Hospice Weeknight Registered Nurse

The hospice Second Shift RN uses the nursing process (assesses, plans, implements, evaluates) to provide patient care in the home setting. Provides individualized patient care for patients in the terminal phase of their lives according to established policies, procedures, guidelines and nursing standards of care. This position is responsible for the initial, comprehensive, and ongoing assessments of the patient’s needs and ensuring interdisciplinary collaboration in the development of a patient specific plan of care based on identified needs. Will perform admissions and non-start-of-care visits as necessary to ensure physician orders are being followed and patients receive quality care. Will take on-call duties during the night and respond to patients needs including medication concerns, symptom management, urgent care concerns, and provide in person visits as needed.

Hours of Work: Monday- Thursday, 5pm- 8am

• PRIMARY JOB DUTIES
• 1.    
• Assesses, interprets, plans, implements and evaluates patients according to the patient’s age, diagnosis, and prognosis.
• 2.    
• Effectively and efficiently manages the assessment of new patients and coordinates care with an interdisciplinary team and performs follow up visits when necessary.
• 3.    
• Appropriately communicates with the physician (Attending and Hospice) regarding the patient’s needs, response to treatment, and changes in the patient’s condition; obtain/receive physician orders as required.
• 4.    
• Work closely with other members 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.
• 5.    
• Respond promptly to on-call patient needs, including questions, concerns, symptoms, and requests for visits and death visits.
• 6.    
• Organizes and performs work effectively and efficiently.
• 7.    
• Maintains and adjusts schedule to enhance agency performance.
• 8.    
• Demonstrates a daily commitment to the values of the agency.
• 9.    
• Demonstrates positive interpersonal relations in dealing with all members of the agency.
• 10.    
• Maintains and promotes customer satisfaction.
• 11.    
• Effectively demonstrates the mission, vision, and values of the Agency on a daily basis.

  1.0    40%    QUALITY OF WORK:1.1    15%    Utilizing all aspects of the Nursing Process (assessment, planning, implementation, evaluation) with appropriate skill to effectively develop the Plan of Care for each patient as evidenced by:

  •     Develop nursing intervention based on physiological needs and clinical assessment appropriate for the patient’s age and developmental stage.Providing and/or facilitating beginning education according to the Plan of Care and within the level of understanding and developmental age for both the patient and his/her family.
  •     In collaboration with the patient/family and the physician, performs and documents a thorough, timely initial assessment to determine the eligibility for hospice and to identify needs and problems based on age and prognosis.Collaborates with the patient, physician (Attending and Hospice) and other members of the interdisciplinary team in developing an individualized plan of care appropriate to patient’s age and clinical status.
  •     Implements interventions in a manner consistent with agency policy and discipline standards.  
  • Evaluates patient response to interventions according to agency policy.
  •     Obtains physician orders and utilizes data collected during the admission assessment; agency teaching guidelines and appropriate nursing skills to implement and follow an established plan of care.
  • 1.2        12%            Effectively and efficiently manages the care of new admissions and coordinates care with interdisciplinary team.
  •     Plans admission process the day before admission when possible by calling patient and gathering necessary supplies and paperwork.Conferences with case manager and other members of interdisciplinary team regarding the status of patient and provides appropriate paperwork to follow the plan of care.
  •     Make appropriate referrals to other disciplines when indicated and provides information related to patient’s status.Appropriately informs the physician (Attending and Hospice) and other members of interdisciplinary team of any changes in patient’s condition, safety issues, or other complications that might impede the plan of care.
  •     Informs supervisor of any potential or actual client concerns, risk  
  • management issues and referrals to Child/Adult Protective Services 100% of time.
  •     Provides scheduled and PRN visits to patients when requested by the Management Team. 1.3        
  • 8%            Appropriately communicates information in accordance with agency policies and procedures and discipline specific guidelines as evidenced by:
  •     Completes all forms accurately and in accordance with agency guidelines/policies.Appropriately describes the patient’s functional limitations to justify hospice eligibility.
  •     Documents all verbal orders for new or changed orders according to agency guidelines.Completes clinical notes in accordance with agency guidelines and time frames.
  •     Consistently describes interdisciplinary, interagency, and intragency communication and coordination of services as per agency guidelines.Documents involvement of the patient and family in the development of the plan of care. 1.4        5%            Contributes to program effectiveness as evidenced by:
  •     Demonstrating understanding of the interdisciplinary team approach and continuum of care in accordance with the hospice mission.Incorporating recommendations and goals of other disciplines and patient/family into nursing visits.
  •     Demonstrating willingness and ability to accommodate agency needs in order to provide optimum patient care.Accepting constructive criticism as evidenced by implementation of suggested actions for improved performance.
  •     Promoting change and being proactive in suggesting ideas and new ways of doing things.Demonstrating ability to prioritize and enhance services during fluctuating patient census. 2.0        20%        PRODUCTIVITY/USE OF TIME: 2.1        10%        Organizes and performs work effectively and efficiently as evidenced by:
  •     Participating in continuous performance improvement and completing all required educational programs for the Agency and profession.Recognizing and performing duties in an independent manner.
  •     Accepting personal responsibility for the completion and quality of work outcomes.Meeting assigned deadlines.
  •     Maintaining a clean and safe environment.
  • 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/unit operations.
  •     Assisting other team members to ensure completion of all work assignments.Demonstrating flexibility with changing workload/assignments. 3.0        20%        TEAM WORK: Demonstrates positive interpersonal relations in dealing with all members of the team (i.e. co-workers, supervisors, physicians, etc.) as evidenced by:
  •     Communicating in a positive and productive manner.Demonstrating respect for team members.
  •     Managing stress and personal feelings without a negative impact on the team.Maintaining positive attitude about assignments and team members.
  •     Promoting professional / personal growth of co-workers by sharing knowledge and resources.Working collaboratively and cooperating with other agencys / units.

  4.0    20%    MISSION, VISION, VALUES:4.1       10%    Maintains and promotes customer satisfaction.

•     Responding to all customers in a courteous, sensitive and respectful manner.Abiding by the confidentiality and ethics policies of Well Care Hospice.
•     Participates in community outreach activities that promotes goals and objectives of the agency.
• 4.2    10%    Continuously and effectively demonstrates customer service standards of courtesy, efficiency, and presentation as evidenced by:
•     Practicing personal cost containment by responsible use of equipment, supplies, and resources.Completing the review period without a formal disciplinary action.*
•     Presenting a clean and neat appearance in personal attire and one’s work area.Performing his / her job in accordance with documented procedures established to maintain the safety and health of patients, employees, and visitors and demonstrates compliance in the proper wearing and use of protective clothing and equipment to conform to the OSHA Blood Borne Pathogen Standard and also reports any exposure to the appropriate Manager in a timely manner.** Not exceedable.

  Failure to “Meet” an asterisk category will result in a “Does Not Meet” for the standard.JOB SPECIFICATIONS 1.    Education:  Graduate of an accredited or approved school of nursing, either an AD, Diploma, or BSN program.

    2.    Licensure / Certifications:  Must have current Registered Nurse license in NC, NC drivers license with an automobile that is insured in accordance with state or organization, and a current American Heart Association CPR certification.

    3.    Experience:  Minimum of one years’ clinical experience required; hospice experience preferred.

    4.    Essential Technical/Motor Skills:  Working knowledge of Word, E-mail, typing of 30 wpm, basic technical or medical knowledge of home health billing requirements.  Advanced customer service skills to respond with simple answers, etc.

    5.    Interpersonal Skills:  Ability to work independently as well as effectively as part of an interdisciplinary team.

    6.    Essential Physical Requirements:  Ability to transfer and/or maneuver objects weighing at least 50 pounds in the assessment and implementation of patient care.  Requires frequent pushing, moving, lifting of patients.  Positioning of patients, giving patients baths and ambulating patients expending much physical effort.  Occasionally requires reaching overhead, stair climbing and fine motor manipulation.

    7.    Essential Mental Abilities:  Must be able to assess a patient’s condition, formulate a plan of care, select appropriate interventions, evaluate patient’s response to care/treatment, and to explain/teach patients about their disease progression and end of life care.  Requires higher level of mental faculties accompanied by short-and long-term memory.  Able to prioritize duties, learn new skills and techniques in patient care.  

    8.    Essential Sensory Requirements:  Ability to visually assess patients and to utilize sight and hearing to implement and evaluate plan of care, and effectively communicate with patients, families, physician, and staff.

    9.    Exposure to Hazards:  Noise, exposure to blood borne pathogens and body fluids, infectious diseases, and needle puncture wounds.  May be exposed to dangerous animals and traffic hazards while home visiting.  May encounter patients and other situations which present a potential threat to personal safety.  May encounter temperature changes and weather extremes.

  10.    Hours of Work:  as agreed upon by director, not to exceed 72 hours, with on call responsibilities