Full Time Home Health and Hospice RN or PRN Home Health & Hospice RN

Northwest Colorado Health
Job Type:
Full Time
Posted Date:
Sep. 9th 2020
  • Granby, CO 80446

Job Description

- Full Time Home Health and Hospice RN-$1000 sign-on bonus

General Statement of Duties:
Performs direct patient care, evaluates needs, and conducts case and resource management for patients under the direction of a licensed physician.

Supervision Received:
Works under the general supervision of the Clinical Manager.

Supervision Exercised:
Assists with the supervision of Licensed Practical Nurses and Home Health Aides by directly observing care, evaluating documentation and interviewing client; reports information back to supervisor through written or phone correspondence.

Essential Functions:

1. Provides consistently high quality of care to patients.
• Maintains and enhances nursing skills needed to provide adequate care; attends classes within the Agency or externally as needed to update skills; learns new procedures appropriate to home care.
• Acts as case manager to coordinate other services; calls other caregivers assigned to client upon admission, discharge, changes in condition and/or plan of care warrants; communicates by phone or in writing with physician as condition warrants; meets with supervisor as required to evaluate other needs.
• Informs family and physician verbally and in writing as needed regarding plan of care, progress, or changes.
• Maintains a professional demeanor and customer service orientation to clients, peers, physicians, etc. as evidenced by feedback from nurses and customers.
• Is independent with I.V. skills and provides high quality I.V. care after approval from appropriate clinical staff.

Procedures which may be required of the home care/hospice nurse include but are not limited to any combination of the following:
• Bladder irrigation and training.
• Blood draw; venous/peripheral or from central line.
• Bowel training; rectal tube care and maintenance.
• Catheter insertion for males and females, including patients with frozen hips or other disabilities; catheter care and maintenance; external catheters; suprapubic reinsertion; suprapubic care and maintenance; teaching self-catheterization technique.
• Expected death and unexpected death care in the home; including CPR for home health patients (not inclusive of Hospice) and Death in the Home procedures.
• Decubitus care and prevention; debriding wounds.
• Diabetic care, teaching, injections, monitoring; use of glucose meters and insulin pumps.
• Vaginal douche.
• Dressing changes; sterile, non-sterile, occlusive, wet-to dry, transparent, unna boot.
• Enema.
• Gastric tube replacement, care, maintenance; J tube care, maintenance; NG insertion, care, maintenance; gastric suctioning; enteral pumps.
• Isolation; universal precautions, safety and infection control.
• Range of motion exercises.
• Fistula care.
• Staple and suture removal.
• Terminal care counseling, communication.
• IM, SQ injections.
• Mental health crisis intervention; short-term management of emotional behaviors.
• Ostomy care: colostomy care, irrigation; ileostomy care; nephrotomy care; ureterostomy care; urostomy care.
• Physical assessment: abdomen, head and neck, heart, lung, lymph nodes, extremities, neurological.
• Respiratory care: postural drainage; CPT; humidifier treatment and care of equipment; mouth/nasopharyngeal suctioning; O2 therapy and setup; tracheostomy care; changing inner cannula; trach suctioning; nebulizer treatments; aerosolized pentamidine.
• Transfers: standing; pivot; hoyer; partial weight-bearing; full weightbearing; non weight-bearing.
• Vital signs, taking and recording; evaluating results.
• Insertion, care and maintenance of peripheral lines.
• Care, maintenance, and blood draws through central lines such as Hickman/Broviac, Groshong, subclavian/triple-lumen, and implanted (i.e. Infusaport, Portacath, Metaport).
• Use of I.V. pumps such as a CADD
• Administration of I.V. therapies, following Agency protocols, including antibiotics, vancomycin, hydration, hyperalimentation, narcotics, pentamidine, declotting, etc.
• Patient teaching of infusion, both with and without pump.
• PICC line care, maintenance, and insertion.
• Patient care is provided in private homes, inpatient settings, or the Rollingstone Respite House, often without the advantage of hospital beds or other conveniences. Kneeling, sitting, squatting, climbing (i.e. onto or over a bed), reaching, and bending in order to get to the patient is necessary.
• Teaches patient or family to optimum level of functioning, appropriate to their degree of comprehension and skill.

2. Turns in accurate and timely documentation of care to appropriate Agency personnel.
• Communicates with other caregivers regarding case(s), documents interdisciplinary communication entering it into the patient's medical record.
• Charts accurately, thoroughly and legibly, and meets regulatory agency and/or pay source requirements to include goals, interventions, outcomes, frequency/duration of care, and other required information regarding patient care.
• Plans ahead for recertification or discharge as notified by appropriate Agency personnel, submitting necessary information three to four weeks in advance of recertification date.

3. Effectively manages a caseload.
• Cases are generally assigned to optimize client and staffing needs.
• Caregiver regularly communicates with supervisor, via telephone or in person regarding caseload status.
• Attends meetings such as team meetings, ad hoc informational meetings regarding safety, policy updates, utilization review, education, etc.
• Assures continuity of care by seeing patients regularly and following Agency protocols for transferring visits to other caregivers in the event of vacation, time off, etc.

Completion of an approved educational program for nursing and be licensed in the state where practicing.

Previous nursing experience as an RN with overall general knowledge of best practices and good holistic nursing skills.

1. Active Colorado RN license.
2. If car is used, must provide proof of adequate insurance coverage totaling at least $300,000 and valid Colorado driver’s license.
3. Current CPR certification according to agency policy.

1. Psychomotor skills to provide nursing care, including daily and repetitive pinching, grasping, and manipulating (i.e. wound care, flushing I.V. lines).
2. Daily standing, squatting, walking, bending, and maneuvering in private homes which are not barrier-free.
3. Heavy lifting (>50 pounds) to transfer or turn an adult, with or without assistive devices; and lifting requirement of 25 pounds (to pick up nursing bag from floor and place shoulder strap on shoulder), approximately twice per patient.
4. Insert peripheral vascular devices and perform peripheral venous blood draw.

1. Thorough knowledge of nursing theory and practice.
2. Knowledge of evaluation techniques utilized in the establishment of a specialized regimen of nursing care.

1. Can read and interpret physicians' orders and notes from other caregivers, as well as respond to them, verbally and in writing.
2. Has ability to calculate drug dosages, mix insulin, measure intake/output, program I.V. pump, etc.

1. Equipment to be utilized for home visits may include wheelchairs, ventilators, pulse oximetry units, oxygen tanks, etc. Per-patient use of oral thermometer, sphygmomanometer, syringes, etc. and making home visits in all weather conditions.
2. IV pumps, IV tubing, blood draw supplies.

Working Conditions:
1. Work environment in home visits is highly variable, as care is performed in private homes. Lighting, acoustics, air quality, temperature, and environmental hazards are not predictable.
2. Works occasional weekends and/or holidays as determined by agency need.
3. This position meets the criteria for Category 1 of OSHA's guidelines for exposure to biohazards.

- PRN Home Health and Hospice RN


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