Hospice and Supportive Care Nurse Practitioner – PRN: Charleston, SC
The Advanced Practice Registered Nurse (APRN) functions as a Nurse Practitioner (NP) who collaborates with the interdisciplinary team to ensure care coordination and patient centered care. The primary responsibility in hospice is to conduct the Face to Face (F2F) which is an advanced assessment to support the medical director’s evaluation for continued eligibility for hospice care. Recognizes face to face encounters as an advanced assessment and follows the state board of nursing definitions of advanced practice and scope of practice. If identified as functioning in the role of a provider of palliative (supportive) care consulting, recognizes individual state nurse practice in regards to assessment, diagnosis, prescribing, evaluation and documentation. Demonstrates competency in management of serious illness and disease management and in the select patient population. Provides clinical expertise to the interdisciplinary and provides ongoing education.
Essential Duties and Responsibilities:
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Provides face to face encounters for identified patients required for admission certification and recertification within the regulatory timeframes.
- Ensures regulatory compliance of all clinical practices with all federal and state regulations governing hospice agencies, organizational policies, and billing compliance within the scope of practice of the advanced practice nurse.
- Collaborates with designated registered nurse coordinating visits to ensure timely and efficient services.
- Collaborates with referring physician concerning assessment findings, diagnostic and therapeutic measures.
- Evaluates quality of life and responses to treatment.
- Performs visits to assess patients in their environment; provides symptom management, education regarding disease processes, coordination of providers, end-of-life planning and linkage with available resources to enhance quality of life, coordination of providers, end-of-life planning and linkage with available resources to enhance quality of life.
- Participates in QAPI activities and continuing education related to areas of practice as requested.
- Provides consultation to the clinical staff to support evidenced-based nursing practice as needed.
- Participates in orientation of new staff, acting as a resource, supporting the preceptors, and identifies opportunities for progress toward goals.
- Identifies expected outcomes and disease trajectory based on critical analysis of both complex assessment data and relevant diagnoses, and with consideration of the benefits and burdens of care.
- Promotes discussion of advanced care planning, informed decision-making about all aspects of care including goals of care, use of life-sustaining treatments; withholding, or removal of treatments.
- Advocates for observance of patient’s expressed wishes across settings of care through the plan of care, and other documentation.
- Prescribes, recommends, and implements interventions informed by evidence-based practice to alleviate physical and psychological symptoms associated with serious or life-threatening illness, which may include pharmacotherapeutics, nonpharmacological interventions and complementary /alternative therapies.
- Assumes responsibility for overall evaluation, documentation, and communication of palliative (supportive) care assessment and plan of care across healthcare settings.
- Accurately documents comprehensive or problem-focused palliative (supportive) care assessment and plan of care of patients and families experiencing serious or life-threatening illness, recording the extent of provided services, and promoting maximal reimbursement of services.
- Assumes accountability for hospice and palliative nursing practice, striving to attain the highest standards of advanced practice care.
- Completes all mandatory requirements.
- The advanced practice hospice nurse demonstrates greater depth and breadth of knowledge, skills, theory, research and practice and abilities demonstrated when providing evidence-based physical, emotional, psychosocial, and spiritual care. Care is provided in a collaborative manner across the life span in diverse settings to individuals and families experiencing life-limiting, progressive illness. The core competencies from Hospice and Palliative Nursing Association (HPNA) include:
- Clinical Judgment: Demonstrates advanced clinical judgment and decision-making, based on expert knowledge and skill in the assessment, physical examination, diagnosis, planning, and management of complex human responses to serious or life-threatening illness. Participates in the provision of patient-centered/ family-focused care to address the physical, emotional, psychosocial, and spiritual needs of the patients and families. Identifies expected outcomes and disease trajectory based on critical analysis of the complex assessment data.
- Advocacy and Ethics: Incorporates ethical principles and advanced practice nursing professional standards in the care of patients and families receiving hospice and palliative care, while advocating for patients’ and families’ rights and access to quality care.
- Professionalism: Demonstrates knowledge, skills, and behaviors consistent with the ANA/HPNA’s Palliative Nursing: Scope and Standards of Practice- an Essential Resource for Palliative Nurses as well as the HPNA Code of Ethical Conduct and the ANA Code of Ethics for Nurses.
- Collaboration: Promotes an interdisciplinary team approach in the provision of hospice and palliative care to the patient and family with serious or life-threatening illness. Promotes palliative care concepts to the public regarding potential or actual physician, psychological, emotional, social, and spiritual components of living with a serious or life-threatening illness.
- Systems Thinking: Manages and negotiates the healthcare delivery system to enhance quality of life for patients and families experiencing serious or life-threatening illness, and facilitates the provision of comprehensive coordinated care within and across healthcare settings.
- Cultural and Spiritual Competence: Demonstrates and promotes culturally and spiritually competent care by respecting diversity, in regards to ethnicity, culture, spirituality, religion, gender, socioeconomic status, sexual orientation, education level, literacy, and location.
- Facilitator of Learning: Demonstrates knowledge, skills, confidence, and the application of adult learning principles when providing palliative care education to patients/families, healthcare professionals, and the community inherent in the role of the hospice and palliative advanced practice registered nurse.
- Communication: Communicates effectively with patients, families, and healthcare professionals by applying knowledge of communication theory and principles.
- Evidence-Based Practice and Research: Utilizes research to identify, examine, validate, and evaluate current theories and palliative care practice, with the goal of improved outcomes for palliative care patients, families, and the community.
- Flexibility: Be flexible with schedule and able to modify to any change needed for emergencies.
- Performs other duties as assigned.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
This position operates in a professional facilities and patient home environments; routinely uses standard office equipment such as computers, phones, medical equipment. This would require the ability to lift up to 50 pounds, and bending as necessary. Prolonged standing and walking required. Requires working under occasional stressful conditions to meet deadlines and patient needs. May require visits in unsafe neighborhoods and dwellings that may not have elevators.
E= Essential D= Desirable
E Education: Graduate of an accredited college with a Master’s of Science in Nursing.
E Licensure: Unencumbered state license as an Advanced Practice Registered Nurse.
E Nurse Practitioner specialty board certification within scope of service provided as defined by the state board of nursing.
E For the APRN providing palliative care (supportive care) consultation, must maintain prescriptive authority and active DEA.
E Current CPR
E Licensure: Current state driver’s license.
E Transportation: Reliable transportation with valid and current auto liability insurance. Will need to travel locally with some exposure to weather.
E Minimum of 2 years Nurse Practitioner experience. Exceptions are at the discretion of the hiring manager based on previous individual experience.
E For the APRN providing palliative care (supportive care) consultation, must demonstrate documentation components, specifically Evaluation and Management (E/M codes).
Skills and Abilities:
E Must possess basic computer skills – Email, Internet, and Microsoft Word.
E Must be able to demonstrate proficiencies in the electronic medical record after orientation completion.
E Must be able to travel within an assigned area and conduct face to face encounters within the patient’s primary setting.
E Ability to maintain habits of personal cleanliness and safe work practices.
E Ability to perform duties with regards to infection control guidelines.
E Ability to instruct others within the Interdisciplinary Team of proper and adequate infection control guidelines.
E Knowledge of advanced disease trajectories and chronic disease management.
D Knowledge of billing requirements for compliance.
D Hospice and Palliative Care certification (CHPN or ACHPN) preferred within two years of hire.
Other Job Specifications:
E Must be in good physical and mental health, free from infectious diseases.
E Must be able to work a minimum of eight hours per week, plus extended hours when the demand requires.
E Lifting – may be required to lift patients, medical equipment, and supplies, with weights up to 50 pounds. May move objects from a lower to higher position or along horizontal level from position to position.
E Vision/Hearing – must possess the power to perceive sound with or without correction. Ability to make fine discrimination in sound. Eyesight needed, or prosthetics used to enable adequate sight to meet requirements.
E Mobility – must have mobility skills as required with standing, walking, stooping, bending, lifting, and reaching. May have prolonged periods of sitting and driving.
E May be subject to fall, infectious diseases, or odors throughout the work-day. Must have the ability to perceive through physical contact, especially the fingertips.
OSHA AND Bloodborne Pathogens Susceptibility:
This position may require hands on patient assessment. Thus, the risk of contact with blood and bloodborne pathogens is moderate. Personal protective equipment is provided. Employees with this risk are encouraged to be inoculated with the HBV vaccine to prevent exposure to Hepatitis B. Universal Precautions techniques must be adhered to in all patient contact.
The employee is required to possess the normal requirements for reading written instructions, spreadsheets and computer screens. The employee will meet the normal requirements for understanding verbal instructions.
This job description in no way states or implies that these are the only duties to be performed by the employee(s) incumbent in this position. Employee(s) are required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments.
A review of this position has excluded the marginal functions of the position that are incidental to the performance of fundamental job duties. All duties and responsibilities are essential job functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. The requirements listed in this document are the minimum levels of knowledge, skills, or abilities. To perform this job successfully, the incumbent(s) will possess the skills, aptitudes, and abilities to perform each duty proficiently. Some requirements may exclude individuals who pose a direct threat or significant risk to the health or safety of themselves or others.
Palladium Hospice and Palliative Care provides equal employment and advancement opportunities to all individuals, employment decisions shall be based on merit, qualifications and abilities. Palladium Hospice and Palliative Care does not discriminate in employment opportunities or practices on the basis of race, national origin, color, sex (including pregnancy), religion, age, disability or handicap, genetic information, veteran status, uniformed service status, or any other characteristics protected by law.
Job Type: Part-time