Hospice Visit RN (1.0 Exempt)

The Hospice Registered Visit Nurse will assist our case managers to support in-patient care. She/he is responsible for providing skilled nursing care and teaching to patients and their families in their place of residence. The nurse completes all necessary documentation and clear communication with the case manager and team to ensure the patient and their family/caregiver are provided the best care. This is a full-time exempt position that will travel throughout Adoray's entire service area.

Essential Duties and Responsibilities

· Contacts all other disciplines involved in hospice patient’s care with an update by 11:59 pm the day the visit occurred for continuity of care.

· Ensures there is appropriate follow-up with the MD if there are discrepancies with medications or treatment protocols.

· Updates the MD with any changes in the patient’s condition 

· Notifies other members of the IDT of hospice death as soon as possible, unless there are special circumstances.

· Updates POC on a regular, ongoing basis to reflect current care.

· Exhibits sound nursing judgment which positively affects individual patient outcomes. 

· Implements new physician orders timely and accurately. 

· Assesses for, provides, and documents patient and family teaching related to patient’s health situation on an ongoing basis (i.e., medications, disease processes, treatments, etc.) and provides written teaching information as appropriate.

· Ensures Hospice Clinical Coordinator is notified if a call is placed to the physician with update, in case there are callbacks and any office staff follow-up is necessary.

· Updates Hospice Clinical Manager regarding status of patients on regular basis, including a consultation for any unusual circumstances. Assesses for, provides, and documents staff teaching related to patient care on an ongoing basis when patient resides in a facility.

· Documents towards patient goals at each visit.

· Completes required hospice recertification paperwork within specified time periods.

· Supervises home health aide at least every two weeks and documents supervision.

· Ensures medication profile is complete (i.e., “new” vs. “changed”, “covered vs. “non-covered”, start and stop dates, all coumadin doses, IV meds, reason for prn meds, etc.) and consistent with physician’s orders. Protocol for initiating standing orders is followed.

Documents evidence of updates to physician for patients whenever there is a change in status.

· Ensure all documentation to be included in the medical record is completed by 11:59 pm on the day of visit. 

· Ensures all documentation included in the medical record is thorough, complete and accurate, requiring minimal corrections from supervisor when reviewed.

· Ensure that all hospice documents are locked at the time of completion.

· Completes hospice discharge summaries within one week of discharge or death.

· Completes medical supply worksheets timely and accurately.

· Completes payroll paperwork timely and accurately.

· Complete visit schedule by 3:30PM each Thursday for the following week and update schedule as it changes.

· Documents evidence of coordination and collaboration when patient resides in a facility.

· Develops and updates patient goals and interventions which require minimal corrections from the supervisor when reviewed.

  Ensure there is evidence that problems, goals, and interventions are patient specific.

· If during your visit a need is identified for other disciplines (aide, PT, OT, SC, SW, Volunteer, MT) alert RNCM for that patient to follow up. 

· Continually works to anticipate hospice patient’s needs regarding symptom management, thus minimizing the likelihood of a patient care crisis. 

· Meets productivity standards as annually established.

· Visit Nurse must take on call in the weekend rotation and the weekday rotation. Holiday sign up also occurs at the beginning of the year. 2 holidays/year at minimum are required. 

· Ensures adherence to all compliance procedures, including the acquisition of regulatory documentation as indicated.

· Follows agency and facility communication protocols to support effective care coordination.

· Attends In-person meetings/trainings as required. 

· Complete on line trainings assigned by the due date . 

· Other duties as assigned.

Qualifications

Adoray expects employees to understand and to incorporate the values of our organization in their day-to-day practice. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Minimum Qualifications

· BSN or minimum of two years of hospice care experienced preferred.

· Minimum of two years of clinical experience.

· Current Wisconsin RN license required.

· Current driver's license.

· Able to take on call responsibilities on rotating basis.

· Excellent communication skills.

Knowledge, Skills and Abilities 

· High level of attention to detail

· Ability to work autonomously and make independent judgments.

· Ability to manage conflicting priorities and handle multiple tasks/projects concurrently

· Ability and willingness to work at all facilities within Adoray’s service area.

· Ability to work well as part of a team and independently

· Exhibit excellent written and verbal communication and organizational skills

· Exceptional customer service skills

· Display and promote high standards of ethical conduct and behaviors consistent with organizational standards

  Physical Requirements

 · Job involves standing more than four hours per day; stooping, bending, lifting/pushing up to 25 lbs. etc. is regularly required. 

 · Visual acuity of 20/20 with or without correction 

 · Talk or hear 

 · Work involves moderate risks or discomforts that require special safety precautions (such as working around sharp or hot objects; exposure to blood borne pathogens or hazardous waste). Employees may be required to use protective clothing or gear, such as masks, gowns, goggles, gloves and/or shields 

 · Moderate noise (examples: office with computers and printers, light traffic)