The Variable Staffing Night Nurse [VSNN] is a member of the Variable Staffing Team and, as such, participates in providing after hours staffing coverage including Nights On-Call Coverage, both Evening Admissions and Night Visit roles as well as Evening Shift coverage and Admissions.

The Variable Staffing Night Nurse [VSNN] is responsible for providing after hours support to patient/families admitted to hospice service. Working in collaboration with Triage, the VSNN responds to pt/family calls and intervenes appropriately, providing phone instruction/support or visit as assessed. Care provided is based on an the individualized Plan of Care developed by the IDT that reflects pt/family goals related of Safe & Comfortable Dying, Self-Determined Life Closure and Effective Bereavement.

The VSNN demonstrates: sensitivity and compassion for the issues involved with serving patients and families facing a terminal illness, death and bereavement; clinical competence in pain and symptom management; and fiscal responsibility in the planning and delivery of services.

Essential Responsibilities

Patient/family Care

• Recognizes the patient and family as the "unit of care" and IDT members
• Respects patient right to self-determination and acts as advocate within the context of the values and ethical standards of HSCC
• Demonstrates ability to meet pt/family where they are
• Offers/makes visits per agency policy
• Offers home visit at time of death
• Utilizes nursing process in providing primary care to pt/families, and professional patient management to facility staff
• Documents all care and care planning per agency policy
• Provides nursing interventions for pt/family as ordered by the physician and in accordance with the POC, safe nursing practice and the policies and procedures of HSCC
• Monitors management of pain and symptoms in collaboration with patient/family, facility staff, IDT and physician to achieve maximum comfort
• Administers medications and treatments as ordered prn
• Instructs and supports pt/family unit and facility staff re: symptom mgmt, patient care, disease process & death/dying

Admission Visits

• Meets with patients & families in all settings to explain services, answer questions and admit patient as appropriate
• Conducts info visits and discuss difficult treatment and/or symptom management issues to facilitate the admission process
• Develops and implements an individualized, interdisciplinary Plans of Care for patients and families
• Uses electronic medical record (EMR) systems effectively and efficiently to complete required documentation in a variety of patient care settings

On Call

• Works cooperatively with Variable Staffing Team members to provide after hours coverage for HSCC pt/families and staff of our facility partners.
• Participates in providing extra coverage for planned and unplanned absences
• Secures current information on each patient prior to making call
• Assesses patient status via telephone response
• Follows agency policy in determining whether to make/offer visit for patient/family
• Assists, supports & educates patient and family through physical and emotional crisis utilizing all Variable Staffing Team after hours resources available; Social Workers, Chaplains, Hospice Aides, Administrator On Call.
• Assesses for and promotes caregiver confidence via telephone teaching or onsite visits.
• Obtains medications, medical supplies and equipment per pt need/physician order and HSCC policies and procedures when needed
• Demonstrates understanding of pharmacy-related policies & procedures
• Disposes or instructs re: disposal of Schedule II medications at time of death per agency policy
• Opens, closes and revises POC per HSCC guidelines
• Documents all contacts, instructions and interventions in the electronic medical record per HSCC policies & procedures
• Documents all contacts, instructions and interventions provided per HSCC policies & procedures
• Creates individualized POC based on the assessment of pt/family needs and goals
• POC addresses pt/family physical, psychosocial and spiritual needs a written POC that includes identified goals, interventions and outcomes and documents

Secondary Responsibilities

IDT Participation

• Functions as a member of the HSCC IDT maintaining open & organized communication with hospice staff, volunteers and supervisor
• Works collaboratively with IDT to develop common goals to meet the needs of the pt/family
• Completes and submits all documentation in accordance with policies and procedures

Quality Improvement

• Meets all standards and requirement as indicated by licensing and accrediting agencies
• Completes and submits all documentation in accordance with policies and procedures
• Submits verification of current employment related documents per HSCC policies, procedures and licensing agencies
• Participates in activities that affirm, enhance and develop the highest quality standards for HSCC
• Participates in developing standards for quality patient care within HSCC
• Participates in Quality Assessment & Improvement activities as requested

Special Projects

• Participates in special projects as requested
• Performs other related job duties as assigned by Supervisor

Compliance

• Ensures all HIPAA Privacy and Security Regulations, Medicare Conditions of Participation, and all other regulatory/compliance requirements are understood and followed
• Submits verification of current RN license
• Submits proof of auto insurance annually; keeps drivers license current and maintains a good driving record
• Ensures TB checks are completed in a timely manner; at least annually

Requirements

• Require current California RN license
• Valid state driver's license and liability auto insurance
• Available to work weekends and holidays routinely
• Required to attend regular meetings and in-services

Skills Required

• Critical thinking and ability to function both independently and as a member of the Variable Staffing Team after hours support.
• Familiarity with electronic charting programs and/or demonstrated keyboard and computer skills sufficient to utilize electronic medical record charting.

Education/Experience

• Degree in Nursing from an accredited college
• 1 year minimum of RN experience
• 2-5 years RN experience in hospice, oncology, medsurg, ICU, ER, skilled nursing facilities or homecare preferred
• Acute care experience preferred
• Hospice and/or home health experience preferred
• End-of-life and pain management experience preferred

Certifications, Licenses, Registrations

• California State issued RN license.
• Pass OIG/GSA review and all required background checks

Skills Desired

• Bilingual in English/Spanish encouraged but not required.
• Previous experience working with end of life is desirable.

Physical Demands

• Sufficient dexterity to utilize electronic record keeping systems, computers/keyboards and or laptops and other related equipment
• Ability to travel to patient locations; includes ability to drive, negotiate stairs and walkways including uneven surfaces at private homes or facilities
• Vision ability to read manual and electronic documentation, medications, charts, office related equipment, and instructions
• Hearing ability within normal range to elicit and detect pertinent information while communicating with patients and health team
• Speech to verbally communicate to assess and impart information concerning patient status; to complete patient/family teaching and to interact with health care team

Work Environment/Environmental Condition

• Performs services in private homes and care facilities and will experience a variety of settings and situations
• Office work is performed in combination of private homes, care facilities and office environment.