POSITION DETAILS Full time with benefits; Day shift: 8a-4:30p M-F; on-call requirement; holiday rotation JOB SUMMARY The Registered Nurse participates as a member of the hospice Interdisciplinary Group (Physician, Nurse, Social Worker, Chaplain) to provide holistic care to hospice patients and to their families. The nurse initiates the Minimum Standard Plan of Care and completes the Functional Health Pattern Assessment. This assessment, assessments from the other Group members, and input from the patient and family are used to formulate a Comprehensive Interdisciplinary Plan of Care to address problems and meet identified needs and goals of the hospice patient and family. The hospice Registered Nurse provides direct nursing care and supervises the care provided by nursing assistant, licensed practical nurse, and volunteer. A high level of clinical, communication, and coping skills are needed and used to manage symptoms, teach, support the hospice patient and family, and evaluate the plan of care and progress toward goals. MAJOR JOB FUNCTION 1. Participates as a member of the Hospice Interdisciplinary Group to plan and provide holistic care to the hospice patient and family. a. Provides nursing input towards the initial and updated interdisciplinary plans of care for clients and families. b. Monitors progress toward goals and updates the plan of care as needed. c. Is committed to the team concept of care and participates in bi-weekly care conferences providing applicable nursing expertise to the meeting. d. Maintains contact as indicated with hospice Social Worker, Chaplain, Physician, Nursing personnel and Volunteers for collaboration to provide holistic care. Asks for assistance and utilizes the team for optimum patient care and economical use of resource. e. Provides nursing input and collaborates to determine the need for special care (continuous care, inpatient respite or acute care). 2. Provides direct nursing care and support to meet the special care and bereavement needs of child, adolescent, adult, geriatric hospice patient and family. a.Makes nursing visits to clients on a regular basis to provide ongoing assessment of the client’s condition and caregiver’s ability to give care. b. Is proficient in symptom management and promptly notifies physician in response to patient needs, obtains physician orders and medication per policy and in a timely manner. Advocates the patients right to be as comfortable as possible with consistent management of physical, emotional, and spiritual discomfort c. Is proficient in medication administration, and drug calculation and conversion. Maintains knowledge and competency in the potential for drug/food, drug/drug, drug/disease interaction for all age groups. d. Teaches patient and caregivers. Identifies learning needs, barriers, and appropriate methods of teaching to promote learning. Gives special attention to the many safety needs of the dying patient in the home environment. Sensitively explains the dying process and prepares the patient and family as they indicate a readiness and willingness to learn. e. Interacts effectively with patients through both oral and written communication and therapeutic presence. Exhibits effective listening skills and empathetic presence. Respects patients need for privacy, and to deal with emotional pain, grief, and the dying process as he/she chooses. Explains cares to the patient and treats patient as an individual with dignity. f. Participates in an on-call schedule to provide RN availability 24hours/seven days a week. g. Is available to the family at the time of the client’s death, providing support and assistance. h. Makes bereavement contacts in a timely manner with caregivers and family members identified as participants in the bereavement follow-up program. Documents these visits and inform hospice Social Worker of any problems or signs of pathological grief. 3. Supervises staff and volunteers. a. Makes out nursing assistant assignment sheets and assists with completion of the volunteer assignment sheet considering policy and procedure and the patient’s needs and caregiver’s care skills. b. Updates staff and volunteer as needed, verbally and in writing. Documents supervised nursing assistant visits every two weeks. c. Teaches staff and volunteers as needed. Evaluates the effectiveness of teaching by verbal response and direct observation. 4. Documents and maintains data on the patient record. a. Documents results of patient visits and telephone contacts promptly and accurately. b. Updates the plan of care and medication sheets promptly to provide for continuity of care. c. Uses the Admission, Discharge, and On-going Checklists to do chart audits on admission and periodically to ensure the chart is complete and accurate 5. Continuously assesses and evaluates the patients and families satisfaction and acceptance of hospice services and staff’s performance. Promptly notifies Hospice Coordinator of any patient or customer complaint and attempts to correct the problem. 6. Is committed to the practice of professional hospice nursing. a. Keeps current on professional nursing practice and care of the terminally ill by reading journals and attending in-services on aspects of palliative care. b. Attends 100% of mandatory meetings and 50% of Hospice Staff/QI meetings. Views video/reads minutes of meetings not attended. Documents all education completed in education record. c. Assures adherence to ethical and legal standards of the agency. Is aware of and nursing practice is congruent with, the Hospice Touch Mission Statement and Tomah Memorial Mission and Values. Does not exceed the authority of the registered nursing license and is aware of and follows Tomah Health/Hospice Touch policy and procedure. d. Assists in the orientation and education of others. Provides teaching, in-service to staff. Gives presentations or participates in cooperative community educational opportunities. ie health fair, speaking to community groups, etc. e. Acts as a role model, resource, mentor, and teacher as appropriate and needed. f. Displays behaviors, by actions and verbalization, that reflect an acceptance of the hospice/palliative work standards. Maintains appropriate boundaries with patients and families and seeks direction when boundaries become blurred or questionable. Is open to change and a positive change agent. Takes ownership and responsibility for their actions, how they impact others and the provision of patient care, and respects the right of the entire team to have a welcoming, safe, and positive work environment. 7. Recognizes personal need for support and demonstrates self-care behaviors. Notifies Hospice Coordinator or Social Worker when assignment becomes emotionally draining for counseling and additional support. a. Has a personal plan for self-care and stress management. b. Uses open honest communication to verbalize needs and conflict resolution. c. Attends hospice retreats. Takes time to debrief with other staff members and give and receive support. 9. Demonstrates proficiency in regards to the computer documentation of patient cares and any other related computerized patient information/documentation. 10. Performs other related duties as assigned or requested. EDUCATIONAL REQUIREMENTS 1. Graduation from an accredited school of nursing, BSN preferred. 2. Current licensure to permit to practice as a registered nurse in the state of Wisconsin. 3. Current certification or eligibility to become BLS and CHPN certified. 4. Minimum one year nursing experience required. 5. Home health or hospice experience preferred. 6. Successful completion or agreement to complete Hospice/Volunteer training. 7. Must have access to insured vehicle and have current and valid WI Driver’s License. QUALIFICATIONS/SKILLS 1. Excellent verbal and written communication skills. 2. Excellent human relation skills as demonstrated by the ability to interface positively with all customers and employees. 3. Must acquire the knowledge and maintain established competency levels to perform essential professional nursing practice. 4. Must have proficient computer skills with the ability to operate within a Windows environment. 5. Must have the ability to work with frequent interruptions, under stress, with minimal supervision, and to exercise initiative and judgment in analyzing, organizing, planning, prioritizing, scheduling and coordinating work with others. 6. Needs to possess a high level of intelligence, integrity, sense of responsibility and ability to comprehend and analyze details. 7. Knowledge of theory, principles, techniques and practice of professional nursing; of scientific principles and nursing research; of preparation, administration, and actions of medications; of treatments and medical procedures; of counseling and teaching techniques; of medical equipment as it relates to patient care. 8. Ability to operate and handle many kinds of complex equipment. 9. Ability to demonstrate clinical competence and maintain current knowledge in caring for children, adolescent, adult and geriatric patients. 10. Computer/keyboard skills required. Must have the ability to operate in a Windows environment. JOB REQUIREMENTS 1. Regularly required to use hands to finger, handle or feel objects, and talk and hear. 2. The Hospice RN is frequently required to stand, walk and reach with hands and arms. The Hospice RN is occasionally required to sit, climb or balance, stoop, kneel or crouch, and smell. 3. The Hospice RN must occasionally lift and/or move up to 50 pounds. 4. Good hearing is necessary to receive detailed information through oral communication and to make fine discriminations in sound. 5. Visual acuity is needed to assess color changes, to verify accuracy of written materials and to administer and accurately prepare medications.