Provides skilled nursing care to hospice clients in their homes or community health settings ensuring the delivery of outcome based, high quality, cost-effective care.
· Reviews referrals, and initiates contact with client and family.
· Conducts a complete nursing assessment based on referral data, client/family interview, and clinical observation of patient health status. Demonstrates clinical expertise in symptom management and end of life issues.
· Develops a plan of care in collaboration with client and all disciplines based on assessment data which documents need for services, appropriate discharge planning, short- and long-term goals, and the utilizations of appropriate resources. Facilitates peaceful death and assures appropriate bereavement follow up through timely documentation of bereavement assessment. Modifies plan of care as conditions change.
· Demonstrates understanding of payer information in order to maximize care planning. Utilizes Hospice Levels of care appropriately.
· Follows IDT process of approving non-formulary medications, treatments, and DME.
· Initiates and maintains a client record utilizing the Agency’s standard for documentation.
· Makes follow-up visits to provide skilled care to assess disease progress and evaluates response to treatment so as to promote peaceful death; provides support to client/family utilizing teaching principles to promote and restore health and prevent disease and disability, as possible; coordinates care with providers. Utilizes interdisciplinary team members to support patient/family needs.
· Teaches patients and reinforces client/caregiver teaching and education. Prepares/teaches/supports family regarding signs and symptoms of death, as appropriate.
· Refers, collaborates, and coordinates all client care services. Consults with physician regarding client needs and plan of care.
· Directs LPNs in carrying out the established plan of care. Directs Home Care Aides and supervises plan of care.
Minimum Requirements:
Education: Graduate of an Associate’s of diploma program in nursing
Experience: One year nursing experience OR one year nursing experience in a specialty
Licensure: License to practice in the State of Connecticut
Preferred:
Education: Graduate of NLN approved BSN program
Experience: Medical/surgery or home care experience
