Job Details

Palliative Care RN-Case Manager Sign on Bonus $5,000

The Registered Nurse  works closely with other palliative care team members in planning, organizing and coordinating palliative care consultations as described in the patient’s Plan of Care. The Registered Nurse is responsible for direct patient care that meets the needs of  patients, caregivers, and family members.

Patient Care

• Acts as Case Manager as assigned by Director of Patient Care Services and assumes responsibility to coordinate patient care for assigned caseload.
• Completes an initial comprehensive and ongoing comprehensive assessment of patient and family/caregiver to determine hospice needs.
• Provides a complete physical assessment, record of current illnesses and history of previous illnesses.
• Assesses and evaluates patient’s status.
• Writes and initiates the Plan of Care.
• Regularly re-evaluates patient and family/caregiver needs.
• Develops and documents the Plan of Care that establishes goals, based on nursing diagnosis and incorporates palliative nursing actions; makes necessary revisions as patient status and needs change.
• Counsels the patient and family/caregiver in meeting nursing and related needs.
• Provides health care instructions to the patient and family/caregiver as appropriate per assessment and Plan of Care.
• Facilitates the patient’s efforts toward optimal comfort care.
• Provides nursing care to patients through visits and telephone calls per the patient’s needs and Plan of Care.
• When not in the field, may be in office available to triage patient calls.

Patient Activity Documentation

• Completes, maintains and submits accurate and relevant clinical notes regarding patient’s condition and the care given. Records pain/symptom management changes and outcomes as appropriate.
• Provides documentation, consistent with Hospice Services Palliative Care Policy and Procedures and Standards of Practice, to the medical record no more than 24 hours following the contact.

Communication

• Communicates with the Medical Director and/or Attending Physician regarding the patient’s needs and reports changes in the patient’s condition; obtains/receives physician’s orders as required.
• Communicates with Interdisciplinary Group to coordinate the Plan of Care.
• Teaches the patient and family/caregiver self-care techniques as appropriate. Provides medication, diet and other instructions as ordered by the physician and recognizes and utilizes opportunities for health counseling with patients and families/caregivers.
• Provides and maintains a safe environment for the patient.
• Assists the patient and family/caregiver and other Interdisciplinary Group members in providing continuity of care.
• Works in cooperation with the family/caregiver and Interdisciplinary Group to meet the emotional needs of the patient and family/caregiver.

Current California RN license and a minimum of one year of acute or SNF care experience preferred. Hospice experience a plus. Driver’s license, drug screening and background check will be required.