Evening Nurse

Position Shift Hours: 3pm - 11:30pm

Job Summary

The Nurse, Evening is a member of the Variable Staffing Team and, as such, participates in providing after hours staffing coverage including both Evening Admissions and Evening Visits.

The Nurse, Evening is responsible for providing after hours support to patient/families admitted to hospice service. Working in collaboration with Triage, responds to pt/family calls and intervenes appropriately, providing phone instruction/support or visit as assessed. Care provided is based on the individualized Plan of Care developed by the IDT that reflects pt/family goals related of Safe & Comfortable Dying, Self-Determined Life Closure and Effective Bereavement.

The Nurse, Evening demonstrates sensitivity and compassion for the issues involved with serving patients and families facing a terminal illness, death and bereavement; clinical competence in pain and symptom management; and fiscal responsibility in the planning and delivery of services. The Nurse, Evening is responsible for providing skilled nursing care within their scope of practice and license, to hospice patients and their families in all settings: home, SNF and RCFE.

Essential Responsibilities

Patient/family Care

* Recognizes the patient and family as the "unit of care" and IDT members
* Respects patient right to self-determination and acts as advocate within the context of the values and ethical standards of HSCC
* Demonstrates ability to meet pt/family where they are
* Offers/makes visits per agency policy
* Offers home visit at time of death
* Utilizes nursing process in providing primary care to pt/families, and professional patient management to facility staff
* Documents all care and care planning per agency policy
* Provides nursing interventions for pt/family as ordered by the physician and in accordance with the POC, safe nursing practice and the policies and procedures of HSCC
* Monitors management of pain and symptoms in collaboration with patient/family, facility staff, IDT and physician to achieve maximum comfort
* Administers medications and treatments as ordered prn
* Instructs and supports pt/family unit and facility staff re: symptom mgmt, patient care, disease process & death/dying

Admission Visits

* Meets with patients & families in all settings to explain services, answer questions and admit patient as appropriate
* Conducts info visits and discuss difficult treatment and/or symptom management issues to facilitate the admission process
* Develops and implements an individualized, interdisciplinary Plans of Care for patients and families
* Uses electronic medical record (EMR) systems effectively and efficiently to complete required documentation in a variety of patient care settings

On Call

* Works cooperatively with Variable Staffing Team members to provide after hours coverage for HSCC pt/families and staff of our facility partners.
* Participates in providing extra coverage for planned and unplanned absences
* Secures current information on each patient prior to making call
* Assesses patient status via telephone response
* Follows agency policy in determining whether to make/offer visit for patient/family
* Assists, supports & educates patient and family through physical and emotional crisis utilizing all Variable Staffing Team after hours resources available; Social Workers, Chaplains, Hospice Aides, Administrator On Call.
* Assesses for and promotes caregiver confidence via telephone teaching or onsite visits.
* Obtains medications, medical supplies and equipment per pt need/physician order and HSCC policies and procedures when needed
* Demonstrates understanding of pharmacy-related policies & procedures
* Disposes or instructs re: disposal of Schedule II medications at time of death per agency policy
* Opens, closes and revises POC per HSCC guidelines
* Documents all contacts, instructions and interventions in the electronic medical record per HSCC policies & procedures
* Documents all contacts, instructions and interventions provided per HSCC policies & procedures
* Creates individualized POC based on the assessment of pt/family needs and goals
* POC addresses pt/family physical, psychosocial and spiritual needs a written POC that includes identified goals, interventions and outcomes and documents

Secondary Responsibilities

IDT Participation

* Functions as a member of the HSCC IDT maintaining open & organized communication with hospice staff, volunteers and supervisor
* Works collaboratively with IDT to develop common goals to meet the needs of the pt/family
* Completes and submits all documentation in accordance with policies and procedures

Quality Improvement

* Meets all standards and requirement as indicated by licensing and accrediting agencies
* Completes and submits all documentation in accordance with policies and procedures
* Submits verification of current employment related documents per HSCC policies, procedures and licensing agencies
* Participates in activities that affirm, enhance and develop the highest quality standards for HSCC
* Participates in developing standards for quality patient care within HSCC
* Participates in Quality Assessment & Improvement activities as requested

Special Projects

* Participates in special projects as requested
* Performs other related job duties as assigned by Supervisor

Compliance

* Ensures all HIPAA Privacy and Security Regulations, Medicare Conditions of Participation, and all other regulatory/compliance requirements are understood and followed
* Submits verification of current RN license
* Submits proof of auto insurance annually; keeps drivers license current and maintains a good driving record
* Ensures TB checks are completed in a timely manner; at least annually
* As determined by license governing body, provides care within the scope of license

Requirements

* Require current California RN or LVN license
* Valid state driver's license and liability auto insurance
* Available to work weekends and holidays occasionally
* Required to attend regular meetings and in-services

Skills Required

* Critical thinking and ability to function both independently and as a member of the Variable Staffing Team after hours support.
* Familiarity with electronic charting programs and/or demonstrated keyboard and computer skills sufficient to utilize electronic medical record charting.

Education/Experience

* Degree in Nursing from an accredited college
* 1 year minimum of nursing experience
* 2-5 years nursing experience in hospice, oncology, medsurg, ICU, ER, skilled nursing facilities or homecare preferred
* Hospice and/or home health experience preferred
* End-of-life and pain management experience preferred

Certifications, Licenses, Registrations

* California State issued RN or LVN license.
* Pass OIG/GSA review and all required background checks

Skills Desired

* Bilingual in English/Spanish encouraged but not required.
* Previous experience working with end of life is desirable.

Physical Demands

* Sufficient dexterity to utilize electronic record keeping systems, computers/keyboards and or laptops and other related equipment
* Ability to travel to patient locations; includes ability to drive, negotiate stairs and walkways including uneven surfaces at private homes or facilities
* Vision ability to read manual and electronic documentation, medications, charts, office related equipment, and instructions
* Hearing ability within normal range to elicit and detect pertinent information while communicating with patients and health team
* Speech to verbally communicate to assess and impart information concerning patient status; to complete patient/family teaching and to interact with health care team

Work Environment/Environmental Condition

* Performs services in private homes and care facilities and will experience a variety of settings and situations
* Office work is performed in combination of private homes, care facilities and office environment.

LVN Range: 35.10 - 46.00/hr

RN Range: 45.00 - 61.00/hr