Transitional Nurse Liaison

SUMMARY

Promote the delivery of coordinated, comprehensive care to patients through the activities of assessment, planning documentation, and provision of direct nursing care within the policies and standards of the Agency and under the direction of the Hospice Clinical Supervisor. Accurately complete assessments, administer skilled nursing care to patients requiring intermittent professional nursing services, and determine what additional disciplines and/or programs are required for the care of the patient.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Accurately complete required start‑of‑care documentation within 24 hours Develop, implement, and adjust the patient care plan in cooperation with the Hospice interdisciplinary team Observe signs and symptoms and any changes in patient status and report to the Hospice team Communicate with physicians, agencies, and team to coordinate patient/family care Profile/reconcile medications in conjunction with pharmacy vendors and physician Communicate with Intake to order DME specific to patient needs Understand Medicare disease‑specific criteria, Hospice level of care, and Hospice benefit Teach, supervise, and counsel the patient and family members regarding the nursing care needs and initiate preventive and rehabilitative nursing procedures as appropriate for the patient’s care and safety Assess and assign Hospice Aides as appropriate by providing a written plan of care and specific duties the aide is to perform for each individual patient Attend and participate in all required agency meetings Adhere to the Agency’s personnel policies and compliance plan Complete 3 (three) SOCs daily and, if SOCs are not available, assist team as assigned by the Supervisor Organize daily visit schedule to minimize travel time and mileage Travel where business needs require to reach weekly productivity Assist with routine and follow‑up visits as needed Comply with Company’s Core Values and Core Competencies Perform other duties as assigned by supervisor

QUALIFICATION REQUIREMENTS

Associate degree from an accredited School of Nursing Hold, in good standing, a license as a Registered Nurse, issued by the state in which you work A minimum of two (2) years of experience working as a Registered Nurse, including Hospice experience Proficiency in Agency IT programs HCHB/PointCare processes Able to meet the physical demands of providing nursing care, ambulating patients, transferring patients, assisting with exercises, etc. Able to transfer patients as needed according to proper techniques of body mechanics to promote patient and staff safety Able to follow up as needed and appropriately with doctor’s office, Hospice multidisciplinary team, and management staff pertaining to any concerns regarding patient care Possesses and maintains current CPR and BCLS certification

PHYSICAL DEMANDS

While performing the duties of this job, the employee is required to talk or hear, stand, walk, sit, climb stairs, use hand to finger, handle or feel objects, tools, or controls, and reach with hands and arms. The employee frequently lifts and/or moves up to 50 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

WORK ENVIRONMENT

Employee will be required to drive daily for meetings and/or visits to residential homes, work in varied residential environments based on assigned case load, and may travel by automobile and be exposed to changing weather conditions. #J-18808-Ljbffr Graham Healthcare Group