Hospice Nurse - On Call

Kaiser Permanente-posted 4 months ago
Honolulu, HI
Ambulatory Health Care Services
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Provides nursing case management and direct clinical care to terminally ill patients. Provides assistance and understanding to the family in the home and in time of bereavement. As a core member of the hospice team, the nurse works cooperatively with the attending physician, Medical Director, and other members of the interdisciplinary group, provides clinical interventions including but not limited to pain management and symptom control, conducts assessments and evaluations, and provides education and supportive end of life care to patient and family. Provides case management and oversight of IDG team and plan of care for hospice patients. Provides direction to home care aide & LPN. Delegates nursing care according to legal and regulatory guidelines/statutes and organizational policies. Maintains professional, clinical, technical, and interpersonal skills to provide best possible service.

  • Establishes and coordinates plan of care for patients assessing educational, equipment, skilled and non-skilled services and needs.
  • Coordinates implementation of the plan of care for patients in SNF, NF, ICF, ALF and other residential care facilities.
  • Provides direct patient care on an as needed basis.
  • Develops and/or revises an appropriate plan of care.
  • Communicates and coordinates plan of care with physician(s), patients and family, and other health care providers.
  • Implements care, as ordered.
  • Identifies problems accurately.
  • Establishes reasonable/measurable goals.
  • Establishes discharge planning in conjunction with the care planning process.
  • Prepares and delivers medical supplies and orders equipment necessary for provision of prescribed care/service.
  • Evaluates patients, families, and home environment on admission and subsequent home visits.
  • Determines if home environment is safe and appropriate for provision of Hospice services.
  • Assesses patients physical and psychosocial needs.
  • Evaluates patients response to identified interventions.
  • Reviews and interprets laboratory values.
  • Demonstrates knowledge and skill in providing wound care.
  • Provides all care according to established, written plan of care.
  • Modifies/updates/changes plan of care when indicated by patients condition and/or physician orders.
  • Obtains physician orders as required by State and Federal laws.
  • Recognizes and interprets significant physiological and behavioral changes in patients condition.
  • Reports findings appropriately to physician, Hospice Supervisor and/or other individuals involved in care of patient.
  • Demonstrates critical thinking such as problem-solving, reflective practice, clinical reasoning, prioritizing, etc.
  • Determines in collaboration with physician when patient care needs to be shifted into another setting.
  • Assesses physical, psychosocial and spiritual needs, incorporating other disciplines into the Plan of Care, as appropriate.
  • Demonstrates compassion presence and empathy while providing end of life care to ensure the best Care Experience possible for both member and family.
  • Instructs patient, family, and other caregivers on nursing and aide-related care to promote independence and comfort care.
  • Teaches, supervises, and counsels patients and family members about providing end of life care for the patient.
  • Documents all care provided to patients and plans pertaining to care according to Hospice Services standards, federal and state regulation(s).
  • Assures that medical record is accurate, legible, and complete; and follows timekeeping practices.
  • Completes assessments and documentation per State and Federal law for all applicable patients assigned.
  • Submits documentation in timelines specified by Hospice Standards, Federal and State regulation(s).
  • Provides oversight and coordination of interdisciplinary team.
  • Supervises other disciplines based on scope of practice, including oversight of LPN and HCA, when applicable.
  • Participates in interdisciplinary team conferences (formal and informal) to coordinate, discuss, and evaluate services provided to patient.
  • Communicates with other Hospice personnel, other departments and with community resources to coordinate care and services for Hospice Services patients.
  • Plans for and participates in professional development activities to keep current of trends in Hospice nursing and/or clinical nursing skills.
  • Participates in Hospice Services functions such as staff meetings, staff in-services, and committees, as assigned.
  • Participates in orientation of new personnel to Hospice Services and precepts students as assigned.
  • Participates in performance improvement.
  • Identifies and presents improvement opportunities to organization and implements Quality Improvement process(es).
  • Identifies and reports infections of patients.
  • Assists with development and implementation of departments annual work plan.
  • Performs clinical record audits, as assigned.
  • Maintains educational record and provides evidence of competency.
  • Maintains productivity levels per agency standard.
  • Prepares weekly schedule of patient visits for self, and licensed practical nurse, and keeps agency apprised of schedule changes and openings for new admissions and other added visits.
  • Required to work weekends, holiday and provide after hour coverage as assigned.
  • Notifies Hospice Supervisor and/or designee of unusual circumstances or abnormal conditions which might result in schedule change for self or other employees.
  • Reports problems, incidents and/or concerns to Hospice Manager in timely manner.
  • Follows all applicable laws, rules, and recommendations for safe driving while on duty.
  • Provides verification of current licensure/certification.
  • Maintains, uses, and responds to (as applicable): voicemail, e-mail, and computer.
  • Minimum of one (1) year nursing experience providing direct patient care, including successful completion of training program in area of specialty, if applicable.
  • Associates degree from accredited school of nursing.
  • Registered Nurse License (Hawaii) required at hire.
  • Driver's License (from any state) required at hire.
  • Basic Life Support from American Heart Association.
  • Accredited certification in hospice and palliative care a plus.
  • Over one (1) year experience as RN providing direct patient care in Hospice, Palliative Care, Home Health, or Oncology setting strongly preferred, willing to train the right candidate.
  • In-depth knowledge of monitoring and managing terminally ill patients conditions and comfort.
  • Experience in and ability to support postmortem care.
  • Knowledge or experience in helping families with grief and loss process and initial bereavement needs.
  • Superb analytical and diagnostic skills.
  • Demonstrated knowledge of venipuncture and IV therapy, antibiotic therapy, respiratory therapy, patient assessment (physical and psych/social), hyperalimentation and TPN, colostomy and ileostomy care, and catheterization (male and female), bowel and bladder training, wound care, diabetic care, transfer skills, care of terminally ill, and patient teaching.
  • Great interpersonal, communication, and collaboration abilities, as well as an ability to provide compassionate end of life care.
  • Exceptional ability to manage stress and emotional challenges.
  • Competency in electronic patient and hospice management systems, such as Epic.
  • Bachelors degree in nursing.
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