Registered Nurse (RN) - Hospice Case Manger - Full-Time Day at Prisma Health

Accountabilities

Assessment and Planning

a. Assesses patient physiological, psychosocial, developmental, environmental needs, and the
    families' need for supportive care. Considers the physical, emotional, and spiritual aspects of the
    patient/family when assessing the patient's needs. Assesses pain and other symptoms. Offers
    input into the interdisciplinary Plan of Care based on assessments. Provides assessment to
    physician. Documents assessments in the medical record .

b. Develops an individualized nursing and a CNA plan of care, as needed, seeking input from the
    patient and family. Monitors and updates the plans of care, as needed, due to changes in status
    and family needs.

c. Assess for, and provides education to, patient/family. Monitors the patient's/family's need for
    additional services and refers to other members of the hospice team.

d. Develops a plan of care for the time of death that meets the express wishes of the patient/family.

Implementation

a.Performs appropriate nursing interventions with thorough and timely documentation in patient's
   chart.  Utilizes standing orders and medical authorization guidelines to guide practice.

b. Reports assessment findings and changes in patient's condition to physician;  makes

   recommendations.

c. Recognizes the family decision-making role and patient's right to self-determination.

d. Oversees CNA's performance of the Plan of Care according to requirements.

Evaluation

Evaluates the the effectiveness of specific interventions and the resulting movement toward goals. The evaluation process is reflected by patient's response to any treatment and/or medication administered, patient's disease progression and family's response to change, patient's progress toward goals and achieved outcomes, patient/family response to teaching, family caregiver's potential and current ability to cope with the physical and emotional demands of their role in patient's care, and cultural needs and/or developmental needs. 

Bereavement

Understands the importance of continued support for the family during the process of bereavement through bereavement follow-up with patient's family, supporting the bereavement POC, attending funeral, visitations or memorial services whenever possible, and attending scheduled bereavement program events, supporting those families served. Is knowledgeable of the process of grief/loss and demonstrates appropriate supportive interventions.

Continuity

a. Facilitates continuity of care with other team members and other agencies through accurate and
    timely exchange of information.  Communicates on a regular basis with all staff/volunteers
    regarding patient status. Communicates with physicians and others, as needed, to coordinate and
    ensure quality care. Provides ongoing communication with all Hospice team members. Attends
    and participates in  team meetings, briefings and other related activities.

b. Communicates verbally and in writing with pharmacy, DME vendors, material management and insurance
    companies to help control agency costs.

c. Documents all clinical findings, interventions, physician orders, changes in the Plan of Care, telephone calls, team conferences and referrals.

d. Initiates POC at time of death and notifies all appropriate persons/agencies. Completes all discharge paperwork.

Agency Needs

Performs the following tasks in support of the general needs of the department:

a. Participates in review of quality data and makes appropriate recommendations for improvement.

b. Performs admission, evaluation visits and consultative services as requested.

c. Works on various projects and committees as requested.

d. Educates the public regarding end-of life issues.

e. Assists with the orientation and training of students/new employees/Volunteers.

Supervisory/Management Responsibilities

This is a non-management job that will report to a supervisor, manager, director or executive.

Minimum Education

Associate's Degree- Nursing

Minimum Experience

No experience required.

2 years- Acute Care Nursing is preferred.

Required Certifications/Registrations/Licenses

RN - REGISTERED NURSE - (Code NLRN)

Valid driver's license, an acceptable motor vehicle record as defined by the Acceptable Motor Vehicle Record (MVR) Chart, and a certificate of auto insurance.

Other Required Experience

BSN- Preferred

Experience in hospice or other home care services- Preferred