Overall responsibility for providing direct and indirect nursing care to assigned participants of the Prisma Health Senior Care PACE program. Provides routine and urgent/emergent care for participants in the center and the home, may be independent in the application of advanced nursing knowledge and skill. The RN provides thorough and accurate assessments, interventions and treatments for urgent, emergent and routine participants in a clinic setting or patient home. Utilizes critical thinking and knowledge to identify abnormal findings and respond and react with appropriate interventions based on protocols without the direct supervision of a provider. Functions Independently as a clinical leader and within the team as a community resource, educator, advocate, and consultant. Triage's and determines priority and level of participants care based on physical, psychological, and social needs. Collaborates with provider and other team members to facilitate patient flow and ensure quality and timeliness of care for all patients. Bonus Eligible This position is bonus-eligible; follow this link for details. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. Collects patient data and completes required forms with appropriate responses according to unit standards; identifies patient’s overt problems/needs and sets priorities; identifies problems requiring further referral and/or follow-up; interprets and records latest diagnostic results; performs advanced nursing assessment using critical thinking skills. Develops plan of care based on nursing process which incorporates the plans of other disciplines and continuing care needs; includes the patient/family in developing or revising plan of care; makes referrals to multidisciplinary support services. Initial and periodic assessments (minimally every 6 months) to be completed prior to the scheduled team meeting. Communicates participant changes to team members. Care provided conforms to accepted practice standards; provides correct treatments/procedures and other care as prescribed according to patient care standards; demonstrates understanding of age-related characteristics and needs of patients served; explains nursing procedures in appropriate forms; provides participant and family education in coordination of 24 hour care delivery; identifies emergency situations and independently initiates advanced therapy; acts as coordinator of patient care with other health care personnel and evaluates patient care measures instituted; understands and demonstrates respect for patients rights and utilizes established mechanisms for management of ethical issues in patient care. Records patient care delivered as planned and any variation, with appropriate rationale; makes and records observations related to impending or associated problems; implements nursing measures related to impending or associated problems. Using nursing process, delegates nursing care to appropriate personnel and monitors their performance; integrates cost effective measures into nursing practice; recognizes unit problems and takes responsibility for documenting same; demonstrates active participation in QI processes; complies with hospital expectations to meet staffing demands based on patient care needs; complies with policies addressing safe working conditions; monitors unsafe working conditions; recognizes inappropriate and/or ineffective patient care management, resolves issue/problem and completes written reports; fulfils call for unit as assigned and adjusts staffing for census (volume) and acuity. Participates as a member of the Interdisciplinary Team. Attends staff meetings and takes part in participant care planning. Champions the development, implementation and evaluation of improvement projects, policies and procedures specific to the facility. Precepts and mentors new team members and students until they are proficient. Fosters team development and works with team members to address identified areas of improvement. Provides efficient direct patient care in a PACE clinic or participant's home treating routine, urgent and emergent situations. Maintains advanced knowledge base of disease entities, medications, and other treatments and procedures specific to routine and urgent care/ emergent practice. Provides timely and accurate assessment, evaluation and treatment of participants. Consistently evaluates effectiveness of care, monitors and documents changes in patient conditions and Intervenes as necessary according to policy or after consultation with provider. Performs other duties as assigned.
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Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
Number of Employees
5,001-10,000 employees