Participates in on call, holiday, weekend rotation as assigned