Transitional Care Nurse
About The Position
Join Our Team as a Transitional Care Nurse at Bethany Village! Are you passionate about ensuring patients experience seamless, compassionate care as they move between healthcare settings? As a Transitional Care Nurse, you’ll play a key role in guiding residents through every step of their journey, from admission to discharge, while coordinating with families, healthcare teams, and community resources. Your expertise will help ensure that every transition is smooth, safe, and personalized to each resident’s needs, making a real difference in their recovery and quality of life. Position Overview: A transitional care nurse is involved when a patient/client leaves one care setting and moves to another The transitional care nurse ensures that there is a smooth transition into and out of the skilled nursing facility.
Requirements
- Licenses Practical Nurse NYS Registered Nurse License
- Knowledge of Community Services and local Agencies for discharge referral resources
- Ability to build relationships with community services and physicians to create a smooth transition from subacute rehab to lower level of care.
Responsibilities
- Assist with developing discharge plans that address patients’ specific needs with the interdisciplinary team.
- Assessing and coordination patient’s discharge planning needs with members of their health care team, and community supports.
- Identifying, assessing and discharging patients with complex needs.
- Communicate and coordinate services between subacute care and community primary care provider.
- Coordinate appropriate medications for discharge.
- Has close interaction with the residents, their families, and various agencies in accordance with discharge.
- Maintains all updated infection control practice guidelines.
- Maintains all in-house infectious control requirements and establishes policy and procedures to meet the requirements and to provide reporting, including, but not limited to; influenza, pneumococcus, etc.
- Must maintain all updated reporting requirements for county, state and federal agencies.
- Endorses and complies with the vision, objectives, procedures, and policies of Bethany Village.
- Assist with admission orders, and the admission process
- Assist with unit treatments, medication pass as needed
- All other duties as assigned.
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What This Job Offers
Job Type
Full-time
Education Level
No Education Listed
