Primary Purpose

• The primary purpose of this nursing position is to supervise and coordinate the overall care delivered to patients assigned to his/her care by the Hospice team.
• It is the responsibility of the nurse to promote and support the agency goals and to stay informed and in tune with policy changes, CMS (Center for Medicare Services) and NC DHHS (Department of Health and Human Services) regulations.
• Work schedule is Monday through Friday from 8:00am to 5:00pm with one hour for lunch.
• Hospice services are made available 24 hours/day, seven days per week.
• Participation in the "on-call" schedule is required.

Essential Functions

40%Care Coordination This position involves the dissemination of information, verification, and continued documentation of appropriateness for hospice care, supervision of aide services and all aspects of patients care, ensuring patients disease/condition is managed for palliation of symptoms. This nurse helps manage patient medications, orders appropriate durable medical equipment and ensures the needs of the patient are met as much as is possible. Once oriented, supervision consists of (1) assignment of duties, (2) assessment of abilities to execute duties according to Hospice policies and procedures, (3) instruction to staff regarding their application of duties and (4) Identify deficient work areas and recommend training/education sufficient for improvement. Hospice Quality Improvement Activities which consist of auditing Hospice records quarterly for Utilization Review, pain/symptom management, stress management, continuity of care and inpatient care, when needed.

Participate in planning and coordination of community education and awareness events pertaining to Hospice program.

25%Assessment The Hospice nurse evaluates and assesses Hospice referrals to determine the appropriate level of care. This decision is based upon information obtained from the patient assessment as well as information received from the referral source, the hospital discharge planner, the primary care physician, the Hospice Medical Director and the Hospice Social Worker and Spiritual Care Coordinator. A plan of care is developed and is the result of careful team planning and will be inclusive not only for patient needs but for family support. Once the initial plan of care is formulated, the Hospice nurse may assign visits to an LPN as needed and available. The Hospice nurse possesses knowledge of the terminally ill patient. Change in the plan of care is coordinated and approved by the Hospice IDG Team. The plan of care is monitored to determine that standards are met; visit frequencies match physician orders; assistance in patient and familys goals of care are met, re-evaluations completed in a timely manner, and problem solving practiced to provide quality of care to the patient and family.

Coordinate with the PHN Supervisor I (Hospice Supervisor Clinical Director or Designee) patient care conferences and communicates with the interdisciplinary team on a regularly scheduled basis. Present the nursing aspect in Hospice staff development and serve as a resource person internally and externally. Assist program supervisor in development and revision of training programs as well as staff orientation to Hospice. Review spiritual coordinator and volunteer reports/visit notes/care plans with the Volunteer Coordinator and Chaplain as needed, provide feedback for ongoing education and problem solving. Research and share pertinent current informational material for improved and scientific patient care management of the terminally ill patient.

Attend Hospice meetings, locally and statewide as needed, requested, or required; become familiar with state and national standards of Hospice care and interpret to other staff members.

25%Patient Care Provide skilled nursing to the hospice patients. Hospice patients have acute, terminal sometimes multi-systemic conditions, hich require frequent or continuous monitoring and assessment/observation and adjustment in treatment, medications and/or instructions. The attending physician usually refers to the patient and approves of and continually supervises these services. Responsible for the total management of these patients.

Establish and maintain an electronic medical record on each patient, complete care plans as required by CMS intermediary, record visits, make Hospice Aide Supervisory visits and provide other care as needed.

7%Travel Travel to and from patient homes.

3%Training / Additional Support Attend educational meetings to stay current with new trends and procedures including seminars, in-service and classes when available. 16 hours in-service education per year, maintain CPR certification, attend CCHD OSHA / Annual training and have tuberculosis skin test each year. Provide proof of BSN degree OR complete Public Health Nurse Orientation Training within the first year of date of hire. In the event of a disaster, may be required to assist as needed. Other duties as assigned by supervisor and/or management.

Minimum Education and Experience

• Graduation from a four-year college or university with a B.S. in Nursing which includes a Public Health Nursing rotation and two years of Public Health nursing experience;
• or a Master's in Public Health and graduation from a school of professional nursing and two years of professional nursing experience;
• or graduation from a school of professional nursing and three years of professional nursing experience including two years of Public Health nursing experience;
• or an equivalent combination of training and experience.

License or Certification Required by Statue or Regulation:Currently licensed to practice as a Registered Nurse in the state of North Carolina. Valid drivers license.

Additional Information

In addition to the annual salary, $2,400 additional incentive pay is also available for this position (paid out in equal increments over 26 pay periods).