Registered Nurse RN Home Care

JOB SUMMARY :

The RN Registered Nurse performs nursing services requiring the application of the biological, physical, and social sciences and nursing skills in the care of the sick, the prevention of disease, and the conservation of health. The RN Registered Nurse is responsible for the care of patients and families assigned. Additional responsibilities may be assigned at the discretion of the Supervisor of Clinical Services to whom the PCN reports.

FUNCTIONS :

• Admits to service those patients who require skilled nursing and / or Home Health Aide service by performing a thorough physical, social, emotional, pain and safety assessment and obtaining a comprehensive health history.
• Determines present and potential patient problems, learning needs, level of functioning and resources of the patient, sets objectives and implements a treatment plan individualized to patient and family needs. Includes the patient and family in the planning process.
• Obtains physician orders initially and in an ongoing manner for all nursing and Home Health Aide services.
• Evaluates and documents patient's progress towards goals and revises plan of care as needed, including using different teaching techniques or interventions tools as appropriate. Counsels the patient and family in meeting nursing and related needs.
• Identifies discharge planning needs during care plan development and implements the discharge plan with patient and family involvement. Appropriately discontinues care when goals of treatment are attained or the patient is no longer appropriate for home care services.
• Is responsible to take prompt action upon observing or being notified of a change in a patient's condition. Documents and reports key information to physicians, supervisors and others as appropriate in a timely manner.
• Identifies and makes referrals for other disciplines or services as indicated in the treatment plan, including community resources and patient's needs outside the scope of home health services provided by the agency.
• Effectively collaborates and coordinates care with other disciplines, functioning at all times as a team member, supporting other agency staff in providing services.
• Adequately manages secondary symptoms associated with disease and treatments, as well as comorbidities.
• Arranges for supply and DME requisition. Ensures other necessary items and services are available.
• Supervises and evaluates patient's self-care and care given by family or others and redirects as needed.
• Follows all infection control and safety practices in providing patient care.
• Respects all patients' advance directives and rights including their individual rights regarding protected health information and adheres to HIPAA regulations.
• Completes required documentation within 24 hours in an accurate, thorough manner per agency policies, reflecting the reason or skilled nature of services as appropriate. Is aware of and participates in preventing fraud and abuse per Stratford VNA Corporate Compliance Plan.
• Adheres to Medicare and Medicaid guidelines and follows all payor guidelines in providing services including obtaining timely authorizations as required.
• Participates in the orientation, teaching and instruction of other nursing staff or nursing students as delegated.
• Responsible to provide quality services in a cost-effective manner, including service and supply utilization.
• Develops a Home Health Aide care plan and instructs, supervises and evaluates the Home Health Aide care provided per agency policy and procedure, State and Federal regulations.
• Readily seeks and accepts supervision to promote professional growth.
• Accepts and fulfills the obligation of assigned cases.
• Assumes responsibility for personal growth and development and maintains and upgrades professional knowledge and practice skills through attendance and participation in continuing education and inservice classes.
• Participates in agency committees as assigned and in quality improvement activities within the agency.
• Participates in agency weekend and on-call program.
• Personally implements and complies with Stratford VNA Corporate Values System.
• Upon completion of orientation, the nurse will demonstrate competent skills as indicated on the nursing competency checklist.

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

QUALIFICATIONS