Hospice RN Case Manager - East Valley

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Registered Nurse (FT), Case Manager, East Valley

DUTIES AND RESPONSIBILITIES :

• Apply specific criteria for admission and re-certification to establish the patient’s eligibility and appropriate levels of care.
• Assess the impact of the terminal diagnosis on the patient’s physical, functional, environmental, safety, ADL, and psycho-social needs, including risk for pathological grief.
• Assess all aspects of the patient’s pain and develop an individualized pain management plan.
• Assess the ability of the caregiver to meet the patient’s immediate needs at the start of care and throughout care.
• Develop an individualized palliative plan of care based on the needs identified which demonstrates the management of discomfort and provision of symptom relief.
• Determine the scope and frequency of services based on acuity and patient / family needs.
• Implement the care plan utilizing appropriate preventative and rehabilitative nursing procedures.
• Consult and collaborate with the interdisciplinary team and others involved in the patient’s care.
• Coordinate all patient / family services and participate in prioritizing the needs of members of the interdisciplinary team.
• Use the case management approach, referring to other services as needed.
• Support, consult, and educate the patient, family, and caregiver regarding the disease process, self-care techniques, end-of-life care, and managing ethical concerns.
• Document nursing assessments, care plans with problems, appropriate goals and interventions identified, care provided, and patient / family outcomes demonstrating progress toward established goals.
• Document and communicate information using current processes and technology available to the Agency.
• Attend Interdisciplinary Group meetings and participate in care plan revision / update.
• Work in a team approach with members of the interdisciplinary team to evaluate ongoing patient / family responses to and satisfaction with care.
• Support the patient’s and family’s unique spiritual and cultural beliefs.
• Provide holistic, family-centered care across treatment settings to improve quality of life.
• Perform duties consistent with the Nursing Practice Act including the Standards of Competent Performance.
• Demonstrate the ability to correctly use and direct the use of medical supplies and equipment.
• Provide specialized hospice training to other staff the patient’s family and informal caregivers to ensure adequate care.
• Participate in the On-Call rotation as requested.
• Participate in orientation, in-service education, and performance improvement.
• Prepare and submit, as directed, all case documentation and required payroll information according to Agency policy.
• Prepare re-certification and discharge paperwork as appropriate and submit timely.
• Evaluate own needs for support and communicate concerns to manager.
• Consistently display a professional appearance and conduct in all settings.
• Assume responsibility and display reliability for the completion of all tasks, duties, communications, and actions.
• Support the mission, vision, and goals of the Agency.
• Participate in performance improvement activities.
• Abide by Agency policies and procedures.
• Accept other duties as assigned.

EDUCATION, EXPERIENCE, AND TRAINING :