Palliative Care Nurse Practitioner

The Palliative Care Nurse Practitioner/APRN provides direct patient and family care through palliative care consultation to ensure specialty services to patients with serious illness and a prognosis of one year or less who are not ready or eligible for hospice care. Proactively identifies patient-centered opportunities to improve the patient’s and family's experience of illness, anticipates and treats distressing symptoms. As a member of the palliative care interdisciplinary team, provides and facilitates evidence-based plan of care that improves the quality, efficiency, and effectiveness of needed health-related interventions and resources. The NP/APRN will provide specialized assessment, diagnose, and implement high-quality palliative plan of care utilizing evidence-based treatment protocols to provide patient-centered goals of care, symptom management, disease trajectory, prognostic education and counseling. Actively fosters team processes that support appropriate referral for setting management. Closely communicates with the patient’s referring physician to make recommendations and discuss the ongoing plan of care. Provides outreach to community agencies and health care settings (such as nursing homes) to provide direct patient care in those settings when consulted. Under the direction and in collaboration with the Palliative Care Medical Director, patient's referring physician, collaborating physicians, Palliative Care Clinical Director, and Palliative Care Interdisciplinary Team assures practice is in compliance with legal and regulatory standards, clinical protocols, policies, and procedures.

• Demonstrates effective and ethical use of approved evidence-based palliative medicine practices in the delivery of all patient
  care based on physical, emotional, spiritual, psycho/social, ethical, educational, safety and related criteria, appropriate to the ages of patients served
• Demonstrates knowledgeable clinical expertise by incorporating palliative care body of knowledge to formulate an effective plan of care
• Gathers pertinent information systematically from all sources, including medical records, family history, and caregivers, and thorough specialty physical, emotional, psychosocial, and spiritual clinical patient assessment
Completes a comprehensive assessment utilizing the palliative care domains of assessment, interprets findings, conducts medication reconciliation, and formulates problem-related diagnoses, initiates plan of care utilizing therapeutic interventions, and evaluates the results of these actions for adequate outcome responses.

• Provides thorough assessment of distressing symptoms utilizing appropriate scales and assessment techniques and prescribes evidence-based medications and adjunctive interventions for the palliation of symptoms
• Formulates diagnoses and documents a problem list which reflects the appropriate history, physical examination, and results of diagnostic tests
• Demonstrates professional consult etiquette and effective communication skills when discussing the plan of care and
  appropriate recommendations with medical director, patient’s primary care provider, specialist providers, and interdisciplinary team to insure the appropriate communication concerning the plan of care
• As indicated by patient /caregiver needs, appropriately performs and documents an ongoing reassessment of the problems, and implications for revision of management, utilizing problem-oriented documentation
• Demonstrates effective therapeutic communication /counseling techniques performing illness counseling and conducting family
  conferences with patient, caregivers, family, and/or significant others to discuss patient’s plan of care. Interacts in a positive manner with the family unit, providing appropriate information, emotional and spiritual support
• Contributes to the health teaching of patients, caregivers, families, and significant others regarding the patient's
  anticipated/active distressing symptoms, identified diagnoses, disease trajectory, advance directives, prognostic awareness and end of life issues with appropriate teaching materials and strategies
• Functions independently, autonomously without supervision, utilizing time constructively and organizing assignments for maximum productivity
• Provides timely, effective medical record documentation, coding and placing charges utilizing appropriate professional clinical language and approved abbreviations
• Available daily to triage referrals to the palliative care service to determine appropriate level of intervention and urgency of intervention
• Maintains contact with patients' Home Care providers to assist in care management as necessary to facilitate optimal care
• Assists in leading interdisciplinary team meetings to facilitate interdisciplinary collaboration through discussion of patient plan
  of care, progress, significant events or patient decline, caregiver needs and family dynamics on an as-needed basis. Makes recommendations to the team when needed
• Demonstrates an attitude of inquiry towards medical/nursing practices and assists in developing evidence-based nursing/medical protocols for quality outcomes
• Assists in the orientation of new members of the palliative care interdisciplinary team while serving as a resource and preceptor. Acts as a role model for open communication and collaboration will all members of the team
• Consults with the medical director and collaborating physicians when needed
• Pursues problems to resolution and/or refers them through the appropriate chain of command
• Participates in assigned departmental activities and committees, working in a constructive manner
• Participates in on-call rotation as assigned
• Reviews current professional literature and utilizes evidence based medical/nursing research to improve own clinical practice and stay updated
• Maintains required continued education for APRN licensure, prescriptive authority, certifications, technical skills, training and credentials
• Supports the growth of palliative care service lines by contributing time and expertise to community education as needed
• All other duties as assigned

• RN/APRN licensure in state of practice
• Nurse Practitioner/CNS with prescriptive authority. Must maintain all requirements for licensure
• 5 years of clinical nursing experience. At least 1 year as APRN with Hospice, Palliative Care or Oncology preferred
• Advanced practice palliative care certification (ACHPN) is preferred. Certification in an appropriate advanced practice area will be considered. BCLS Licensure requirement. ACHPN Certification is encouraged following 2 years of employment or sooner when requirements for experience met.