RN-Transitional Care Unit (Full-time, Day, 7am to 7:30pm)

CarePoint Health•Bayonne, NJ

11d

About The Position

The Transitional Care Unit Registered Nurse (RN) is responsible for assessing, planning, implementing and evaluating the delivery of care. The professional nurse assumes the responsibility and accountability for the delegation of patient care to other members of the health care team, which may include coordination of services with rehabilitation staff to maximize the patient’s independence to return to their prior residence.

Requirements

Associates Degree in Nursing required; Bachelor’s Degree in nursing preferred.
Must possess licensure as a Registered Nurse in the State of New Jersey
1-2 years of relevant experience
Completion of an BLS, ACLS (American Heart Association), and IV certification.
Must demonstrate excellent communication and interpersonal skills.

Responsibilities

Identifies patient/family education needs and ensures that patient/family members have adequate information to participate in transition planning.
Evaluates and analyzes physical and psychosocial assessment data.
Interprets laboratory/diagnostic tests.
Conducts a comprehensive patient/family assessment and transition/home care planning evaluation upon program enrollment to initiate and maintain the patient's transitional plan of care.
Initiates and maintains communication and collaboration with physicians, social workers, care team leaders, staff nurses, other care giving disciplines, and patients/families to develop, implement, and evaluate a transition plan of care for each patient.
Assesses complexity of care needs and potential/actual issues or gaps in care.
Arranges post-discharge medical and community referrals for patients with health problems requiring further evaluation and/or additional services.
Advocates for patients and families within the health care system with community providers and across the continuum of care.
Identifies, tracks, and conducts root cause analyses on readmissions to address programmatic and system-wide improvements.
Works with physicians, providers, researchers, and Transitional Care leadership to identify broader system issues affecting patient care.
Perform other duties as needed or assigned.