Registered Nurse (RN)
Under the general supervision of the RN Manager, she/he provides intermittent skilled nursing services; communicates the patient’s progress with other disciplines and directs, supervises and instructs non-professional home health aide staff in the provision of personal care to the patient.
QUALIFICATIONS
-ls currently licensed in the State of Texas or in accordance with the Board of Nurse Examiners rules for Nurse Licensure Compact (NLC), and
-One year experience as a professional nurse preferred
-Ability to work in a field setting and exhibited ability to make sound nursing judgments
-Ability to assess patient needs and formulate individualized patient care plans to meet those need
-Effective communication skills
-Must have and maintain an automobile to be used for
-Ability to meet physical demand of standing, bending, lifting, stooping or performing other work requiring light physical exertion (up to 30 pounds) on a continuous basis (over 50% of time); or moderate physical exertion (30 to 50 pounds) on a frequent basis (16% to 50% of time); or physical exertion on an occasional basis (up to 15% of time)
DUTIES
-Under the physician’s order, admits patients eligible for home care service
-Assess and evaluates patient needs/problems, identifies mutually agreed upon goals with patients.
-Reports patient status and need for other disciplines to agency RN Clinical Manager and referring physician.
-Develops patient care plan that specifically addresses identified patient problems; nursing problems and goals. Updates care plans on an ongoing basis; revises and resolves patient problems and goals as changes occur and/or
-Admit paperwork and patient care plan submitted to RN Clinical Manager within regulatory time frame
-Assures that all admit paperwork is completed in full for timely data entry of the Plan of care/plan of treatment information.
-Provides intermittent skilled nursing services including assessment, evaluation, procedures, teaching and training activities as outlined in the patient Plan of Treatment.
-Provides skilled nursing visits according to visit schedule and notifies agency of need to alter schedule in any way.
-Reports significant findings to patient’s physician and RN Clinical Manager as they
-Submits completed skilled nursing notes, communication notes and home health aide supervisory notes per
-Submits change orders to RN Clinical
-Submits recertification paperwork by the due date provided by the RN Clinical
-Schedules a Clinical case conference with assigned RN Clinical Manager to review patient’s needs, problems, level of care and any changes in Plan of care/ plan of treatment for next cert period.
-Completes communication note-documenting plans for recertification were discussed and agreed upon between the physician, patient, and RN Clinical Manager.
-Completes other required documents for recertification: new Medication Profile, updates Care Plan, and updates or completes new Home Health Aide care plan, if applicable.
-Performs HCA supervisory visit at least every 14 days
-Completes Discharge Summary within 5 days of patient discharge or
-Effectively communicates with all members of the healthcare
-Acts as a patient advocate and as such, is a liaison to assist in communicating
the patient’s needs to the multidisciplinary
-Supervises the home health aide every 14 Provides direction and instruction as it
relates to provision of personal care and related support services.
-Completes documentation on Home Health Aide supervisory
-Reports identified performance related problems; patient complaints and/or deviation from the Home Health Aide instruction sheet to the RN Clinical Manager.
-Acts as a preceptor in the orientation of new nursing
-Attends staff meetings and educational in-services per agency
-Continually strives to improve nursing care by broadening knowledge through formal education, attendance at workshops, conferences and participation in professional and related organizations and individual research
-Obtains contact hours as dictated by the State Board of
-Attends at least 50% of the skilled nurse in-services and meetings provided by
-ls responsible for obtaining information provided at skilled nurse in-services and meetings and demonstrates appropriate follow-up related to information given at meetings and in-services.
-As applicable, participates in Performance Improvement program through submission of data collection as it relates to direct patient care problems and serving on Performance Improvement
-Follows agency policies and
-Participates in discharge planning
-Documents Discharge Planning beginning with admit and documents at least 2 weeks in advance instructions given related to discharge.
COMPLETES:
-Patient Care Plan
-Discharge Nurse’s Note
-Discharge Summary within 5 days of patient discharge and submit them alongwith other notes turned in per agency policy.