RN Home Health

Covenant Health•Knoxville, TN

About The Position

The Registered Nurse provides professional nursing care to an assigned group of terminally ill patients and coordinates care planning with the interdisciplinary team to support the best possible outcomes throughout patients’ duration of life. The role includes assessing patient and family needs, implementing and updating individualized plans of care, providing symptom-focused palliative and end-of-life care, and coordinating services with providers and other care team members. The Hospice RN reports to the assigned Hospice Clinical Supervisor. The nurse educates and supports patients, families, caregivers, and staff; supervises LPNs and Hospice/Home Health Aides; documents disease progression and care; and follows applicable Covenant HomeCare policies, Medicare guidelines, safety standards, and clinical procedures. Travel is required throughout all counties served by Covenant Hospice.

Requirements

Graduation from an accredited school of nursing.
At least one year of professional experience in a hospital or prior home health experience.
Tennessee RN licensure, maintained throughout employment.
Current CPR certification.
Valid Tennessee Class D driver’s license and state-mandated minimum insurance coverage.
Driving record must meet Covenant Health minimum standards at hire and throughout employment.
Ability to travel to all counties served by Covenant Hospice.

Nice To Haves

Clinical experience pertinent to hospice, including oncology, palliative care, or end-of-life care.

Responsibilities

Assess the impact of terminal illness on patients’ physical, functional, psychosocial, environmental, and activities-of-daily-living needs, initially and on an ongoing basis.
Facilitate a palliative home environment that supports a smooth transition at the time of death, considering risk for pathological grief and cultural, spiritual, and communication needs.
Implement individualized plans of care and recommend or make revisions as needed, including symptom management focused on comfort and reduction of pain and suffering.
Consult with and educate patients and families about the terminal diagnosis and disease process, self-care techniques, end-of-life care, and ethical concerns.
Initiate preventive and rehabilitative nursing procedures, including pressure ulcer, pain crisis, and bowel impaction prevention and care of bed-confined patients.
Prepare clinical and nursing notes that reflect the progression of the disease process.
Coordinate patient and family services and prioritize needs with the interdisciplinary team through daily communication as needed and bi-weekly IDG meetings.
Use a case-management approach, refer patients to other services as needed, and act as liaison between providers and patients or families.
Communicate with providers, process and relay orders, and inform providers and staff of changes in patient needs.
Determine the scope and frequency of services based on patient acuity and patient and family needs; update plans of care and visit calendars as needed.
Develop and oversee individualized Home Health Aide plans of care.
Supervise LPNs and Hospice/Home Health Aides providing services.
Assist with orienting new employees and provide specialized hospice training to staff, family members, and informal caregivers.
Evaluate patient and family responses to education and care, and assess caregiver ability to meet the patient’s immediate needs upon admission and throughout care.
Advocate for respite care as needed.
Maintain working knowledge of Medicare guidelines and comply with them.
Follow admission, discharge, on-call, and death procedures in accordance with Covenant HomeCare policy.
Perform infection-control procedures, including proper bag technique, handwashing, glove use, waste and needle disposal, handling of soiled items, and cleaning equipment used in the home.
Plan visits appropriately, including scheduling an estimated arrival time with the patient or caregiver.
Meet age-specific, culture-specific, and religious-specific needs of the population served and demonstrate skills on the annual skills checklist.
Travel throughout all counties served by Covenant Hospice.
Follow policies, procedures, and safety standards; complete annual education assignments; work toward goals and objectives; participate in quality-improvement initiatives as requested; and perform other assigned duties.