Registered Nurse Admissions Nurse VNA Full Time

Job Description Summary

Responsible as a member of the interdisciplinary team to the Director and Nurse Manager for assigned functions related to providing information about services to potential South Shore VNA patients and admitting patients to South Shore VNA.

Job Description

ESSENTIAL FUNCTIONS

1 - Demonstrated ability to relate effectively with patients, staff, physicians, community agencies and facility staff.

a - Plan for admission of SSVNA patients in coordination with community liaison nurse and/or patient care coordinator. Expectation is 3 admissions/day for 9 hour work day and 3 admissions/day and 1 revisit for 10 hour day

b - Assume initial responsibility for assessing patient/family needs and consulting with attending physicians and other care team staff members

c - Admit patients, develop plans of care and complete related documentation in accordance with South Shore VNA policy and procedures.

d - Obtain data on physical, psychological, social and spiritual factors that may influence patient/family health status and incorporate that data into the plan of care.

e - Inform the community liaison nurse and patient care coordinator/manager of unusual or potentially problematic patient or family issues.

f - Determine patient's appropriateness for homecare services

g - Utilize appropriate Local Coverage Determination (LCD) per CMS and document all required information in patient record.

h - Consult with primary physician for appropriateness to service as needed.

i - Make telephone calls to potential SSVNA patients to provide information on homecare care and services and/or assess patient's status. Document all patient interactions and plans in patient’s medical record.

j - Assist with the implementation and coordination of services required for discharge of patients to provide for discharge patients from hospitals and skilled nursing facilities SSVNA

2 - Demonstrated ability to communicate effectively with members of the interdisciplinary team (IDT)

a - Instruct primary caregivers, volunteers and employed caregivers to provide care as indicated.

b - Attend IDT meetings to relay information to the IDT about the new patients and to ensure continuity of patient care services as indicated.

c - Facilitate transition of patient/family already in care to primary nurse at the appropriate time.

d - Communicates pertinent patient care information to evening and night staff utilizing voicemail if needed, direct contact or other means to provide information.

e - Manage patient/family care plan and accompanying services between time of admission and transition to primary nurse as necessary.

3 - Demonstrate ability to assist team members in case management of patients and providing team support in contributing to quality educational needs.

a - Assist primary nurses in management of their caseloads by making patient visits as needed.

b - Assist with QAPI and utilization review activities as needed or requested.

c - Accept other assignments as appropriate.

d - Participate in agency and community programs as requested to promote professional growth and understanding of home care.

e - Participate in homecare orientation and in-service training programs for professional staff.

4 - REASSESSMENT/VISIT DOCUMENTATION
For each visit, demonstrates the skills and judgment necessary to implement the Plan of Care, nursing interventions, and procedures necessary for the skilled care of the patient, as evidenced by chart review and observation.

a - Updates the Plan of Care with any change in the patient’s status at each visit.

b - Coordinates and communicates with other clinical team members any changes in the patients’ medical or physical condition resulting in a change in the plan of care.

c - Completes required documentation to communicate changes in the plan of care.

d - Performs comprehensive physical and psychosocial assessment at each visit.

e - Demonstrates knowledge of Homecare Department policies and procedures for administering and recording medications.

f - Assesses pain every visit utilizing appropriate pain scale. Document findings, plan and desired outcomes.

g - Adheres to the Fall Risk Assessment Process and completes documentation as required.

h - Orients and supervises the Home Health Aide at a minimum every 14 days and completes required documentation.

5 - DISCHARGE/DOCUMENTATION DISCHARGE
For each discharge, documentation demonstrates decline, improvement or appropriate variances are identified. Documentation of notification to all disciplines involved.

a - Completes Discipline Discharge or Agency/Clinic Discharge Task including actual discharge, disposition and reason facts.

b - Discharge documentation reflects summary of care provided.
c - Completes appropriate paperwork

d - Display status has been modified to reflect DC date.

e - Documentation of notification to all disciplines

6 - TECHNOLOGY
Embraces technological solutions to work processes and practices.
a - Demonstrates clinical proficiency and competency in the agency/program automated clinical record as evidenced by successful completion of education program and utilization of software.

b - Consistently utilizes phone system and telecommunication services, i.e. responds to Tiger and checks voicemail.

c - Operates clinical equipment correctly, i.e. PT/INR monitor, 02 saturation and IV pumps.

7 - SAFETY
Fosters a "Culture of Safety" through personal ownership and commitment to a safe environment.

a - Understands individual roles/responsibilities during emergency situations in patients' home or at office, e.g. Emergency Preparedness Plan.

b - Adheres to patient identification policies/practices, i.e. patient identifiers.

c - Tests alarms on IVs to assure that they are set at appropriate settings.

d - Demonstrates proper bag technique and use of personal protective equipment.

e - Adheres to respiratory etiquette guidelines.

f - Handles hazardous waste according to departmental protocol.

g - Utilizes proper body mechanics when performing all aspects of job.

h - Determines significance of critical laboratory values

i - Follows Telephone order policy and procedure. Writes down and reads back.

j - Complies with current CDC hand hygiene guidelines through proper handwashing.

a - Adheres to the five (5) rights for medication administration

b - Maintains accurate medication profile and reviews medication profile with the patient/family/caregiver at each home visit.

c - Completes DRR and medication reconciliation upon admission and with every new medication.
d - Demonstrates knowledge of commonly used medications' action, dose and side effects, and readily utilizes resources for research.

9 - PROFESSIONAL DEVELOPMENT

a - Demonstrates knowledge of developmental effects of aging.

b - Demonstrates knowledge of family violence, child/elder/disabled neglect and abuse so as to identify those at risk.
c - Maintains current knowledge of nursing practice by attendance at in services and participation in seminars and courses to increase knowledge in are of nursing specialty.

d - Attends and participates in staff meetings, reads all applicable minutes.

10 - LEADERSHIP DEVELOPMENT

a - May act as Patient Care Coordinator if needed

b - Delegates responsibilities according to the patient care needs and skills of caregivers.

c - Practices within the legal boundaries of the MA Nurse Practice Act and according to Hospital Policy and procedure.
d - Participates in committees or project teams to resolve process/system issues.

e - Acts as a mentor for all staff and is recognized as a positive influence throughout the agency.

f - Demonstrates the ability to act as a formal/informal leader.

11 - ADVANCED CLINICAL SKILLS/KNOWLEDGE

a - Certified by the professional association most highly regarded in the specialty.

b - Seeks out and participates in educational opportunities to develop and/or maintain specialized clinical skills and knowledge, i.e. IV infusion, Chemotherapy administration

c - Serves as a teacher/mentor for other nurses to advance clinical skills.

d - Receptive to Just in Time Education to meet the clinical needs of the patient.

e - Identifies new techniques, products or equipment to improve patient

f - Assumes responsibility for own professional development by incorporating evidence-based practice and research into clinical practice.

g - Attends CEU programs appropriate to clinical/professional development.

12 - EDUCATOR
Independently seeks out opportunities to teach, learn and influence others.

a - Employs expertise as a role model, preceptor and/or coach.

b - Demonstrates effectiveness as a preceptor through successful completion of program by orientee.

c - Demonstrates the ability to organize unit specific and/or agency wide educational events.

d - Independently seeks out opportunities to teach, learn and influence others.

JOB REQUIREMENTS

Minimum Education - Preferred

Graduate of an NLN accredited school of nursing

Minimum Work Experience

Two (2) or more years’ experience as a community health nurse
Two (2) years of medical/surgical nurse
Required Licenses / Registrations

RN - Registered Nurse

Required additional Knowledge and Abilities

Advanced clinical and assessment skills with ability to deal with a variety of clinical situations.

Pain management experience

Critical thinking, ability to multi-task, excellent communication skills, ability to work within a team or autonomously

Flexible, excellent attention to details, well-developed documentation skills