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

RN, ON CALL- HOME HEALTH & HOSPICE

The on-call RN will have primary responsibility to assess patient need via phone triage or referral information, and provide appropriate care to home care and hospice patients after business hours Monday - Friday Weeknights. The RN will assess, plan, implement and evaluate the care for a designated group of patients in their home. The RN will coordinate, direct, and promote positive patient outcomes and contribute to efficient agency operations. In addition, the Hospice RN will provide 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; call 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; anticipate needed supplies place and expedite orders for supplies; verify receipt of supplies; use 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; respond to requests; build rapport; participate in team continuous quality improvement and problem-solving methods. * Contribute to team effort by accomplishing related results as needed. * Cognitive ability to function and concentrate on the essential and specialty functions of the job at a high level. * Achieves thoroughness and accuracy when accomplishing an essential or specialty function of the job. * Ability to think and concentrate for an entire shift. Specialty Job Functions * Provide nursing care and assessment to home care and hospice patient after normal business hours. * Triage patient phone calls received by the answering service. * Provide appropriate professional care based on triage phone call. This may be phone assessment and instruction, a home visit, phone call to the physician, or facilitate a transfer to another level care. * Receive and process from referral sources after hours referrals for home care or hospice care. * Contact patient/family to assess need for immediate home visit. * Make home visit or schedules for the next day. * Communicate care needs to appropriate personnel - supervisor, primary nurse or therapist. * Hospice Role to understand the Hospice philosophy and perform care accordingly to enhance the quality of life of the terminally ill patient. * Maintain and demonstrate an understanding of the Hospice benefit and comply with regulatory conditions of participation. * Assess eligibility for Hospice care and obtain the informed consent prior to the initiation of services. * 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 need of the terminally ill patient and their family. * Follow established guideline for pain and symptom management to enhance quality of life. * Educate patient and caregivers regarding the care needs at the end-of-life, including palliative care measures. * Provide supportive psychotherapy. * Demonstrate knowledge of commitment laws, mental health clinical programming, and community resources * Function as a resource for Agency staff with patients demonstrating mental health issues as a secondary diagnosis. * 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 report to the physician. * Maternal/Child Nurse Role: Provide 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 and intervention of complications. * 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. * Demonstrate a general knowledge of all Excela Health services and a high degree of knowledge in targeted programs and services. * Communicate operational changes or newly created programs and services to physicians and their office staff. * 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 * Minimum of one-year recent experience in home care, hospice, hospital or other related setting. 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 PA Driver's License. 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 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/hrs./wk.) x x Travel Between Sites x 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 x Body Protection x x Latex Exposure x x Solvent Exposure 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 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 ### 10# Lifting Seat Pan to Knuckle ### 50# Lifting Knuckle to Shoulder ### 20# Lifting Shoulder to Overhead ### 10# When lift requirement is in excess of 50#, lift assistance (2 person) and/or transfer device is required