PRN Palliative Care Nurse Practitioner

Position Overview

The Nurse Practitioner is a registered professional nurse with advanced graduate education and clinical training who provides comprehensive hospice services in compliance with the state Nurse Practice Act and under the supervision of a collaborating physician. He/she provides hospice care through the evaluation and assessment of the health history, health promotion, diagnosing medical conditions, and management of health problems by directing and developing the plan of care, prescribing medications or treatments, coordinating and collaborating with patients, families, and other healthcare practitioners. Under the supervision of a physician, the nurse practitioner visits patients, completes physical assessments, performs face-to-face assessments and evaluates hospice eligibility as assigned in consultation with the hospice interdisciplinary team. The nurse practitioner builds from the resources of the community to plan and direct services to meet the need of individuals and families within their homes and communities.

Essential Job Functions

Must be able to read, write, speak, and understand the English language

Must have reliable transportation to travel to patient homes per patient schedule and agency needs, as appropriate

Using effective body mechanics, must be able to lift 20 lbs. floor to waist; lift 10 lbs. waist to shoulder; lift and carry 20 lbs. and push/pull 40 lbs.

Must be able to ensure agency is in compliance with all applicable federal, state, and local regulatory agencies

Must be able to sit, stand, bend, lift, and move intermittently throughout the work day

Must be able to document and chart appropriately and within specific time frames

Must be able to follow physician orders and nursing treatment plans for patients

Must be able to (or assist with) lift, turn, move and position patients

Must be able to knowledgeably and competently deliver nursing care to patients

Must be able to evaluate patient needs through ongoing assessment and revise care plans based on changes in patient condition

Must be able to concentrate and use reasoning skills and good judgment

Must be able to communicate and function in an interdisciplinary team

Must practice regular and dependable attendance

Must be able to coordinate and oversee medical care and treatment and provision of services of other professionals to patients

Specific Requirements

Must be able to read, write, speak, and understand the English language

Must have excellent verbal and written communication, organizational, problem solving, and basic math skills

Must be competent in standard Microsoft Office applications, internet, and email

Must comply with accepted professional standards and practice

Must have excellent observation and good nursing judgment

Must be able to concentrate and use reasoning skills

Must be able to interact professionally with the community

Must possess the ability to work harmoniously with professional and non-professional personnel

Must be knowledgeable of nursing practices and procedures based on state practice acts

Must be self-directed and possess leadership and supervisory skills

Must understand and follow company policies and procedures

Must possess the ability to make independent decisions when circumstances warrant such actions

Must have a valid driver’s license and auto liability insurance with automobile being in good working condition

Must be able to multi-task and accept additional duties as assigned

Must present a professional image

Must practice regular and dependable attendance

Education and Experience

Graduation from an accredited School of Nursing and accredited Nurse Practitioner Program and Current nursing licensure in State and CPR certification

Master's degree with a minimum of (1) year Nurse Practitioner experience and a minimum of (1) year hospice or palliative care experience

Accreditation from an approved certifying body for advanced practice nursing as required by State

Certification in a specialist area preferred; (e.g. Hospice and Palliative Nursing (CHPN), Pediatrics or Geriatrics)

Excellent observation, verbal and written communication skill, problem solving skills, mathematical skills; nursing skills per competency checklist

Prolonged or considerable walking or standing. Able to lift, position and / or transfer patients. Able to lift supplies and equipment. Considerable reaching, stooping, bending, kneeling and/or crouching. Visual acuity and hearing to perform required nursing skills

Must be a licensed driver with an automobile that is insured in accordance with state/or organization requirements and is in good working order

Working Conditions

Will work in and travel to patient homes as well as agency office

Sits, stands, bends, lifts, and moves intermittently during working hours

Subject to frequent interruptions

Attends and participates in continuing education programs

Possible exposure to infectious waste, diseases, conditions, etc. including exposure to the AIDS and Hepatitis B viruses

Subject to hostile and emotionally upset patients, family members, caregivers, etc.

May work beyond normal working hours, weekends, and holidays as needed and in other positions temporarily as necessary

Involved with patients, associates, caregivers, government agencies/personnel, etc. under various circumstances

General Responsibilities

Work in collaboration with the Palliative Care Medical Director and other palliative team members to deliver palliative care by providing diagnosis, treatment and follow-up for patients referred to palliative care.

Establish the palliative plan of care, individualized for each patient, in consultation with the patient, family and other members of the Palliative Care Team

Provides medical care, palliates, and manages terminal illness in compliance with the state Nurse Practice Act under the supervision of a collaborating physician

Completes history and physical examinations, by evaluating the patient’s medical condition and health history, ordering and interpreting results from laboratory and diagnostic tests or procedures, diagnosing health conditions and documents the findings in the patient’s medical record

Manages health conditions and terminal illnesses by developing an individualized plan of care, prescribing medications and/or treatments, obtaining consultations or making referrals and coordinating hospice care services

Completes the hospice face to face visit requirements prior to the third and subsequent hospice benefit periods to assess hospice eligibility based on the hospice conditions of participation and the local coverage determinations. Provides clinical information to the hospice medical director for interpretation for eligibility for hospice recertification

Makes recommendations to the hospice medical director regarding patient eligibility for certification and recertification for hospice care

Reviews clinical information, coordinates and oversees patient care in consultation with the hospice interdisciplinary team and other healthcare practitioners

Assures that patient receives appropriate measures to control symptoms, through collaboration with interdisciplinary team members

Reviews and develops protocols for treatment and proposes options for interventions based on the literature in collaboration with the collaborating physician

Consults the collaborating physician when the patient's plan of care is outside standardized practice and protocols

Communicates and collaborates with the interdisciplinary group to create, review and revise the patient's plan of care

Consults with the patient's attending physician, the hospice medical director and other healthcare practitioners regarding the patient's eligibility for hospice care, ongoing care needs and medical management related to the patient's terminal condition

Communicates with other community health practitioners to coordinate the plan of care

Attends and participates in hospice interdisciplinary group meetings

Completes, maintains and submits accurate and relevant clinical notes, physical examination notes, assessment visit notes, medical orders, collaboration notes and other documentation in the medical record

Educates/counsels patients, families, and/or caregivers as to preventative care, medical problems, psychological problems, and spiritual problems in conjunction with the interdisciplinary team to meet the total needs of patients

Provides and maintains a safe environment for the patient

Assists the patient and family / caregiver and other team members in providing continuity of care

Works in cooperation with the family / caregiver and hospice interdisciplinary group to identify the goals of care and meet the care needs of the patient and family / caregiver

Serves as a nursing resource for consultation and educations to members of the interdisciplinary team and other healthcare practitioners in the community

Establishes, builds and nurtures relationships with staff and community referral sources to facilitate program growth

Maintains knowledge of and compliance with current Medicare/Medicaid, state/federal rules and regulations for hospice services

Ensures compliance with the Medicare conditions of participation and other state regulations govern the provision of healthcare

Complies with all Health Insurance Portability and Accountability Act (HIPAA) requirements in accordance with federal, state and organizational policies

Participates in organizational monitoring of the quality of medical services and quality improvement initiatives

Assumes responsibility for personal growth. Develops, maintains and upgrades professional knowledge and practice skills through attendance at seminars, conferences and participation in continuing education and in-service classes

Fulfills the obligation of requested and/or accepted assignments

Demonstrate knowledge in communication and counseling patient/family in dealing with end-of-life issues