Description

Job Description Summary:

The Case Manager plans, organizes and directs hospice care and is experienced in nursing with emphasis on community health and education. The professional nurse builds from the resources of the community to plan and direct services to meet the needs of individuals and families within their homes and communities. Responsibilities include provision of nursing care to terminally ill patients, on-going support to the patient’s family, and direction of the Hospice Aide. Service area Ashland, Richland, Knox and surrounding counties per patient service need.

Every other Saturday daytime schedule commitment required.

Essential Job Functions/Responsibilities:

• Coordinates patient care for assigned caseload
• Completes assessment of patient and family to determine hospice needs including a physical assessment and history of current and previous illness
• Provides professional nursing care by utilizing all elements of nursing process
• Develops a Care Plan that establishes goals based on nursing diagnosis and incorporates palliative nursing actions. Includes the patient and the family in the planning process, and if relevant, nursing facility input
• Assesses and evaluates patient’s status by writing and initiating the plan of care, regularly re-evaluating patient and family caregiver needs, and revising the plan of care as needs change using measurable criteria to evaluate pain management and symptom control
• Establishes the Hospice Aide care plan based on the patient’s needs
• Uses health assessment data to determine nursing diagnosis
• Initiates appropriate preventive and rehabilitative nursing procedures.
• Administers medications and treatments as prescribed by the physician in the physician’s plan of care
• Counsels the patient and family in meeting nursing and related needs
• Provides health care instructions to the patient as appropriate per assessment and plan
• Assists the patient with the activities of daily living and facilitates the patient’s efforts toward self-sufficiency and optional comfort care
• Fulfills the obligation of requested and/or accepted case assignments
• Communicates patient information and coordinates care
• Completes, maintains and submits accurate and relevant clinical notes regarding patient’s condition and care given
• Records pain/symptom management changes/outcomes as appropriate
• Communicates with the physician regarding the patient’s needs, reports changes in the patient’s condition and obtains/receives physician’s orders as required
• Communicates with community health related individuals to coordinate the plan of care
• Attends patient care conferences at nursing facilities when scheduled
• Teaches the patient and family/caregiver self-care techniques as appropriate
• Provides medication, diet and other instructions as ordered by the physician and recognizes and utilizes opportunities for health counseling with patients and families/caregivers; works in concert with the interdisciplinary group
• Provides or re-emphasizes education of skilled facility employees dealing with Hospice patients in that setting
• Collaborates with other hospice interdisciplinary team members
• Assists the patient and family/caregiver and other team members in providing continuity of care
• Works in cooperation with the family /caregiver and hospice interdisciplinary team members to meet the emotional needs of the patient and family/caregiver
• Attends interdisciplinary team meetings
• Performs administrative tasks and participates in professional development activities
• Ensures that arrangements for equipment and other necessary items and services are available
• Supervises ancillary employees and delegates responsibilities when required
• Provides continuous care, as needed
• Actively participates in quality assessment performance improvement initiatives and activities
• Participates in personal and professional development
• Attends HNCO meetings and HNCO sponsored events
• Performs on-call duties as defined by the on-call policy
• Performs all other duties as assigned

Requirements

Position Qualifications:

Experience and Education:

• Graduate of an accredited school of nursing (BSN preferred)
• One to two years of recent acute care experience, preferred
• One to two years recent acute care, home care, and/or hospice care experience, preferred

Required Certification/Licensure:

• Current licensure to practice nursing in the state of Ohio
• Current CPR certification
• Valid Ohio driver’s license with current automobile insurance
• Reliable transportation accessible for travel while on HNCO business

Management Experience:

• None

Knowledge/Skills/Abilities:

• Current nursing practices, principles, methods and procedures used to provide palliative care
• Nursing assessment skills with/without visual inspection utilizing basic nursing theory
• Good math skills; ability to complete dosage calculations accurately
• Excellent written, verbal, and interpersonal communication skills
• Good computer skills; EMR experience preferred
• Excellent observation, critical thinking and problem solving skills
• Good judgment and decision making based on hospice guidelines
• Decisive judgement
• Assess data reflecting the patient’s status and interpret appropriate information
• Define problems, collect data, establish facts, and draw valid conclusions
• Good organizational skills and ability to prioritize work
• Assess and respond to the needs of patient and families in varied settings
• Deal with people in crisis effectively
• Work in a stressful environment and take appropriate action
• Demonstrate sensitivity to issues of grief and loss; cope with family emotional stress and individual life styles
• Empathize with the needs of ill, injured, frail and the impaired
• Work independently and in a collaborative team environment
• Maintain confidentiality of protected health information and general hospice information in accordance with applicable laws and HNCO policy
• Demonstrate ethical behavior and HNCO core values

Physical Requirements:

• Requires full range of motion, manual and finger dexterity and eye-hand coordination
• Direct contact with patients, which may require moving patients, lifting, stretching, reaching, stooping, bending, kneeling and/or crouching
• Prolonged or considerable walking or standing
• Must be able to lift position and/or transfer patients, supplies and equipment
• Visual acuity and hearing to perform required nursing skills

Continuing Education Requirements:

Organization personnel are expected to participate in appropriate continuing education as may be requested and/or required by their immediate supervisor. In addition, organization personnel are expected to accept personal responsibility for other educational activities to enhance job-related skills and abilities. All personnel must attend mandatory educational programs.

Environmental and Working Conditions

• Environmental Conditions:

May be exposed to extremes of heat and cold in all weather conditions. Must drive in various weather conditions on roads in varying degrees of repair.

• Working Conditions:

The incumbent may be exposed to individuals with infectious and contagious diseases and must observe standardized guidelines to protect against disease and other dangers (i.e. accidental needle stick, chemicals for sterilization of instruments, and anesthetics). Contact with patients under wide variety of circumstances. May be exposed to/occasionally exposed to patient elements. Subject to varying and unpredictable situations. Handles emergency or crisis situations. Travel to patients’ homes and/or medical/nursing facilities.

• OSHA exposure category:

Category I ? Position includes tasks that involve exposure to blood, body fluids, tissues.

• Required Personal Protective Equipment:

mask, gloves, gowns, goggles (follows standard precautions using personal protective equipment as required for procedures.

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