Nurse Per Diem

Job Summary

The Variable Staffing Nurse VSN is a member of the Variable Staffing Team and as such participates in providing after hours staffing coverage including but not limited to; Weekend Day Coverage Evening/Night Shift coverage Holiday and PTO coverage for Case Managers Visit Support Nurses and Admission Nurses as needed.

The Variable Staffing Nurse VSN is responsible for providing after hours support to patient/families admitted to hospice service. Working in collaboration with Triage Patient Care Managers and the Scheduling Coordinator the VSN responds to patient/family calls and intervenes appropriately providing phone instruction/support or visit as assessed. Care provided is based on an the individualized Plan of Care developed by the IDT that reflects patient/family goals related of Safe & Comfortable Dying SelfDetermined Life Closure and Effective Bereavement.

The VSN demonstrates: sensitivity and compassion for the issues involved with serving patients and families facing a terminal illness death and bereavement; clinical competence in pain and symptom management; and fiscal responsibility in the planning and delivery of services. The VSN also provides direct supervision for Hospice Aides.

Essential Responsibilities

Patient/family Care

• Recognizes the patient and family as the unit of care and IDT members
• Respects patient right to selfdetermination and acts as advocate within the context of the values and ethical standards of HSCC
• Demonstrates ability to meet patient/family where they are
• Offers/makes visits per agency policy
• Offers home visit at time of death
• Utilizes nursing process in providing primary care to patient/families and professional patient management to facility staff
• Documents all care and care planning per agency policy
• Provides nursing interventions for patient/family as ordered by the physician or Nurse Practitioner and in accordance with the Plan of Care (POC) safe nursing practice and the policies and procedures of HSCC
• Monitors management of pain and symptoms in collaboration with patient/family facility staff IDT and physician to achieve maximum comfort
• Administers medications and treatments as ordered
• Instructs and supports patient/family unit and facility staff re: symptom management patient care disease process & death/dying

On Call

• Works cooperatively with Variable Staffing Team members to provide after hours/weekends and holiday coverage for HSCC patient/families and staff of our facility partners.
• Participates in providing extra coverage for planned and unplanned absences
• Secures current information on each patient prior to making calls
• Assesses patient status via telephone response
• Follows agency policy in determining whether to make/offer visit or use telehealth for patient/family
• Assists supports & educates patient and family through physical and emotional crisis utilizing all Variable Staffing Team after hours resources available; Social Workers Spiritual Care Counselors Hospice Aides Administrator On Call.
• Assesses for and promotes caregiver confidence via telephone teaching onsite visits or telehealth visits.
• Obtains medications medical supplies and equipment per pt need/physician order and HSCC policies and procedures when needed
• Demonstrates understanding of pharmacyrelated policies & procedures
• Disposes or instructs re: disposal of Schedule II medications at time of death per agency policy
• Opens closes and revises POC per HSCC guidelines
• Documents all contacts instructions and interventions in the electronic medical record per HSCC policies & procedures
• Documents all contacts instructions and interventions provided per HSCC policies & procedures
• Submits completed paperwork & time logs within the time frames per HSCC policies & procedures
• Creates individualized POC based on the assessment of pt/family needs and goals
• POC addresses patient/family physical psychosocial and spiritual needs a written POC that includes identified goals interventions and outcomes and documents

Secondary Responsibilities

IDT Participation

• Functions as a member of the HSCC IDT maintaining open & organized communication with hospice staff volunteers and supervisor
• Works collaboratively with IDT to develop common goals to meet the needs of the patient/family
• Participates in IDT meeting when appropriate per protocol to promote care planning problem solving and education
• Completes and submits all documentation in accordance with policies and procedures

Quality Improvement

• Meets all standards and requirement as indicated by licensing and accrediting agencies
• Completes and submits all documentation in accordance with policies and procedures
• Submits verification of current employment related documents per HSCC policies procedures and licensing agencies
• Participates in activities that affirm enhance and develop the highest quality standards for HSCC
• Participates in developing standards for quality patient care within HSCC
• Participates in Quality Assessment & Improvement activities as requested

Special Projects

• Participates in special projects as requested
• Performs other related job duties as assigned by Supervisor

Compliance

• Ensures all HIPAA Privacy and Security Regulations Medicare Conditions of Participation and all other regulatory/compliance requirements are understood and followed
• Submits verification of current RN license
• Submits proof of auto insurance annually; keeps drivers license current and maintains a good driving record
• Ensures TB checks are completed in a timely manner; at least annually

Requirements

• Require current California RN license
• Valid state drivers license and liability auto insurance
• Available to work 4 weekend days/nights/evenings per month and alternates Christmas/Christmas Eve and Thanksgiving annually
• Required to attend regular meetings and inservices

Skills Required

• Critical thinking and ability to function both independently and as a member of the Variable Staffing Team after hours support.
• Familiarity with electronic charting programs and/or demonstrated keyboard and computer skills sufficient to utilize electronic medical record charting.

Education/Experience

• Degree in Nursing from an accredited college
• 25 years RN experience in hospice oncology medsurg ICU ER skilled nursing facilities or homecare
• Acute care experience preferred
• Hospice and/or home health experience preferred
• Endoflife and pain management experience preferred

Certifications Licenses Registrations

• California State issued RN license
• Current BLS
• Pass OIG/GSA review and all required background checks

Skills Desired

• Bilingual in English/Spanish highly encouraged but not required.
• Previous experience working with end of life is desirable.

Physical Demands

• Sufficient dexterity to utilize electronic record keeping systems computers/keyboards and or laptops and other related equipment
• Ability to travel to patient locations; includes ability to drive negotiate stairs and walkways including uneven surfaces at private homes or facilities
• Vision ability to read manual and electronic documentation medications charts office related equipment and instructions
• Hearing ability within normal range to elicit and detect pertinent information while communicating with patients and health team
• Speech to verbally communicate to assess and impart information concerning patient status; to complete patient/family teaching and to interact with health care team

Work Environment/Environmental Condition

• Performs services in private homes and care facilities and will experience a variety of settings and situations
• Office work is performed in combination of private homes care facilities and office environment.