TITLE OF POSITION: HOSPICE REGISTERED NURSE
IMMEDIATE SUPERVISOR: HOSPICE MEDICAL DIRECTOR AND/OR ADMINISTRATOR
POSITION REQUIREMENTS:
Must have a current license in the state of practice. Minimum of one year of clinical practice in nursing. Oncology, psychiatry, and home care experience are preferred. Knowledge of pathophysiology and disease progression with an understanding of pain and symptom management. Should have excellent assessment and communication skills. The ability to work within and contribute to an interdisciplinary team, and assist the patient and family in coping with emotional stress. An understanding of and aptitude for organization and communication with patients, family, and team members.
POSITION SUMMARY:.
Nursing services are provided in accordance with accepted standards of practice of the Nurse Practice Act under the supervision of a registered nurse. Nursing care is provided in accordance with the client’s plan of care, including comprehensive health and pychosocial evaluation, monitoring of the client’s condition, health promotion, prevention, and coordination of services with other members of the interdisciplinary hospice team. The hospice RN provides, teaching, training activities, and provide direct nursing care, and other duties as deemed necessary. The Registered Nurse is a highly qualified professional who provides nursing services to clients under the direction of the Hospice Medical Director and/or administrator. The hospice nurse is a principal figure in assessing coping mechanism which address patient’s need for information concerning his/her disease and symptoms. He/she helps insure an open and honest dialogue while helping the family retain as much control as they desire within the plan of care.
PRINCIPAL RESPONSIBILITIES AND DUTIES:
The hospice registered nurse coordinates the implementation of the plan of care for each patient and is responsible for insuring the following:
1. Initial assessment of the patient/family and identification of risks and interventions on admission
2. Development of an initial plan of care with IDT/IDG input
3. Communication of findings to the attending physician, Medical Director and IDT/IDG members
4. Implementation of the plan of care with a focus on palliative care
5. Appropriate referral and follow-up
6. Care coordination and case management
7. Ongoing evaluation and assessment of the provision of hospice care
8. Recommending to the IDT/IDG modifications to the plan of care based on patient/family/caregiver response to hospice services
9. Facilitating the implementation of another level of hospice care when necessary
10. Utilization review
11. Assessment of risks associated with grieving
12. Communication between hospice and other health care providers
13. Complying with the patient’s plan by :
A. Providing a comprehensive health and psychosocial evaluation
B. Monitoring the patient’s condition
C. Teaching and training activities
D. Coordination of care
E. Direct provision of nursing care based on:
i) Hospice nursing standards
ii) Clearly defined treatment protocols
14. Providing the initial and ongoing assessment of the impact of the terminal diagnosis
on the patient’s physical, functional, psychosocial and environmental needs and
activities of daily living including:
A. Risk for pathological grief
B. Cultural and spiritual implications
C Verbal and non-verbal communication patterns
15. Implementing the individualized plan of care and recommending revisions to the plan
as necessary: by
A. Managing discomfort and providing symptoms relief
B. Providing specialized nursing skills related to palliative and end-of-life care
16. Consulting with and educating the patient/family regarding:
A. The disease process
B. Self-care techniques
C. End-of-life care
D. The processes for dealing with issues of ethical concern
17. Developing and updating the plan of care in consultation with the Hospice Medical
Director and/or Administrator and all team members of the interdisciplinary team who
perform comprehensive assessment of the client. Must have the skill and knowledge to
modify the plan of care as the disease progresses.
18. Initiating appropriate preventive and rehabilitative nursing procedures
19. Preparing clinical and progress notes that demonstrate progress toward established goals
and presents it to the interdisciplinary team as indicated
20. Coordinating all patient/family services, requests and prioritization of needs with the
members of the interdisciplinary team
21. Informing the physician and other personnel of changes in the patient’s needs and
outcomes of intervention
22. Use of case management approach and referring to other services as needed
23. Continually evaluating, with the IDT/IDG team, the scope and frequency of services
needed based on acuity and patient/family needs
11. Supervising LVNs and paraprofessionals providing services to the patient according to
regulatory guidelines
12. Providing specialized hospice training to other staff, family members and informal
caregivers to insure adequate care
13. On-going evaluation of patient/family response to care
14. Assessing the ability of the caregiver to meet the patient’s immediate needs upon
admission and throughout care
15. Evaluating own needs for support and using identified systems to meet the need
16. Applying specific criteria for admission and recertification to hospice care to establish
appropriate levels of care and patient’s eligibility
17. Communicating information using current process and technology available to the
organization.
18 Possesses the capacity to manage physical, psychological, social, and spiritual problems
of dying patients and their families.
19. Has the ability to coordinate the extended components of hospice services
1. Acquires advanced skills and assists others with counseling, managing, instructing, caring, and communicating skills/knowledge
2. Balances the nurse’s self-care needs with the complexities and intensities of repeated encounters with death.
3. Assesses physical symptoms and initiates intervention quickly that proceeds to a logical sequence.
4. Prepares and presents patient’s record to the IDT/IDG team as indicated.
5. Cooperates with other agencies providing nursing or related services to provide continuity of care and to implement a comprehensive care plan.
6. Continually strives to improve his/her nursing care by attending inservice education, through formal education, attendance at workshops, conferences, active participation in professional and related organizations, individual research, and reading.
7. Responsible for the overall clinical record maintenance to include documentation on medication profile, timely orders/plan of care, comprehensive assessments.
8. Notifies Agency of absences due to illness, emergency leave, planned vacation, or special professional meetings which will affect agreed services with the agency.
9. Performs other duties as deemed necessary.
JOB CONDITIONS:
The ability to drive extensively in a geographic area. Must be able to access client’s homes which will not be routinely wheelchair accessible. Hearing, eyesight and physical dexterity must be sufficient to perform a physical assessment of the client’s condition and to perform and demonstrate client care. Physical activities may include walking, sitting, stooping, standing. Maximum to minimal lifting of clients and turning clients. On occasion may be required to bend, stoop, reach, and move client weighing up to 250 pounds; lift and/or carry up to 30 pounds. Lifting and carrying nurses equipment. Frequent writing and telephone communication. Must be able to hear and speak in a manner understood by most people. Must be able to communicate both verbally and in writing.
EQUIPMENT OPERATIONS
Thermometer, B/P cuff, glucometer, penlight, handwashing materials.
COMPANY INFORMATION
Access to all client medical records and/or personnel records which may be discussed with the Hospice Medical Director and/or Administrator, or other members of the interdisciplinary team. Compliance with HIPPA is required and a condition of this position because of access to all client medical/service records, personnel records, and various company records.
