RN (Hospice, In-Home program)
RiverStone Health - Billings, MT

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Job Title: Registered Nurse

Department: Hospice Program (In-home)

Reports To: RN Supervisor

FLSA Status: Non-Exempt

Schedule: Monday-Friday, 8:00 AM to 5:00 PM; on-call 2 times a month

SUMMARY: The hospice nurse is responsible for the delivery of quality patient care through the nursing process of assessment, diagnosing, planning, implementation, and evaluation. The nurse is responsible for oversees and directs patient care, case management, documentation and customer satisfaction of all patient care services. Duties include assessing the patient’s palliative care needs, home environment and instruction for patient and families while working with the interdisciplinary team. The hospice patient can include those with cancer, chronic illnesses, accidents, disabilities or cognitive impairments at end of life.

ESSENTIAL KNOWLEDGE, SKILLS AND RESPONSIBILITIES include the following. Other duties may be assigned.

Ability to work independently and collaboratively to provide and end of life care and instruction for patients and families based on established clinical nursing practice standards.

This includes but not limited to:
  • Directing end of life care, symptom management, medication administration in compliance with physician’s orders and plan of care,
  • Monitoring and interpreting symptoms and treatments and developing a plan of care in collaboration with an interdisciplinary team
  • Providing education and support to patients and families
  • Responsible for evaluating patient referrals and doing admissions and nursing visits as assigned. This includes:
    • Initiating the plan of care and priority setting to ensure effective and efficient patient care deliver and achievement.
    • Consulting and coordinating with the interdisciplinary team members to assess, plan, implement and evaluate patient’s plan of care.
    • Following a plan of care that assures the patient and family needs are identified, prioritized, and met in order to achieve desired clinical outcomes/goals.
    • Regularly reevaluates the patient’s nursing needs and makes the necessary revisions in the plan of care.
  • Assures that care, educational and end of life planning needs of patients are met.
    • Teaches patients and families disease progression, medical, social, spiritual and psychological care as well as medication review.
    • Monitors ongoing patient care, through care conferencing and review of documentation, to determine educational and palliative care needs.
    • Utilizes knowledge of patient’s age and cultural diversity in the provision of patient care and education needs.
    • Evaluates outcomes to look for decline and any discrepancies
  • Directs and supervises, including supervisory visits, within the area of responsibility including Licensed Practical Nurses (LPN) and Certified Home Health Aides (CHHA).
  • Communicates a report to the appropriate team members for the continuation of care, including reporting any changes in patient’s condition to the physician and family as needed.
  • Demonstrates the knowledge and skills necessary to provide care appropriate to patients of all age groups–must demonstrate knowledge of the principles of growth and development through the life span, possess the ability to assess data reflective of the patient’s status, and interpret the appropriate information needed to identify each patient’s needs.
  • Documents care provided for the patient encounter in the electronic medical records (per documentation standards) in a timely manner. Must document/chart observations, activities and other data related to the clinical condition of the patient and palliative care.
  • Maintains universal precautions guidelines and safety measures according to RiverStone Health policies and procedures
  • Experienced in end of live care, symptom management and control, quality and reimbursement measures for Hospice outcomes.

    Contributes to the provision of quality process through performance improvement techniques that demonstrates positive outcomes in patient care. Receives and works to resolve patient/family concerns/complaints.

  • Maintain knowledge of and compliance with current Medicare/Medicaid, state regulations and rules, Health Insurance Portability and Accountability Act (HIPAA) compliance and accreditation regulations for hospice services.
  • Maintain and enhance professional growth and development through attendance in orientation, continuing educational offerings as well as organizational educational programs as requested.
  • Demonstrates interpersonal, cognitive, and technical competencies and standards of care consistent with the program’s and organization’s mission, values and services.

  • Ability to help cover needs in hospice, hospice facilities and home care visits as assigned.
  • Must carry a program computer and telephone to receive and place calls for patient care operations during non-office hours when on call.

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