Hospice Registered Nurse Case Manager

2 weeks ago


St Louis, United States Lutheran Senior Services Full time
Job Description:

Introduction

At Lutheran Senior Services, team members at all levels find their calling in our mission of Older Adults Living Life to the Fullest. In this work environment, all team members are part of a community and appreciated by the people they work with - residents and coworkers - every day.

Summary

The Hospice registered nurse is responsible for providing skilled nursing services to hospice patients.

Essential Duties and Responsibilities:
  • Provides skilled nursing services in accordance with the orders of a physician and under a plan of care in a patient's home; Has the responsibility for the observation, assessment, nursing diagnosis, counsel, care and health teaching of the hospice patient and family
  • Performs, completes, and documents initial and ongoing assessment of the impact of the terminal diagnosis on the patient's physical, functional, psycho-social and environmental needs and activities of daily living including:
    • Risk for pathological grief
    • Cultural and spiritual implications
    • Verbal and non-verbal communication patterns
  • Initiates IDT Plan of Care with consultation from the basic IDT members, attending physician and medical director; Reviews and revises the plan as necessary
  • Determines the scope and frequency of services needed based on acuity and patient/family needs
  • Applies specific criteria for admission and re-certification to hospice care to establish appropriate levels of care and the patient's eligibility
  • Assesses the ability of the caregiver to meet the patient's immediate needs upon admission and throughout care; Evaluates and documents the appropriateness and ability of the patient or family member's administration of medications
  • Completes all required consent, election, and notification paperwork
  • Evaluates the effects of the care given and regularly reevaluates the patient's nursing needs
  • Provides those services requiring substantial specialized nursing skill based on the physician's orders and the nursing diagnosis related to palliative and end-of-life care; Examples of such services include, but are not limited to, appropriate preventive and rehabilitative nursing procedures, physical assessment, managing discomfort and providing symptom relief, patient and family teaching, urinary catheter insertion and care, venipuncture and administration of IV fluids or medications, sterile and nonsterile dressing changes
  • Counsels the patient and his/her family regarding the disease process including self-care techniques, end-of-life care, and the processes for dealing with issues of ethical concern
  • Reviews medication use with the patient and/or family and provides medication information, counseling, and education when appropriate
  • Uses the case management approach and acts as the coordinator of the interdisciplinary team to maintain the proper linkages with a continuum of care
  • When a patient is a facility resident, will coordinate the implementation of the plan of care with the facility and will respond to questions and concerns from the nursing facility
  • Informs the attending physician, medical director, and other personnel of changes in the patient's needs and outcomes of intervention
  • Makes referrals to other agencies or services as needed
  • Prepares clinical and progress notes on the relevant and specialized nursing services he/she provides
  • Utilizes the medical record software system via laptop or agency desktop for patient documentation; Initiates documentation in the patient's home and completes it after the visit
  • Submits documentation per agency policy
  • Participates in Clinical Record Reviews
  • Participates in in-service programs and staff meetings including provision of specialized hospice training to other staff, family members and informal caregivers to insure adequate care
  • Develops a written aide assignment based upon the patient's/family's needs when home health aide services are provided
  • Visits the patient's home at least every two weeks, when aide services are provided; The visit shall include an assessment of the aide services and relationship issues; Documents to show that the aide is providing services in accordance with the plan of care and/or makes revision to the aides plan of care as needed
  • Evaluates own needs for support and using identified system(s) to meet the need


Qualifications, Knowledge, Skills & Abilities:

To perform the job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

• Must possess a current RN license to practice nursing in the state of practice

• Graduate of an accredited nursing school

• Must be CPR BLS (basic life support) certified with the American Red Cross

• Prior experience in general nursing practice, hospice experience and/or palliative, end of life care preferred

• Should have computer and excellent communication skills

• Ability to work well with others, function well under pressure, and function independently

• Must comply with the standards outlined in the Nurse Practice Act

• Must demonstrate basic knowledge of all procedures included in the LSS Registered Nurse description

• Must have the ability to follow instructions from the physician, nursing supervisor and other professional staff

• Ability to communicate effectively with managers, patients, families and co-workers

• Ability to assess safety of home situations for self, patients, and other staff members, including physical and psychological dangers

• Must have the ability to effectively cope with patients, families and all others with varying backgrounds, socioeconomic conditions, and value judgments

Physical Requirements and Working Conditions:

The physical activities, demands and working conditions described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job duties and responsibilities.

While performing the duties of this job, the employee must be able to lift 75lbs, Lift 20lbs from floor to shoulder, and push/pull 35lbs. Must be able to roll resident from prone to supine to sitting. The employee is regularly required to stand; walk; use hands to finger, handle, or feel objects, tools, or controls. The employee frequently is required to sit; reach with hands and arms; squat and stoop, kneel, crouch, or crawl. The employee is occasionally required to climb or balance, speech clarity, speech recognition, written expression, and requires sensory abilities.

Is subject to the hazards of vehicular travel out in the community that allows for exposure to weather conditions and potential for unsafe environments. Is subject to emotionally upset residents, or family members. Is willing to work beyond normal working hours and on weekends and holidays when necessary. Is subject to exposure to fumes or airborne particles, and toxic or caustic chemicals. Is subject to exposure to infectious waste, diseases, conditions, etc., including exposure to the AIDS and Hepatitis B virus within guidelines of standard precautions. Appropriate ergonomic and personal safety equipment is provided as needed.

This job description in no way states or implies that these are the only duties to be performed by the employee occupying this position. Employees may be required to follow other job-related instructions and to perform other job-related duties as requested, subject to all applicable federal, state, and local laws and standards. Certain job functions described herein may be subject to possible modification in accordance with applicable federal, state, and local laws and standards.

Additional Information:

N/A

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