Staff RN

ACHH STAFF REGISTERED NURSE

PER DIEM NIGHT POSITION 7:00 pm to 7:30 am includes some weekends and holidays Weekends and Holiday differential and Bilingual differential applies

DEPARTMENT: Alexander Cohen Hospice House (ACHH)

REPORTS TO: ACHH Administrator

SUMMARY: As a member of the ACHH Interdisciplinary Team (IDT), the RN works under the direction of the ACHH Administrator in the provision of skilled nursing assessment, planning, and care in order to maximize the comfort and quality of life of patients and their families in the inpatient setting. Responsible for coordinating the care provided by the inpatient interdisciplinary team and the outpatient interdisciplinary team when needed.

RESPONSIBILITIES:

1. Assesses all patients admitted to the ACHH, reviews transfer documents, communicates with physician and/or Medical Director, notifies IDT of patient arrival, assures that patient and family have been oriented to the ACHH and plans, implements, and evaluates the plan of care with the IDT and the patient/family.

Standard: Assessment of new patients and communication will be completed within four hours of admission. Patients/families will be oriented to the ACHH following the assessment of patients.

2. Performs reassessment of needs according to patient level of acuity. Provides physical, emotional, and spiritual support to the patient and family directly and by interaction with the IDT. Provides direct patient care according to the plan of care.

Standard: Frequent patient contact, reassessment, and treatments of each patient will be completed each shift according to patient needs.

3. Maintains communication with the IDT in AM report and as needed regarding patient changes in status and any patient/family needs or problems.

Standard: Each shift will communicate to IDT members as needed.

4. Initiates communication with the physician, Medical Director, IDT, community agencies, and administrative staff, as needed to coordinate the plan of care and use of resources for patient/family.

Standard: Communications with other team members and the oncoming shift will be done by the end of each shift unless patient/family needs require immediate attention by the other team members. Patient falls and other safety issues, patient discomforts and changes in status requiring physician orders, and abuse/neglect issues will be communicated to the attending physician at the time of notification or assessment.

5. Maintains up-to-date records so that problems, plans, actions, including patient family teaching and goals are accurately and clearly documented and changes are reflected as they occur.

Standard: Documentation will be completed by the end of each shift and filed in the patient chart.

6. Plans for discharge of patients to acute care, skilled nursing, and to the home environment, and communicates with the outpatient IDT to assure continuity of care.

Standard: Coordinate transfers to inpatient or home with patient/family involvement.

7. Participates in weekly IDT meetings to problem solve, update the plan of care, and share professional support and exchange feedback aimed toward enhancing professional growth.

Standard: Attendance at and preparation for IDT meetings is required. Night shift RNs will participate via shift change report and documentation. RNs must be prepared to discuss changes to the plan of care, recertification's, and changes in status of patients. Interdisciplinary Team Meetings are not meant to take the place of routine communication between team members.

8. Participates in inservices, workshops, and clinical meetings to promote professional growth and understanding of hospice care.

Standard: Attendance at 80% of all mandatory inservices and meetings, designated as RN appropriate, provided by agency. Completes all required inservices.

9. Coordinates physical care of the patient including providing direct patient care, assigning and supervising CHHA and LVN care, teaching patients/families, CHHAs, LVNs, and volunteers.

Standard: Provide all aspects of patient family teaching. Update the Home Health Aide assignment as needed. Supervise Home Health Aides. Coordinate changes in patient level of care/status changes.

10. Provides the appropriate environment as identified by the patient/family to support the patient/family during the dying process.

Standard: Support maintaining a home-like environment to the extent possible (considering safety for patients/families/staff).

11. Participates in the orientation of new employees to the ACHH.

Standard: Assists in the orientation process of new employees. Acts as a preceptor to new employees as assigned.

12. Participates in Community Hospice and ACHH quality improvement process by using Quality Assurance Alert forms to report problems and participating in projects as assigned by the ACHH Administrator.

Standard: Completes audit requests within five business days of receipt. Submits Quality Assurance Alert forms to report quality issues. Submits Hospice Acquired Infection Control Assessment Form. Participates in quality improvement projects as assigned.

13. Follows all ACHH and Community Hospice policies and procedures including, but not limited to, safety, infection control, privacy and confidentiality, and HIPAA.

Standard: 100% Compliance

14. Maintains a professional appearance of self and working area. Exhibits professional and courteous behavior at all times with patients, families, guests, team members and other co-workers, and clients.

15. Must maintain RN license in accordance with federal, state and local laws, and must act only within the scope of his or her state license. All personnel qualifications must be kept current at all times.

Standard 100% Compliance

Other Functions:

1. Other duties as assigned, including work in other areas to cover absences or relief to equalize peak work periods or otherwise meet the needs of the organization.

2. Responsible for establishing and maintaining a safe environment for patients/families, and a safe working environment for self and coworkers.

SUCCESS FACTORS:

1. Maturity and ability to cope with the demands of the job.

2. Empathetic attitude toward the care and needs of the terminal patient and their family.

3. Able to recognize and follow healthy emotional boundaries.

4. Ability to work in a dynamic, rapidly changing environment.

5. Excellent listening, verbal, and written communication skills.

6. Ability to follow written directions and to provide accurate and timely documentation.

7. Ability to work as a member of an interdisciplinary team.

QUALIFICATIONS:

1. Possession of a current license to practice as a registered nurse in the State of California.

2. At least one year of nursing care experience as a professional nurse. Prefer two years general experience plus one year of hospice experience.

3. Able to work with an Interdisciplinary Team and the patient/family in the planning of patient/family care.

4. Able to provide highly skilled care in a homelike environment.

5. Demonstrated ability to assess and respond to needs of the patient/family experience of end-of-life issues and problems.

6. Skills in nursing practice including, but not limited to, care of the patient with IV or SQ access, trach care, tube feedings, aerosol treatments, and families in emotional state and crisis.

7. Possesses and maintains current CPR certification.

WORK ENVIRONMENT: The environment for this position is home-like, with climate controls. The employee may be exposed to virus, disease and infection from patients. The employee may experience situations, with emotionally disturbed, substance abuse, serious illness, and deceased patients.