TITLE OF POSITION: REGISTERED NURSE
TITLE OF IMMEDIATE SUPERVISOR: Director of Clinical Services
RISK OF EXPOSURE TO BLOODBORNE PATHOGENS - HIGH
DUTIES
To provide nursing care in accordance with the patient's plan of care to include comprehensive health and psychosocial evaluation, monitoring of the patient’s condition, health promotion and prevention coordination of services, teaching and training activities and direct nursing care
RESPONSIBILITIES
1. Coordinates total patient care by conducting comprehensive health and psychosocial evaluation, monitoring the patient's condition, promoting sound preventive practices, coordinating services and teaching and training activities
2. Evaluates the effectiveness of nursing service to the patient and family on an ongoing basis
3. Performs admission, re-assessments, transfer, resumption of care and discharge paperwork for the home care patient
4. Prepares and presents patient's record to the Clinical Record Review Committee as indicated
5. Consults with the attending authorized practitioner concerning alterations of Patient Care Plans, checks with the appropriate supervisor and makes changes, as appropriate
6. Coordinates patient services
7. Submits clinical notes no less often than weekly, and progress notes and other clinical record forms outlining the services rendered as indicated
8. Submits a tally of patient care visits made each day
9. Participates in case conferences, discusses with the supervisor problems concerning the patients and how they may best be handled
10. Discusses with the appropriate supervisor the need for the involvement of other members of the health team
11. Obtains orders for paraprofessional service and submits a referral to the appropriate personnel
12. Participates in the patient’s discharge planning process
13. Cooperates with other agencies providing nursing or related services to provide continuity of care and to implement a comprehensive care plan
14. Participates in staff development meeting
15. Continually strives to improve his/her nursing care skills by attending in-service education, through formal education, attendance at workshops, conferences, active participation in professional and related organizations and individual research and reading
16. Participates in the development and periodic revision of the authorized practitioner's Plan of Care and processes change orders as needed
17. Submits timely clinical notes, progress notes and other clinical record forms outlining the services rendered
18. Participates in the patient’s discharge planning process
19. Maintains an on-going knowledge of current drug therapy
20. Adheres to Washington nurse practice act
21. May be requested by Director of Clinical Services to fill in for the other nurses
COORDINATES THE ADMISSION OF A PATIENT TO THE AGENCY
1. Conducts an initial and ongoing comprehensive assessment of the patient’s needs at appropriate time frames
2. Obtains a medical history from the patient and/or a family member particularly as it relates to the present condition
3. Conducts a physical examination of the patient, including vital signs, physical assessment, mental status, appetite and type of diet, etc.
4. Evaluates the patient, family member(s) and home situation to determine what health teaching will be required
5. Evaluates the patient's environment to determine what assistance will be available from family members in caring for the patient
6. Evaluates the patient's condition and home situation to determine if the services of a Home Health Aide will be required and the frequency of this service
7. Explains nursing and other Agency services to patients and families as a part of planning for care
8. Develops and implements the nursing care plan
9. May be requested by the Director of Clinical Services to fill in for other nurses who are on vacation or sick.
PROVIDES SKILLED NURSING CARE AS OUTLINED IN THE NURSING CARE PLAN
1. Nursing services, treatments and preventative procedures requiring substantial specialized skill and ordered by the authorized practitioner
2. The initiation of preventative and rehabilitative nursing procedures as appropriate for the patient's care and safety
3. Observing signs and symptoms and reporting to the authorized practitioner reactions to treatments, including drugs, as well as changes in the patient's physical or emotional condition
4. Teaching, supervising and counseling the patient and caregivers regarding the nursing care needs and other related problems of the patient at home
ASSUMES RESPONIBILITY FOR THE CARE GIVEN BY THE HOME HEALTH AIDE
1. Supervises and evaluates the care given by the Home Health Aide per agency policy
2. Submits to the appropriate department/individual a written evaluation of the Home Health Aides who are providing service to the patients in his/her geographical area
3. Participates in periodic conferences with the Home Health Aide supervisor concerning the Aide's performance
4. Charts those services rendered to the patient by the staff nurse and changes that have been noted in the patient's condition and/or family and home situation, makes revisions in the nursing care plan as needed, records supervisory visits conducted with the Home Health Aide, evaluates patient care and progress and closes charts of discharged patients
5. Evaluates the effectiveness of her nursing service to the individual and family
6. Consults with the attending authorized practitioner concerning alteration of the plan of treatment in consultation with the supervisor
7. Submits a tally of visits made each day
8. Participates in case conferences
9. Discusses with the supervisor problems concerning the patients and possible resolution
10. Discusses with the supervisor the need for involvement of other members of the health team such as the home health aide, physical therapist, speech therapist, occupational therapist, social worker, etc.
11. Obtains orders for paraprofessional service and submits referral to appropriate personnel
12. Provides guidance and supervision to the LPN and supervises the LPN per agency policy
13. Coordinates total patient care
14. Cooperates with other agencies providing nursing or related services to provide continuity of care and to implement a comprehensive care plan
15. Participates in staff development meetings
16. Participates in the educational experiences for student nurses
17. Continually strives to improve his/her nursing care by attending in-service education, through formal education, attendance at workshops, conferences, goal setting, active participation in professional and related organizations and individual research and reading
18. Participates in the planning, operation and evaluation of the nursing service
19. Participates in the development and periodic revision of the authorized practitioner’s Plan of Treatment and processes change orders as needed
20. Participates in the patient’s discharge planning
21. Maintains an on-going knowledge of current drug therapy
22. Prepares the care plan for the Home Health Aide
JOB CONDITIONS
1. Must have a driver’s license and be willing and able to drive to patient’s residences.
2. The ability to access patients’ homes which may not be routinely wheelchair accessible is required. Hearing, eyesight and physical dexterity must be sufficient to perform a physical assessment of the patient's condition and to perform and demonstrate patient care.
3. Physical activities will include, walking, sitting, stooping, and standing and minimal to maximum lifting of patients and the turning of patients.
4. The ability to communicate both verbally and in writing in English is required as frequent communication by telephone and in writing is involved.
EQUIPMENT OPERATION
Thermometer, B/P cuff, glucometer, penlight, hand washing materials
COMPANY INFORMATION
Has access to all patient medical records, personnel records and patient financial accounts which may be discussed with the Director of Clinical Services.
QUALIFICATIONS
1. Must be currently licensed in Washington as a Registered Nurse under chapter 18.79 RCW.
2. A minimum of one-year experience in community/home health agency or in a hospital setting is preferred.
3. Must have a working knowledge of home health care and the principles and techniques of professional nursing and required documentation that pertains to it.
4. Should be skillful in organization and in the principles of time management and have knowledge of management processes.
5. Must be able to contribute to the quality of care being rendered through constructive communication with nursing managers and staff.
6. Must have a criminal background clearance.
7. Must have a current CPR certification.
