Hybrid HH & Hospice Nurse, RN (PRN)

Essential Functions

Abides by and supports 3HC's Compliance Program and Code of Ethics. 3HC's Compliance motto is "Compliance for all and all for Compliance". It is the intent of 3HC to comply with all applicable laws and regulations and that spirit is embedded in all aspects of our services and business practices. Our success hinges on doing things ethically and legally, to which, each and every employee plays a critical role.

Creates positive experiences for internal and external customers that will meet their expectations. (External customers include our patients, families, referral sources, vendors, the community, etc. Internal customers are the people within the agency with whom you work.) Displays a high degree of courtesy, tact, and knowledge of services provided by the agency in all contact with staff, patients, and visitors.

Manages assigned cases and assists office with achieving positive patient outcomes, strategic plan and budget: (a) provides skilled nursing care as outlined in the physician's plan of treatment, according to 3HC's policies and procedures and as allowed by the Practice Act of the N. C. State Board of Nursing; (b) observes and documents signs and symptoms and reports to the physician and other applicable personnel, reactions to treatments, including drugs and changes in the patient's physical or emotional condition and outcomes of intervention; (c) ensures on-going evaluation of patient/family needs and response to care; (d) refers to other services as needed; (e) initiates appropriate preventative and rehabilitative nursing procedures, as appropriate, for the patient's care and safety; (f) educates, supervises, consults, and counsels the patient/family regarding the nursing care needs, other related problems of the patient at home, the disease process, self-care techniques, and processes for dealing with issues of ethical concern and (g) Assures the development and implementation of the patient individualized plan of care and updates as needed.

Conducts a complete assessment of the patient to identify appropriate care needs: (a) obtains a medical history to include OASIS when needed, particularly as it relates to the present condition; (b) performs a physical assessment; (c) assesses the support system to determine what assistance will be available from family members and their ability to meet the patient's immediate needs upon changes throughout care; (d) assesses the patient, family member(s) and home situation to determine what health teaching will be required; (e) assess the patient's condition and home situation to determine if other home health services are needed; (f) interprets nursing and other services of the agency to the patient and family as a part of planning for care; and, (g) plans for discharge from services.

Completes OASIS at specific point in time, such as admission, resumption of care, recertification, etc.

Provides comfort to patient/family to facilitate quality of life and death with dignity: (a) provides skilled nursing care as outlined in the physician's plan of care, according to 3HC's policies and procedures and as allowed by the Practice Act of the N. C. State Board of Nursing; (b) responsible for completing hospice admissions, educating patients and families on the hospice concept and the hospice benefit. (c) Plans, coordinates, provides and directs the delivery of compassionate, quality patient care. (d) actively participates in the coordination of all aspects of the patient's hospice care, in accordance with current professional standards and practice, including participating in on-going interdisciplinary comprehensive assessments, developing and evaluating the plan of care, and contributing to patient counseling and education. (e) Provides continuity of care to all hospice patients. (f) Assist the interdisciplinary team in the development and implementation of the patient/family care plan (g) Refers hospice patients to other services as needed. (h) Provides end of life care as outlined in plan of care and policy and procedures. Provides ongoing assessment of medicinal, DME needs. (i) Participates in QAPI and QI projects as requested. (j) assists the Social Workers with bereavement counseling as requested. Continuously evaluates the patient’s condition to provide support and nursing visits individualized to the patient need.

Notify attending physicians, staff members and family members of patient deaths when they occur.

Collaborates with PBM regarding medication changes, administration, and recommendations. Share PBM recommendations with the attending MD.

Documents in the medical record electronically and downloads daily: (a) those services rendered to the patient; (b) conferences held with other disciplines, physician, or community resources; (c) changes noted in the patient's condition and/or family home situation; (d) revisions in the nursing care plan as needed; (e) evaluation of patient care and clinical and progress notes that demonstrate progress towards established goals. Download will include time and travel documentation. Responds within 48 hours to requests for documentation correction/completion.

Ensures that the physician is involved ongoing with the patient's care: (a) reports to the physician and other applicable personnel, reactions to treatments, including drugs, and change in the patient's physical or emotional condition and outcomes of intervention, and (b) consults with the attending physician concerning alterations of the plan of treatment and documents appropriate change of orders where necessary. Verifies that physician listed on order/plan of treatment will sign orders.

Provides regular supervision to the Licensed Practical Nurses and paraprofessionals who are providing services to the patient according to regulatory guidelines, CMS/Hospice guidelines.

Ensures task assigned to the

LPN: (a) are within the Nurse Practice Act and (b) Supervises LPN on every patient at least every 30 days.

Ensures that care is provided by the nursing assistant: (a) provides the certified nursing assistant with a telephonic plan of care and specific duties to be performed; (b) supervises and evaluates the care given at least every two weeks and (c) participates in periodic conferences with supervisor concerning the certified nursing assistant's performance.

Collaborates with supervisor to meet assigned productivity of 100%. Rotates weekday, weekend, and holiday "on-call" and "back-up-call".

Maintains regular communication with supervisor. Communicates problems of the patient(s) on a timely basis following chain of command. Communicates information using current process and technology available to 3HC.

For

Hospice

Patients: Completes IDG notes and communicates with the team.

Ensures that 3HC can bill for services appropriately: (a) completes certifications and re-certifications within designated timeframes; and (b) keeps up-to-date on reimbursement criteria and documentation requirements for all patients under his/her care management, including preauthorization and re-authorization for insurance.

Travels to other offices to meet the demand of patient needs as requested by the Director of Clinical Practice/Assistant Director of Clinical Practice.

Stays abreast of overall patient care and improves nursing care skills: (a) participates in office staff meetings, patient care conferences, record audits, utilization reviews, quality improvement activities, and in-services; (b) attends and participates in interdisciplinary team conferences at least 75% of the time; (c) attends agency mandatory in-services and satisfies CEU requirements of the State Board of Nursing; and (d) strives to improve nursing care through continuing education, active participation in professional and related organizations and individual research and readings.

Demonstrates an interest in personal and professional growth for self and staff: (a) attends and participates in workshops, seminars, webcasts to keep abreast of current changes in rules, regulations, relating to job functions and department; (b) does individual reading and research; and (c) recommends educational opportunities for staff and encourages participation.

Demonstrates a willingness to be cost effective in the use of agency resources, the monitoring of waste, and the proper and safe use of supplies and equipment.