Field Nurse, Home Health Care

The Registered Nurse Field plans and delivers care to patients in their place of residence utilizing the nursing process of assessment, planning, interventions, implementation, and evaluation; and effectively interacts with patients, families, and other team members while maintaining standards of professional nursing.

*Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position.

Assess physical, psychological, social and spiritual needs of the patient and family within 24 hours of admission.

Assess and evaluates the patient for physical home care needs, medications and nursing care needs timely.

Develops and implements an individualized plan of care including creating measurable patient-centered goals in collaboration with the physician and the patient, that consistently is updated and reviewed to reflect assessment findings to ensure quality patient home care.

Reviews and updates plan of care including interventions, medication profile, visit frequency to meet the patient’s changing needs.

Assess and reports to physician changes of patient condition, needs and facilitates documentation to meet program’s eligibility for services timely.

Documents physicians’ orders when received to provide accurate information and ensure safe delivery of services.

Identifies discharge planning needs as part of the care plan development and implements prior to discharge of the patient.

Supervises, teaches and evaluates care provided by other care providers to ensure compliance to the plan of care.

Documents assessments, interventions and all changes thoroughly at the point of service in the electronic health record and synchronizes this documentation for each patient according to Catholic Hospice standards Communicates handoffs, timely to ensure communication is relayed appropriately for continuation of quality care.

Administers medications and treatments prescribed by the attending physician and/or hospice physician.

Participates in hospice activities such as Memorial Services, Community Education, etc., Able to identify and provide ongoing assessment of the physical, psychological, social and spiritual needs of the patient and family and act accordingly or initiate appropriate intervention or referral.

Assists in other activities and departments when requested to ensure complete and thorough patient care for all Catholic Hospice patients.

Participates in Continuous Quality Improvement activities to support the quality of services.

Completes accurate and appropriate documentation of patient/family services within 24 hours of visit and maintains accuracy of electronic medical record including accuracy of medication profile.

Coordinates care to the patient and family within the Interdisciplinary team and availability of all resources.

Collaborates with Nursing Home staff by initiating the written plan of care, maintaining professional management of hospice care and attending care plan meetings.

Actively participates in quality assurance and performance improvement projects as directed by Clinical Team.

Serves as case manager and advocate to the patient and family while collaborating with attending physicians, insurance case managers, skilled nursing facility staff, assisted living facility staff as well as all health-related practitioners.

Evaluates services provided by the Hospice Aide every two weeks with periodic on-site supervisory visits if needed.

Demonstrates knowledge of hospice levels of care, Medicare and Medicaid Hospice Benefits by providing appropriate documentation when the need arises.

Provides on-going assessments of physical, psychological, social and spiritual needs of the patient and family and initiates appropriate intervention or referral.

Actively participate in the care planning process, updating care plans according to the needs of the patient in the IPU.

Provides education to a diverse group of caregivers audibly and in writing, on how to properly care for patient/family care.

Participates in the team responsibility of providing patient care twenty-four hours a day, seven days a week.

Maintaining the ability to extend hospitality and patience while assisting patients, families, physicians and peers under stressful circumstances.

Attend home deaths as required and communicating with physician, funeral home, and team (if applicable)

Ability to lift and move patients according to accepted nursing standards of body mechanics.

Coordinate several projects at the same time with competing timelines.

Ability to coordinate several projects at the same time with competing demands and tight time lines.

Demonstrate adherence to Catholic Hospice, Inc. policies and procedures and pertinent State and Federal Rules and Regulations.

Ability to travel to any location throughout South Florida as needed and expand territory as business needs dictate.

Comply with all policies, local, state and federal laws and regulations.

Provide other duties of healthcare team member.

May serve as an interim department leader depending on need

CHS provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Associate of Science in Nursing (ASN); Bachelor of Science in Nursing (BSN) preferred.

Clear and Active Registered Nurse license to practice in the state of Florida.

1-2 years of nursing experience preferred. Hospice nursing experience preferred.

Certification in Hospice & Palliative Medicine (CHPN) preferred; Eligible upon completion of 500 hours in last 12 months of hospice/palliative experience.)

Must have knowledge of computer office/clinical software.

Must be able to read, write and understand the English language.

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