Admissions RN - Hospice (Sunday to Thursday)

Admissions Registered Nurse

The Admissions RN is responsible for the coordination of patient information in conjunction with the Director of Nursing, Director of Marketing & Business Development, Intake Coordinators, and Community Liaisons. The Admissions RN is also responsible for completing timely and compassionate hospice admissions in both the hospital and home settings.

The Admission RN meets directly with referred patients to provide a comprehensive assessment of their clinical findings to the Hospice Medical Director for certification and admission to the hospice program or rejection from the hospice program. Once the patient has received a verbal certification from the Hospice Medical Director, the Admissions RN coordinates all aspects of the patients' admission including transportation to their home, when necessary, durable medical equipment and medications related to their hospice prognosis. The Admissions RN then inputs data into the patient's hospice medical record and communicates their findings to the assigned hospice team for continuity of care. The role requires strong clinical judgement, excellent communication skills, and the ability to provide emotional support during critical moments in the patient and family journey.

The schedule may consist of home hospice admissions, hospital admissions, or a mix of both. Although the Admissions RN may typically be scheduled in one setting, flexibility to assist with either type of admission is expected to meet patient and organizational needs.

When available and necessary, the Admissions RN works as part of the clinical team to provide overflow nursing visits, emergency nursing visits, and death calls when other nursing staff is unavailable. The Admissions RN is responsible for completing all admissions paperwork and coordinating the hospice team as ProCare Hospice of Nevada policy dictates.

Accountability: Reports to the Director of Marketing & Business Development and the Director of Nursing or designee

FLSA Status: Exempt/Salary

Job Duties and Responsibilities:

General:

• Adheres to patient rights, abuse reporting, and confidentiality policies
• Gathers, reports, and analyzes patient care data to create a comprehensive patient assessment and reports findings to the Hospice Medical Director for verbal certification of patient admission or refusal of admission
• Immediately reports significant condition issues/safety issues to the Admissions Coordinator, Admissions Assistant, Hospice Medical Director and assigned interdisciplinary team
• Fosters and maintains an effective working relationship between peers, professional staff, and other personnel within the community
• Able to effectively explain the hospice benefit to potential patients, their families, and representatives
• Works with patients and families or caregivers upon admission to create a realistic Plan of Care and set of treatment goals
• Supervises and delegates duties to Certified Nursing Assistants and Licensed Practical Nurses when needed
• Anticipates overall care needs of newly admitted patients as much as possible and coordinates with all hospice disciplines
• Complies with all documentation policies/procedures for patient admission including reviewing hospice admission criteria, gathering all patient data, reviewing pertinent H&P, and disseminating this information to the Hospice Medical Director and/or the assigned hospice interdisciplinary team
• Completes all admission paperwork in the patient's hospice medical record, same day unless prior approval is given for extenuating circumstances
• Demonstrates good judgment with proper decision-making abilities
• Participates in Interdisciplinary Team Meetings and other Performance Improvement Activities as needed
• With previously established physician orders that RN may do so, RN may make Pronouncement of Death
• Calls coroner and completes process related to removal of body from location of death when on call or performing case management
• Attends scheduled staff meetings and or in-service training as required
• Adheres to the departmental dress code requirements related to personal grooming and attire
• Provides intervention and support as needed related to terminal illness and loss
• Provides emotional and spiritual support and makes appropriate referrals to other team members
• Assesses and addresses depression and fear associated with terminal illness
• Facilitates communication among patient, family, and hospice team
• Provides referral to community services and resources as needed
• Identifies caregiver strain which may necessitate respite care relief and/or support
• Provides personal care as assigned by the Interdisciplinary Team, Physician, Director of Nurses/Supervising RN, which may consist of but not limited to:

• Patient Admissions
• Nursing Assessment/reassessment
• Medication management, administration, and teaching
• Provides comfort measures
• Insertion/maintenance/removal of Foley catheters
• Insertion/maintenance/removal of various IV catheters for pain control/comfort
• Application/adjustment of oxygen, IV, NG, G-Tube and other invasive lines as ordered by the physician
• Vital signs (B/P, T, P, R)
• Assist with ambulation/transfers
• Follows the State of Nevada Nurse Practice Act during all patient care activities
• Follow policy and Lippincott Manual of Nursing Practice for clinical care

24. Other duties as assigned

Specific to Job Position:

• Visits potential patients to review and assess for hospice admission
• Reports findings of potential patient assessments directly to the Hospice Medical Director for verbal certification of hospice admission or refusal of hospice admission
• Requests additional H&P when necessary to make final determination
• Communicates findings to the Medical Director, patient's chosen Attending Physician, and Admissions Coordinator
• Appropriately educates patient about hospice services, assessing needs and preferences and referring patient for services needed and desired
• Assures that the initial plan of care (POC) is based on a comprehensive physical, psychosocial, safety, age-related spiritual, financial, environmental, and cultural needs, resources, and preferences assessment
• Assures that the initial assessment includes assessment of pain and symptoms, history of interventions and response, and pertinent knowledge base of patient/ caregiver/family
• Communicates patient findings to assigned RN Case Manager and interdisciplinary team
• Works with CNA Coordinator to ensure that the appropriate aid needs of each patient are met immediately upon admission
• Ensures that all regulatory standards are met, State, Federal, CHAP and other regulatory bodies
• Completes all communications and documentation accurately either electronically, in legible writing or type written
• Coordinates development of the initial Plan of Care with the Interdisciplinary team (IDT) members
• Presents new patient admissions for the IDT meeting, when available, or ensures that patient data is effectively communicated to assigned RN Case Manager or Director of Nursing so that they may give report during the IDT meeting
• Maintains positive, compassionate, and credible image during patient assessments and with referral sources
• When available, works with clinical team and Director of Nursing to assist with overflow patient visits, emergency patient visits, and death calls when no other nursing staff is available
• Creates opportunities for new referrals when out in the community
• Supports the philosophy, objectives, and mission of ProCare Hospice of Nevada
• Maintains professional competency and licensure
• Stays current with accreditation and both state and federal governmental regulations affecting hospice
• Works well both independently and within the Interdisciplinary Team structure
• Able to work with minimal supervision but seeks guidance from higher authority when needed
• Promotes a team approach through cooperation, mutual respect, flexibility, and dependability
• Assists with the training of newly hired Admissions RNs in the department to ensure consistency of care
• Maintains flexibility to complete after hours, weekend and holiday assignments when needed
• Completes all admission documentation per policy and communicates necessary information, in person or via phone to assigned RN Case Manager and interdisciplinary team
• Must be able to complete three (3) admissions/evaluations per scheduled workday with flexibility to complete additional evaluations as needed and assigned

Physical/Safety Requirements:

• Must have the strength and endurance required for standing, going up and down stairs, walking, bending, and pushing, pulling and lifting up to 50 lbs., as needed
• Must utilize appropriate durable medical equipment as needed in a safe manner
• Must use appropriate body mechanics as needed for safe patient care
• Category l for potential exposure to blood/body fluids. (Requires the performance of procedures or other tasks in the work routine that involve an inherent potential for mucous membrane or skin contact with blood, body fluids or tissues, or a potential for spills or splashes of them.

ProCare Hospice of Nevada