Nurse Practitioner - Palliative Care - PRN/Casual - Rotating

Why Work For Nebraska Methodist Health System?

At Nebraska Methodist Health System, we focus on providing exceptional care to the communities we serve and people we employ. We call it The Meaning of Care a culture that has and will continue to set us apart. It's helping families grow by making each delivery special, conveying a difficult diagnosis with a compassionate touch, going above and beyond for a patient's needs, or giving a high five when a patient beats a disease or conquers a personal health challenge. We offer competitive pay, excellent benefits and a great work environment where all employees are valued! Most importantly, our employees are part of a team that makes a real difference in the communities we live and work in.

Job Summary

Location: Methodist Palliative Care Address: 8303 Dodge Road, Omaha Work Schedule: Minimum of 2 shifts per month. M-F 8a-4p as needed, Rotating weekends and Holidays (6-12 weekends per year and 1-2 holidays per year.) Rotating on-call from 4p-8a. Casual/PRN employees work on an 'as needed' basis to meet the needs of the business. Work days/hours will often vary from week to week. Provides quality of care and safety to our patients and employees.

Responsibilities

Essential Functions Perform primary health care for patients by utilizing the processes of assessment and diagnosis of health status.

• Obtain patient's medical and history information, data collection is prioritized according to immediate condition or needs.
• Perform physical exam and determine patient's mental status.
• Develop and implement treatment, follow-up and evaluation plans for patient outcomes.
• Collaborate with physicians and other disciplines as appropriate and provides regular and consistent feedback.
• Use appropriate assessment techniques & diagnostic information. Performs tests relevant to patient condition and record findings.
• Order appropriate ancillary tests.
• Derive diagnosis from the assessment data and diagnostic information as data becomes available.
• Use new or additional data to form a treatment plan.
• Perform telephone triage to determine patient condition and provides appropriate consultation scheduling appointments when needed.
• Incorporate research into clinical practice as appropriate.
• Provides timely initial patient and family assessments for palliative care consults.

Implement interventions consistent with the established plan of care in a safe and appropriate manner.

• Apply established therapeutic practices to patient's problem.
• Administer medications and immunizations using the appropriate method and with physician oversight if applicable.
• Prescribe medications according to Controlled Substance Registration Certificate issued by the DEA.
• Generate referrals to appropriate services as needed to further diagnose and/or progress of care.
• Prescribes medications and other non-pharmacologic interventions, including controlled substances, to promote comfort and symptom management.
• Safely selects and manages medications/dosages for ongoing treatment of symptoms.
• Pain-oral, parenteral, IV, IM, subg, bolus, PCA
• Nausea and vomiting
• Constipation
• Breathlessness
• Delirium
• Other
• Appropriately converts medications using equianlagesic/equipotency formulas (eg. opioids, steroids).
• Manages and preempts common side effects of pharmacologic intervention.
• Recommends and facilitates non-pharmacologic strategies into the plan of care.
• Consults other team experts as needed (eg. Chaplains, Behavioral Health).
• Collaborates with palliative care collaborating providers as needed, recognizing abilities and limitations.
• Conducts, leads and facilitates palliative care consultation meetings and decision making using theoretical principals, skills, and competencies of advanced nursing practice and palliative care.
• Communicates effectively with patient and family understanding of diagnosis, prognosis care and treatment options.

Evaluate patient care to determine response to care/interventions for optimal patient outcome.

• Evaluate the patient's capabilities and/or limitations related to nursing and medical interventions.
• Recognize and address patient and family capabilities and limitations (physical and mental).
• Return patient telephone calls.
• Monitor outcomes and documents patient response to interventions.
• Seek out new treatment methods necessary to ensure patient progress.
• Discusses findings and recommendations for plan of care with attending and consulting physicians and other team members as needed to assure continuity of care.
• Implements actions and provides for communication that promote continuity of care and optimal transition within and outside the hospital setting.
• Collaborates with other disciplines for discharge planning inclusive of financial needs and functional status.

Provide patient and family teaching and education specific to the patient's health care.

• Proper use of medication and health/illness prevention to ensure adequate knowledge/awareness.
• Interview and advise specific to patient needs.
• Demonstrate sensitivity to family regarding need for patient information on a timely basis.
• Work collaboratively with physicians and other team members to provide appropriate patient education geared to the patient's needs and family's ability to provide care.
• Use adult learning principles for teaching purposes being careful to check for understanding and being available for follow-up questions.
• Recommend references and resources such as printed materials, online, community and other information sources to fulfill the family's need for education.

Maintain a professional behavior in attitudes, demeanor, and interactions to achieve organization's mission.

• Communicate effectively with physicians, staff and patients.
• Is approachable and professional in working with other health professionals, patients and their family.
• Maintain a professional appearance, behavior, and work environment.
• Initiate action to correct, prevent, and/or minimize risk(s) to the patient, family or hospital/clinic employees (i.e., falls, needle sticks, patient concerns).
• Communicate to appropriate personnel regarding unresolved issues.
• Serve as a role model in the provision of emerging care.
• Serve as a reliable/knowledgeable resource for staff.
• Participate in meetings, research on special projects and professional organizations.

Comply with the bylaws, rules and regulations of the organization as they pertain to Nurse Practitioners or Physician Assistants.

• Know and follow organization policy & procedures.
• Follow Medical Protocols for professional discipline.
• Maintain certification/licensure.
• Follow guidelines of regulatory bodies (FDA etc.).

Maintain complete patient records.

• Document data appropriately.
• Document treatment plan of care that is individualized, appropriate and reflects patient's needs.
• Document interventions.
• Document consultations with other practitioners/physicians.
• Completes accurate patient records in a timely manner.
• Documentation includes information to support sound medical/nurse practitioner practice.
• Completes timely documentation and dictations for new consults/follow up visits.
• Documents as needed to support billing and reimbursement for services provided.
• Initiates reimbursement billing for services rendered (submits billing).
• Completes adequate number (or %) of palliative care patient/family consults and follow up visits given team workload.

Participate in performance improvement and outcome management.

• Meet regularly with medical director for chart reviews.
• Identify concerns in patient care & follows up according to hospital policy.
• Participate in patient satisfaction and other quality improvement initiatives.
• Participate in tracking of variances in care.
• Develops and maintains knowledge of current research related to clinical practice specialty.
• Uses knowledge of research review to analyze research findings.
• Contributes to PI data collection for the specialty area.
• Assists in analyzing PI data to determine opportunities for improvement.
• Initiates and/or contributes to changes in protocols, standards, policies and practices based on current research and PI data.
• Conducts research as needed based on hospital clinical priorities.
• Completes manuscript for publication on periodic basis

Provide appropriate care specific to the age of the patient to ensure understanding and comfort level of treatment as outlined in the "Age Specific Criteria".