Registered Nurse (RN) - Palliative
Excela Westmoreland Hospital
Greensburg, PA

Registered Nurse RN - Palliative Home Health

The RN assesses, plans, implements and evaluates the care for a designated group of patients in their home. The RN coordinates, directs and promotes positive patient outcomes, and contributes to efficient agency operation. In addition, the Hospice RN provides palliative care and support to terminally ill patients and their families. Essential Job Functions * Identify patient care requirements by establishing personal rapport with potential and actual patients, and other persons in a position to understand care requirements. * Establish a compassionate environment by providing emotional, psychological, and spiritual support to patients and caregivers. * Promote patient's independence by establishing patient care goals; teaching patient/caregiver to understand condition, medications, and self-care skills; answering questions. * Maintain safe and clean working environment by complying with procedures, rules and regulations; calling for assistance from health care support personnel as indicated. * Document patient care services by charting in patient and department records. * Maintain continuity among nursing teams by documenting and communicating actions, irregularities, and continuing needs using Nurse Knowledge Exchange techniques. * Maintain nursing supplies inventory by checking stock to determine inventory level; anticipating needed supplies; placing and expediting orders for supplies; verifying receipt of supplies; using equipment and supplies as needed to accomplish job results. * Provide direct and indirect supervision of personal care provided by the Home Health Aides in the patients' homes, in accordance with federal regulation and accrediting bodies. * Resolve patient problems and needs by utilizing multidisciplinary team strategies. * Maintain a cooperative relationship among health care teams by communicating information; responding to requests; building rapport; participating in team continuous quality improvement and problem-solving methods. * Contribute to team effort by accomplishing related results as needed. Specialty Job Functions * Hospice Role: Understand the Hospice philosophy and performs care accordingly to enhance the quality of life of the terminally ill patient. * Maintain and demonstrate an understanding of the Hospice benefit and complies with regulatory conditions of participation. * Follow established guidelines for pain and symptom management to enhance quality of life. * Educate patients / caregivers regarding the care needs at the end-of-life, including palliative care measures. * Function as a primary nurse and core member of the Interdisciplinary Group to develop a plan of care that addresses the physical, psychosocial, emotional, and spiritual needs of the terminally ill patient and their family. * Assess eligibility for Hospice care and obtains the informed consent prior to the initiation of services. * Mental Health Role - In conjunction with the physician, implements mental health concepts and psychiatric nursing principles in the plan of care. * Provide supportive psychotherapy. * Demonstrate knowledge of commitment laws, mental health clinical programming, and community resources. * Make appropriate referrals based on the nursing assessment and in collaboration with the physician. * Function as a resource for Agency staff with patients demonstrating mental health issues as a secondary diagnosis. * Provide overall guidance to Agency staff and managers related to day-to-day operations and long-term use of laptop computers. * Ensure the process includes education about safely and effectively using medication, pain and pain management. * Acquire and distribute educational resources to Agency staff. * Complete medical conditions reports and forwards to physician for signature. * Complete non-medical nursing visits for private duty division as required (i.e. medication pre-fills). * Complete care plans for Options consumers for Westmoreland County area of aging, consumers of the Veteran's Administration H/HHA program and Community Health Choice participants. * Complete assessments for private duty consumers and completes all associated documentation as requested. * Function as a liaison between consumers and participants, families, physician, allied health personnel. * Supervises Direct Care Partners as requests to assure performance of quality care and adherence to care plans and services delivery plans. Documents supervisor visits per regulatory guidelines. * Provide guidance and training for Direct Care Partners as needed. * Interpret extent and limitations of services available from the Private Duty Division of the agency. * Maternal / Child Nurse Role: Instruct and assess the postpartum patient and newborn for early detection and intervention of complications. * Maternal / Child Nurse Role: Instruct and assess the newborn and child's physical and emotional development, adjustment, and / or abnormalities and reports to the physician. * Maternal / Child Nurse Role: Provides prenatal nursing services, which includes instruction, assessment and monitoring of the physical and emotional status of the patient with a high-risk pregnancy for early detection. * Other related duties as assigned. Required Qualifications * Graduate of an accredited Nursing Program required. * Strong leadership ability, good organizational skills, independent thinking and decision-making ability, analytical problem solving skills, sound judgment, excellent oral and written communication skills, must be able to function in a team environment, and knowledge of legal aspects and liability of nursing practice. Preferred Qualifications * One (1) to two (2) years' RN experience * One (1) to two (2) year's prior hospice and/or oncology experience; Hospice and Palliative Care Certification * Bachelor of Science Degree in Nursing License, Certification & Clearances * Current licensure to practice as a Registered Nurse in the State of Pennsylvania required. * Current Basic Life Support (BLS) approved curriculum of the American Heart Association (CPR and AED) program required. * Act 33 with renewal * Act 34 with renewal * Act 73 FBI Clearance * Valid Pennsylvania Driver's License (if out of state hire current Department of Motor Vehicle record report required and obtain PA Current Driver License within 30 days of hire). Supervisory Responsibilities * This position has no direct supervisory responsibilities, but may serve as a coach and mentor for other positions in the department. Position Type/Expected Hours of Work * Regular, consistent, on-site and timely attendance. * Incumbent will be scheduled based on operational need (rotate shifts, standby, on-call, etc.). * Travel may be expected locally between Excela Health locations. LEAN * Actively promotes a Lean work culture by performing team member duties to encourage consistent use of LEAN principles and processes, including continually seeking work process improvements. Recognizes the necessity of taking ownership of one's own motivation, morale, performance and professional development. Strives for behavior consistent with being committed to Excela's missions, vision and values. AAP/EEO * Excela Health is an Equal Opportunity Employer. It is the policy of Excela Health to prohibit discrimination of any type and to afford equal employment opportunities to employees and applicants, without regard to race, color, religion, sex, national origin, age, marital status, non-job related disability, veteran status, or genetic information, or any other protected class. Excela Health will conform to the spirit as well as the letter of all applicable laws and regulations. * Ability to perform the Essential Functions listed on the Physical Conditions and ability to perform the Essential Functions on the Working Condition chart below. Work Environment Effective March 2020 or during pandemic: goggles, face shield and mask are required according to CDC guidelines When lift requirement is in excess of 50#, lift assistance (2 person) and/or transfer device is required. Essential - Absolute Necessity. Marginal - Minimal Necessity. Constantly - 5.5 to 8 hours or more or 200 reps/shift. Frequently - 2.5 to 5.5 hours or more or 32-200 reps/shift. Occasionally - 0.25 to 2.5 hours or 2-32 reps/shift. Rarely - Less than 0.25 hours or less than 2 reps/shift. Physical Condition Essential Marginal Constantly Frequently Occasionally Rarely Never Extreme Heat X Extreme Cold X Heights X Confined Spaces X Extreme Noise(>85dB) X Mechanical Hazards X Use of Vibrating Tools X Operates Vehicle X Operates Heavy Equipment X Use of Lifting/Transfer Devices X X X Rotates All Shifts X X 8 Hours Shifts X X 10-12 Hours Shifts X X On-Call X X Overtime(+8/hrs/shift; 40/hr/wk) X X Travel Between Sites X Direct Patient Care X X Respirator Protective Equipment X X Eye Protection X X Head Protection (hard hat) X Hearing Protection X Hand Protection X X Feet, Toe Protection X Body Protection X X Latex Exposure X X Solvent Exposure X Paint (direct use) Exposure X Dust (sanding) Exposure X Ethylene Oxide Exposure X Cytotoxic (Chemo) Exposure X Blood/Body Fluid Exposure X X Chemicals (direct use) Exposure X X Mist Exposure X Wax Stripper (direct use) X Non-Ionizing Radiation Exposure X Ionizing Radiation Exposure X Laser Exposure X Physical Demands When lift requirement is in excess of 50#, lift assistance (2 person) and/or transfer device is required. Essential - Absolute Necessity. Marginal - Minimal Necessity. Constantly - 5.5 to 8 hours or more or 200 reps/shift. Frequently - 2.5 to 5.5 hours or more or 32-200 reps/shift. Occasionally - 0.25 to 2.5 hours or 2-32 reps/shift. Rarely - Less than 0.25 hours or less than 2 reps/shift. Physical Condition Essential Marginal Constantly Frequently Occasionally Rarely Never Bending (Stooping) X X Sitting X X Walking X X Climbing Stairs X X Climbing Ladders X Standing X X Kneeling X X Squatting (Crouching) X X Twisting/Turning X X Keyboard/Computer Operation X X Gross Grasp X X Fine Finger Manipulation X X Hand/Arm Coordination X X Pushing/Pulling(lbs. of force) X 10# 50# Carry X 25# Transfer/Push/Pull Patients X X Seeing Near w/Acuity X X Feeling (Sensation) X X Color Vision X X Hearing Clearly X X Pulling/Pushing Objects Overhead X X Reaching Above Shoulder Level X X Reaching Forward X X Lifting Floor to Knuckle X 10# Lifting Seat Pan to Knuckle X 50# Lifting Knuckle to Shoulder X 20# Lifting Shoulder to Overhead X 10# When lift requirement is in excess of 50#, lift assistance (2 person) and/or transfer device is required