Hospice Nurse Practitioner

POSITION: Hospice & Palliative Care Nurse Practitioner

REPORTS TO: Chief Clinical Officer

POSITION SUMMARY: The Nurse Practitioner works in collaboration with the Medical Director, Hospice Physicians, Hospice and Palliative Care Teams to provide Hospice and Palliative care services to patients and families in a variety of settings. The Nurse Practitioner will also perform procedures for which he or she is privileged to do and will document assessments, evaluations, consultation reports and progress notes. Home visits/evaluations, and inpatient evaluations will be part of the Nurse Practitioners role. Duties are performed with the collaboration of the Medical Director, hospice physician, or attending physician, if any. Successful outcomes of this position include high quality patient care provided in a compassionate, competent, and caring manner; clinical program development; skill development for Hospice and Palliative clinical staff, regulatory compliance with proper documentation enhanced community relationships, program visibility; excellent staff and patient satisfaction.

This position is full-time, Monday-Friday and will cover patients within Manitowoc, Sheboygan, Calumet, & Ozaukee Counties. The provider will also be responsible for on-call duties for hospice and palliative care patients for at least 1 day/week from 4:30 pm to 7 am and one weekend a month from 4:30 pm to 7 am Monday. The role may include an occasional weekend rotation to assist with rounds in hospitals and IPU.

Primary & Essential Duties:

1. Performs clinical care which includes bedside evaluation of patients, patients’ histories; physical examinations; radiological and laboratory interpretations; follow-up inpatient care; discharge orders, patient instructions and education; and participation in case management.

2. Provides services related to hospice and palliative care, assesses patient needs and anticipates service requirements. Coordinates with social workers, case managers and applicable ancillary staff regarding hospice and palliative care services.

3. Orders, performs, and interprets laboratory and radiology tests.

4. Prescribes medications including controlled substances to the extent delegated and licensed. Orders, treatments, and durable medical equipment as indicated. Performs other therapeutic measures as indicated.

5. Educates clinical staff, patients and families on applicable disease management and prevention strategies. Adheres to the practice of confidentiality regarding patients, families, staff, and the organization.

6. Assists with the coordination of admissions and discharges as needed on selected patients.

7. Works collaboratively with physicians, and other health care providers to optimize patient care. Consults with Medical Director or designees as needed, informs primary physician of services. Provides written reports to primary physician upon request.

8. Prepares and maintains accurate patient records, charts, and documents to support sound hospice and palliative practices and reimbursement for services provided. Assists in the development of clinical documentation protocols.

9. Initiates reimbursement for services rendered and evaluations.

10. Makes visits to hospice and palliative care patients as delegated by the Medical Director (or his or her designees) or Director of Clinical Services.

11. Daily Rounding in the IPU (Inpatient Unit) to provide GIP (General Inpatient) level of care for inpatients. This will include assessment, care planning, pain and symptom management and documentation of care in the EMR.

12. As required by agency policy, it reports both verbally and in writing significant changes in the patient’s condition. Changes are reported to the physician and other appropriate agency personnel. Consults with the clinical supervisor, as necessary.

13. Maintains regulatory compliance in all areas of position responsibilities. Has an excellent understanding of regulations and accreditation standards.

14. Must demonstrate empathy and sensitivity to the needs of the patient and family.

15. Prepares concise, legible timely clinical notes, utilizing agency guidelines. Becomes trained in laptop charting.

16. Maintains coordination with all other disciplines as needed for patient care.

17. Provides appropriate resources in accordance with agency policies and procedures.

18. Utilizes appropriate communication lines to problem solve personal and departmental issues.

19. Is responsible for his/her continuing education, e.g., professional journals, attending seminars, workshops, assisting in presentation of in-service education and community education.

20. Collects and assesses patient care data, develops, and implements a plan of care, manages, and evaluates outcome of care.

21. The provider will be responsible for on-call duties for hospice and palliative care patients for at least 1 day/week from 4:30 pm to 7 am and one weekend a month from 4:30 pm on Friday to 7 am on Monday. The role may include occasional weekend rotation to assist with rounds in hospitals and IPU.

22. Supports the Agency’s Mission and Value Performance Standards.

23. Providers will participate in IDG meetings with the teams they are assigned to.

24. The provider will be responsible for maintaining their schedule in Wellsky EMR and maintaining productivity standards.

25. Provider will obtain and maintain credentialing with all payor sources for which SSRCH and RPH are network providers, to include Hospital credentialing.

26. Other duties as assigned.

Personal Qualifications

1. Ability to relate to people of diverse cultures and ethnic backgrounds.

2. Must demonstrate maturity, initiative, tact, and good judgment in dealing with staff, patients, and families.

3. Knowledge of medications and sterile techniques.

4. Knowledge of and appropriate use of safety (personal protective) equipment.

5. Strong teaching and leadership skills.

6. Basic personal computer skills required. Clinical documentation experience preferred.

7. All staff driving on agency business are required to have a valid driver’s license, reliable auto, and current auto insurance.

8. Self-directed and ability to handle stressful and emergency situations.

Education/Experience

1. Current Nurse Practitioner License for Wisconsin.

2. Prefer a minimum of one year's Nurse Practitioner experience.

3. Previous Hospice and Palliative Care experience preferred.

4. Graduate from NLN accredited school of Nursing.

5. Master's degree in appropriate field of nursing.

6. ACHPN within 2 years of hire.

Working Conditions

1. Physical Requirements: Frequent ambulation; constant bending, lifting, twisting, pushing and pulling; reposition patients, lift minimum of 30 pounds unassisted; bilateral manual dexterity; climb up and down stairs; Job may include sitting, standing, bending, stretching, stooping, walking, lifting 20 – 50lbs and repetitive hand motion associated with keyboarding; drive to and from patient homes; able to sit for extended periods of time; manual dexterity to operate computer and other office equipment.

2. Mental Requirements: Read, speak, write, and understand English; cognitive processes to interpret patient condition and apply appropriate clinical processes in complex situations; ability to add, subtract, multiply, divide and work with fractions; ability to drive and locate patient homes; must function independently without supervision while working in collaboration with the IDT (Interdisciplinary Team).

3. Working/Environmental Conditions: Fast-paced changing environment, with multiple directives from several disciplines; may at times require work in patient homes with no control over environmental conditions. Potentially unsafe and unsanitary home environments. Potential travel in inclement weather. Work assigned throughout the agencies clinical program setting.

4. Machines, Equipment, Tools Used: Including but not limited to; automobile; telephone; smart phone; computer, laptop, or tablet; fax machine.

5. Exposures: Anticipated exposure to blood, other body fluids or other potentially infectious materials. Exposure to communicable diseases or infections. Anticipated exposure to hazardous equipment, assorted chemicals, gases/vapors, and other pollutants.

6. Personal Protective Equipment Required: Assorted gloves; assorted masks, protective eyewear; impervious gowns; impervious aprons; needleless systems as appropriate.