Chapters Health Systemposted 25 days ago
Full-time • Entry Level
Brooksville, FL
Ambulatory Health Care Services

About the position

When you become part of the Chapters Health Team, you'll realize it's more than a job. It's a mission. We're committed to providing outstanding patient care and a high level of customer service in our communities every day. Our employees make all the difference in our success! The RN, Care Coordinator is responsible for assessing and identifying patient/family needs, utilizing the nursing process, coordinating the Plan of Care with the Interdisciplinary Group (IDG), and providing palliative and supportive care to the patient/family unit.

Responsibilities

  • Provides and manages direct care to patients and families as part of Interdisciplinary Group (IDG), incorporating psychosocial, spiritual, cultural, physical and biological components, and appropriate nursing intervention and follow-up.
  • Coordinates the Plan of Care, ensuring that an individualized Plan of Care is developed that accurately reflects the patient's evolving needs.
  • Educates patient, family, caregivers and other health professionals about disease process and decline, palliative interventions, care giving, dying process and safety practices.
  • Reports changes in the patient's condition to appropriate members of the IDG or other health professionals.
  • Participates with the IDG to evaluate hospice referrals/admissions for level of care appropriateness.
  • Attends patient deaths; prepares body for transport; oversees disposal of medications.
  • Provides appropriate bereavement interventions to the family and caregiver in conjunction with psychosocial staff.
  • Presents concise and pertinent oral and written reports to IDG; respects and encourages input from all disciplines.
  • Communicates accurately and completely to physicians, staff members, patients, families, and supervisors; utilizes positive approaches when working with others.
  • Supervises patient care given by other nursing team members (i.e., LPNs, Hospice Aides, and contract nurses).
  • Acts as the Company representative at assigned facilities while facilitating referrals to all service lines; works closely with referring hospitals, physicians, facilities, patients, families, and the general public.
  • Completes clinical admissions for all Company services including, but not limited to: Explains services to potential patients/families and addresses questions regarding patient fears, physical limitations, while putting the patient/family at ease; presents services in an empathetic and compassionate manner.
  • Identifies admission objections, concerns or other entry barriers and provides responses.
  • Educates patient/family on admission requirements and addresses immediate needs.
  • Completes informed consents and initial assessment according to regulations and Company policy.
  • Provides information to Physicians and initiates Plan of Care to address patient's immediate needs.
  • Initiates skilled nursing interventions to prevent complications, alleviate symptoms and maximize physical and emotional comfort.
  • Obtains Physician orders.
  • Completes documentation per Company policy.
  • Communicates frequently with Admissions to ensure timely follow-up. When assignment is complete, informs Admissions and prepares for next assignment.
  • Provides all necessary clinical communication timely using SBAR.
  • Discusses any potential needs with after-hours staff.
  • Obtains consents for services and arranges safe discharge in an efficient manner for referred and eligible patients while meeting productivity expectations.
  • Obtains medical record information for the referral.
  • Develops strong relationships with case managers, physicians, etc. at facilities.
  • Works with Professional Relations Representatives (PRRs) to provide education on all available services.
  • Provides care for any GIP patients in a hospital including daily visits, professional management, documentation and efficient discharge.

Requirements

  • Current license as RN in the state where the employee will be working.
  • Active BLS for healthcare professionals from the American Heart Association or Red Cross.
  • Minimum one (1) year of in-patient nursing or hospice experience for external candidates; for internal applicants, minimum of 6-months of LPN experience with hospice/home health within an affiliate.
  • Previous experience working with an EMR/EHR (Electronic Medical/Health Record) system.
  • Mobile Driver - Valid driver's license and automobile insurance per Company policy.
  • Reliable transportation to meet visit schedule.
  • Ability to use equipment with visual and auditory mechanisms.
  • Ability to effectively communicate in English (verbal and written).
  • Flexible schedule to meet the needs of Hospice House patients.
  • Ability to manage the emotional stress of working with and caring for terminally ill patients and their families.
  • Ability to physically access patient rooms, other areas of the Hospice House/Hospital/ALF, etc., and any home (i.e., navigate stairs and narrow spaces, tolerate heat and lack of air conditioning) within any part of the service area.
  • Ability to perform the essential functions and physical requirements (including, but not limited to: lifting patients and/or equipment, bending, pushing/pulling, kneeling) of the job with or without reasonable accommodation.

Nice-to-haves

  • Cross training to hospice house or field (home/facility/admission) positions of equal licensure/certification and scope when census calls for flexible staffing.
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