RN Primary MNA, VNA of Cape Cod

Cape Cod Healthcare•Falmouth, MA

3h•Onsite

About The Position

This role is responsible for direct patient care for assigned patients. The nurse will evaluate the clinical needs of the patient, initiate, develop, implement, and revise the patient's plan of care. This includes addressing all problems in the plan of care and documenting accordingly. The role utilizes clinical grouping guidelines, including those for appropriate interdisciplinary utilization, to capture and data enter initial visit frequency. The nurse ensures OASIS assessments accurately reflect documentation and vice-versa. They will update the Clinical Manager regarding referrals to community resources as appropriate, participate in inter-disciplinary patient case conferences, and assist in evaluating the effectiveness of the established plan of care. Additionally, the role involves instructing and providing documented supervision of the Home Health Aide plan of care every 14 days. The nurse must notify the MD/other involved care providers and Clinical Team Manager of significant changes in the patient’s condition and complete all admission and other paperwork on a timely basis. Records narrative documentation to reflect skilled care, ensuring it is clear, concise, complete, and captures/addresses the specifics of teaching, direct care, and patient/caregiver response. The nurse obtains and clarifies valid MD orders for all care delivered. In collaboration with the Clinical Manager and interdisciplinary team, the nurse plans and coordinates discharges appropriately, informs the patient/MD, and records the patient's disposition in the discharge summary, completing all appropriate discharge paperwork. Other duties as assigned.

Requirements

Successful passage of VNA pre-hire medication test
Current RN license in Mass. and other related credentials to meet specialty.
Minimum one (1) year of nursing experience required or 6 months of nursing experience with a BSN.
CPR certification required.

Nice To Haves

Home care and IV experience
Computer skills
BSN preferred

Responsibilities

Responsible for direct patient care for assigned patients
Evaluates the clinical needs of the patient; initiates, develops, implements and makes necessary revisions to the patient's plan of care; addresses all problems in the plan of care and documents accordingly.
Utilizes clinical grouping guidelines including guidelines for appropriate interdisciplinary utilization to capture and data enter the initial visit frequency
Ensures OASIS assessment accurately reflects documentation and vice-versa.
Updates the Clinical Manager regarding referrals to community resources as appropriate.
Participates in inter-disciplinary patient case conferences; assists in evaluating effectiveness of established plan of care.
Instructs and provides documented supervision of the Home Health Aide plan of care every 14 days.
Notifies MD/other involved care providers and Clinical Team Manager of significant changes in the patient’s condition.
Completes admission and other paperwork on a timely basis.
Records narrative documentation to reflect skilled care. Documentation is clear, concise, complete and captures and addresses the specifics of teaching, direct care and response of patient / caregiver.
Obtains and clarifies valid MD orders for all care delivered.
In collaboration with Clinical manager and interdisciplinary team, plans and coordinates discharges appropriately and informs patient/MD and records disposition of patient in the discharge summary.
Completes all appropriate discharge paperwork.
All other duties as assigned.