RN Case Manager - Hospice

Job Summary

The registered nurse plans, organizes and directs hospice care and is experienced in nursing, with emphasis on community health education/experience. The professional nurse builds from the resources of the community to plan and direct services to meet the needs of individual and families within their homes and communities.

Patient Care

• Completes an initial, comprehensive and ongoing assessments of patient and family to determine hospice needs.
• Provides a complete physical assessment and history of current and previous illness(es).
• Provides professional nursing care by utilizing all elements of the nursing process.
• Assesses and evaluates patient’s status by writing and initiating a plan of care, regularly re‑evaluating patient and family/caregiver needs and participating in revising the plan of care as necessary.
• Uses health assessment data to determine nursing diagnosis and develops a care plan that establishes goals, based on nursing diagnosis and incorporates palliative nursing actions.
• Includes the patient and the family in the planning process, initiates appropriate preventive and rehabilitative nursing procedures, administers medications and treatments as prescribed by the physician in the physician’s plan of care, counsels the patient and family in meeting nursing and related needs, provides health care instructions to the patient as appropriate per assessment and plan.
• Assists the patient with activities of daily living and facilitates self‑sufficiency and optional comfort care.
• Acts as Case Manager and assumes responsibility to coordinate patient care for assigned caseload.

Communication

• Completes, maintains and submits accurate and relevant clinical notes regarding patient’s condition and care given.
• Records pain/symptom management changes/outcomes as appropriate.
• Communicates with the physician regarding the patient’s needs, reports changes and obtains/receives physicians’ orders.
• Communicates with community health‑related persons to coordinate the care plan.
• Teaches the patient and family/caregiver self‑care techniques, provides medication, diet and other instructions as ordered by the physician and recognizes and utilizes opportunities for health counseling with patients and families/caregivers.
• Works in concert with the interdisciplinary group, provides and maintains a safe environment, assists patient and family/caregiver and other team members in providing continuity of care, works in cooperation with the family/caregiver and hospice interdisciplinary group members to meet emotional needs of the patient and family/caregiver, attends interdisciplinary group meetings.

Additional Duties

• Participates in on‑call duties as defined by the on‑call policy, ensures arrangements for equipment and other necessary items and services are available.
• Supervises ancillary personnel and delegates responsibilities when required.
• Assumes responsibility for personal growth and development, maintains and upgrades professional knowledge and practice skills through continuing education and in‑service classes.
• Fulfils obligation of requested and/or accepted case assignments.
• Actively participates in quality assessment, performance improvement teams and activities.

• Graduate of a National League for Nursing accredited school of nursing.
• Minimum of two years of experience, at least one in public health, home care, or hospice nursing preferred.
• Registered nurse with current licensure to practice professional nursing in the state.
• Responsible for supervising hospice aides.
• Demonstrates excellent observation, problem solving, verbal and written communications, nursing skills per competency checklist.
• Shows ability to organize and prioritize workload independently.
• Physical requirements:
  
  prolonged or considerable walking or standing; able to lift, position, and/or transfer patients; lift supplies and equipment; considerable reaching, stooping, bending, kneeling, and/or crouching; visual acuity and hearing to perform required nursing skills.
• Maintains a current CPR certification.
• Ability to drive and/or have access to transportation for agency‑related travel; must have a valid driver’s license, automobile insurance, and access to an automobile.
• Self‑directed and able to work with minimal supervision.

We are an equal opportunity employer committed to ensuring that all conditions and privileges of employment, including recruitment, hiring, evaluation, transfer, promotion, discipline, determination of compensation and/or benefits, and termination of employment, for all job classifications are based on qualifications and work record. No employment decision is made, nor do we discriminate, on the basis of race, color, religion, creed, sex/pregnancy, sexual orientation, gender identity, gender expression, age, national origin, ancestry, citizenship, veteran status, or disability.