Hospice Registered Nurse Field Staff

Duties and Responsibilities: 

1. Provides skilled services to VNSHS patients as evidenced by: 

• Adherence to infection control practices and all agency policies and procedures. 
• Utilization of nursing process to evaluate goals (physical/psychosocial and environmental assessment, diagnosis, plan, implementation, evaluation). 

• Use of clinical guidelines of end stage diseases to determine patient prognosis. 
• Is knowledgeable and follows the guidelines of the Hospice Medicare Benefit. 
• Documents with accuracy and completeness consistent with Medicare guidelines that demonstrate measurable outcomes. 
• Functions as part of the Interdisciplinary Team (IDT) and refers to other team members as needed to ensure the physical, emotional, and spiritual well being of the terminally ill. 
• Is knowledgeable with the medications used at end of life for pain and symptom management. 

• Assesses patient needs related to end of life and communicates with primary MD or Hospice medical staff when there are changes in patient’s medical condition. Advocates for patient’s comfort needs.  
• Is kind and compassionate when communicating and caring for patients and their families.  
• Maintains compliance with Narcotic distribution, administration and disposal in accordance with Department of Health and VNSHS policy.  
• Under the direction of the Clinical Manager/DPS assist with the orientation of new staff and students when needed. 
• Covers on-call shifts as needed. 

• Covers back up on call weekend shifts on a quarterly base as per the agency needs. 

2. Provides case-management oversight when assigned and maintains schedule, as evidenced by: 

• Identifies patient centered goals and an interdisciplinary team approach to meet these goals, under the direction of the home care physician, with the most efficient use of resources and avoidance of re-hospitalization.  
• Care plan development and ongoing revision of care plan specific to patient needs.  
• Upon completion of Monday morning IDT meeting, appropriately projects, prioritizes and delegates patient visits for the coming week.  

• Updates visit schedule by 8:30 each weekday morning. Communicates with administrative staff in a timely manner regarding any changes in their schedule as needed. 
• Maintains acceptable average caseload of 16 patients per FTE. 
• Averages 4-5 visits per 7-hour day.  
• At or above the state and national benchmarks for publically reported key performance indicators 

3. Participates in the IDT meeting and demonstrates effective and timely communication as 

evidenced by:   

• Attendance in weekly meetings with completion of IDG notes 
• Interacts and is prepared to discuss and document the cases for review to include patient’s reason for hospice care and progress towards patient centered goals; Any symptom or medication changes that have occurred since last review. Discusses/documents effectiveness of all disciplines and frequency of discipline visits.  follows up on interdisciplinary group recommendations.  
• Effective use of voice mail and e-mail. 

4. Demonstrates timely documentation as evidenced by:   

• Use of the computer in the home. 
• Clinical notes are completed and are available for review within 24 hours of visit. 
• Completion of HHA supervisions every 14 days and prn. 
• Clear documentation of the patient’s progress towards goals and response to intervention 
• Promptly responds to corrections as needed. 

• Demonstrates proficiency with the HIS content  
• Communicates with all other disciplines involved in patients care and documents same.  
• Provides mandated federal and state notices to patients to include, but not limited to, NYS Provision of Care, Home Health Beneficiary notice and Notice of Medicare non-coverage. 

5. Demonstrates commitment to the team and VNSHS as evidenced by:  

• Supports and promotes the mission of VNSHS.  

• Represents the agency in a professional manner and follows the uniform policy.  
• Flexibility in scheduling with a focus on meeting patient needs. 
• Participation in continuing education (minimum of 3 hours per calendar year), attending annual competency and all mandatory in-services. 
• Attendance at team meetings. 

6. Employee adheres to all applicable federal, state, local laws and regulations. 

7. Other duties as assigned.