Nurse, Variable Staff - Per Diem

**Job Summary**

The Variable Staffing Nurse [VSN] is a member of the Variable Staffing Team and, as such, participates in providing after hours staffing coverage including, but not limited to; Weekend Day Coverage, Evening/Night Shift coverage, Holiday' and PTO coverage for Case Managers, Visit Support Nurses, and Admission Nurses as needed.

The Variable Staffing Nurse [VSN] is responsible for providing after hours support to patient/families admitted to hospice service. Working in collaboration with Triage, Patient Care Managers and the Scheduling Coordinator, the VSN responds to patient/family calls and intervenes appropriately, providing phone instruction/support or visit as assessed. Care provided is based on an the individualized Plan of Care developed by the IDT that reflects patient/family goals related of Safe & Comfortable Dying, Self-Determined Life Closure and Effective Bereavement.

The VSN demonstrates: sensitivity and compassion for the issues involved with serving patients and families facing a terminal illness, death and bereavement; clinical competence in pain and symptom management; and fiscal responsibility in the planning and delivery of services.

**Essential Responsibilities**

**Patient/family Care**

* Recognizes the patient and family as the "unit of care" and IDT members
* Respects patient right to self-determination and acts as advocate within the context of the values and ethical standards of HSCC
* Demonstrates ability to meet patient/family where they are
* Offers/makes visits per agency policy
* Offers home visit at time of death
* Utilizes nursing process in providing primary care to patient/families, and professional patient management to facility staff
* Documents all care and care planning per agency policy
* Provides nursing interventions for patient/family as ordered by the physician or Nurse Practitioner and in accordance with the Plan of Care (POC), safe nursing practice and the policies and procedures of HSCC
* Monitors management of pain and symptoms in collaboration with patient/family, facility staff, IDT and physician to achieve maximum comfort
* Administers medications and treatments as ordered
* Instructs and supports patient/family unit and facility staff re: symptom management, patient care, disease process & death/dying

**On Call**

* Works cooperatively with Variable Staffing Team members to provide after- hours/weekends and holiday coverage for HSCC patient/families and staff of our facility partners.
* Participates in providing extra coverage for planned and unplanned absences
* Secures current information on each patient prior to making calls
* Assesses patient status via telephone response
* Follows agency policy in determining whether to make/offer visit or use telehealth for patient/family
* Assists, supports & educates patient and family through physical and emotional crisis utilizing all Variable Staffing Team after hours resources available; Social Workers, Spiritual Care Counselors, Hospice Aides, Administrator On Call.
* Assesses for and promotes caregiver confidence via telephone teaching, onsite visits or telehealth visits.
* Obtains medications, medical supplies and equipment per pt need/physician order and HSCC policies and procedures when needed
* Demonstrates understanding of pharmacy-related policies & procedures
* Disposes or instructs re: disposal of Schedule II medications at time of death per agency policy
* Opens, closes and revises POC per HSCC guidelines
* Documents all contacts, instructions and interventions in the electronic medical record per HSCC policies & procedures
* Documents all contacts, instructions and interventions provided per HSCC policies & procedures
* Submits completed paperwork & time logs within the time frames per HSCC policies & procedures
* Creates individualized POC based on the assessment of pt/family needs and goals
* POC addresses patient/family physical, psychosocial and spiritual needs a written POC that includes identified goals, interventions and outcomes and documents

**Secondary Responsibilities**

**IDT Participation**

* Functions as a member of the HSCC IDT maintaining open & organized communication with hospice staff, volunteers and supervisor
* Works collaboratively with IDT to develop common goals to meet the needs of the patient/family
* Participates in IDT meeting, when appropriate, per protocol to promote care planning, problem solving and education
* Completes and submits all documentation in accordance with policies and procedures

**Quality Improvement**

* Meets all standards and requirement as indicated by licensing and accrediting agencies
* Completes and submits all documentation in accordance with policies and procedures
* Submits verification of current employment related documents per HSCC policies, procedures and licensing agencies
* Participates in activities that affirm, enhance and develop the highest quality standards for HSCC
* Participates in developing standards for quality patient care within HSCC
* Participates in Quality Assessment & Improvement activities as requested

**Special Projects**

* Participates in special projects as requested
* Performs other related job duties as assigned by Supervisor

**Compliance**

* Ensures all HIPAA Privacy and Security Regulations, Medicare Conditions of Participation, and all other regulatory/compliance requirements are understood and followed
* Submits verification of current RN license
* Keeps drivers license current and maintains a good driving record
* Ensures TB checks are completed in a timely manner; at least annually

**Requirements**

* Require current California RN license
* Valid state driver's license and liability auto insurance
* Available to work 4 weekend days/nights/evenings per month and alternates Christmas/Christmas Eve and Thanksgiving annually
* Required to attend regular meetings and in-services

**Skills Required**

* Critical thinking and ability to function both independently and as a member of the Variable Staffing Team after hours support.
* Familiarity with electronic charting programs and/or demonstrated keyboard and computer skills sufficient to utilize electronic medical record charting.

**Education/Experience**

* Degree in Nursing from an accredited college
* 2-5 years RN experience in hospice, oncology, med-surg, ICU, ER, skilled nursing facilities or homecare
* Acute care experience preferred
* Hospice and/or home health experience preferred
* End-of-life and pain management experience preferred

**Certifications, Licenses, Registrations**

* California State issued RN license
* Current BLS
* Pass OIG/GSA review and all required background checks

**Skills Desired**

* Bilingual in English/Spanish highly encouraged but not required.
* Previous experience working with end of life is desirable.

**Physical Demands**

* Sufficient dexterity to utilize electronic record keeping systems, computers/keyboards and or laptops and other related equipment
* Ability to travel to patient locations; includes ability to drive, negotiate stairs and walkways including uneven surfaces at private homes or facilities
* Vision ability to read manual and electronic documentation, medications, charts, office related equipment, and instructions
* Hearing ability within normal range to elicit and detect pertinent information while communicating with patients and health team
* Speech to verbally communicate to assess and impart information concerning patient status; to complete patient/family teaching and to interact with health care team

**Work Environment/Environmental Condition**

* Performs services in private homes and care facilities and will experience a variety of settings and situations
* Office work is performed in combination of private homes, care facilities and office environment.