Public Health Nurse III - Hospice

Public Health Nurse III - Hospice Primary Purpose

The primary purpose of this position is to supervise and coordinate the overall care delivered to patients assigned to their care by the Hospice team. It is the responsibility of the nurse to promote and support the agency goals and to stay informed and in tune with policy changes, CMS (Center for Medicare Services) and NC DHHS (Department of Health and Human Services) regulations.

Work schedule is Monday through Friday from 8:00am to 5:00pm with one hour for lunch. Hospice services are made available 24 hours/day, seven days per week. Participation in the "on-call" schedule is required.

This position involves the dissemination of information, verification, and continued documentation of appropriateness for hospice care, supervision of aide services and all aspects of patient’s care, ensuring patient’s disease/condition is managed for palliation of symptoms. This nurse helps manage patient medications, orders appropriate durable medical equipment and ensures the needs of the patient are met as much as is possible. Once oriented, supervision consists of (1) assignment of duties, (2) assessment of abilities to execute duties according to Hospice policies and procedures, (3) instruction to staff regarding their application of duties and (4) identify deficient work areas and recommend training/education sufficient for improvement.

Hospice Quality Improvement Activities which consist of auditing Hospice records quarterly for Utilization Review, pain/symptom management, stress management, continuity of care and inpatient care, when needed.

Participate in planning and coordination of community education and awareness events pertaining to Hospice program.

The Hospice nurse evaluates and assesses Hospice referrals to determine the appropriate level of care. This decision is based upon information obtained from the patient assessment as well as information received from the referral source, the hospital discharge planner, the primary care physician, the Hospice Medical Director and the Hospice Social Worker and Spiritual Care Coordinator. A plan of care is developed and is the result of careful team planning and will be inclusive not only for patient needs but for family support.

Once the initial plan of care is formulated, the Hospice nurse may assign visits to an LPN as needed and available. The Hospice nurse possesses knowledge of the terminally ill patient. Change in the plan of care is coordinated and approved by the Hospice IDG Team. The plan of care is monitored to determine that standards are met; visit frequencies match physician orders;

assistance in patient and family’s goals of care are met, re-evaluations completed in a timely manner, and problem solving practiced to provide quality of care to the patient and family.

Coordinate with the PHN Supervisor I (Hospice Supervisor Clinical Director or Designee) patient care conferences and communicates with the interdisciplinary team on a regularly scheduled basis. Present the nursing aspect in Hospice staff development and serve as a resource person internally and externally. Assist program supervisor in development and revision of training programs as well as staff orientation to Hospice. Review spiritual coordinator and volunteer reports/visit notes/care plans with the Volunteer Coordinator and Chaplain as needed, provide feedback for ongoing education and problem solving.

Research and share pertinent current informational material for improved and scientific patient care management of the terminally ill patient.

Attend Hospice meetings, locally and statewide as needed, requested, or required; become familiar with state and national standards of Hospice care and interpret to other staff members.

Provide skilled nursing to the hospice patients. Hospice patients have acute, terminal sometimes multi-systemic conditions, which require frequent or continuous monitoring and assessment/observation and adjustment in treatment, medications and/or instructions. The attending physician usually refers to the patient and approves of and continually…