Registered Nurse

Working title: Registered Nurse (RN) 

Classification title: Registered Nurses              

Division: Home Health & Hospice

Program: Hospice

Reports to: Hospice Manager  

FLSA status: Non-Exempt;PRN

Wage Range: $31.48 to $44.37 hourly in addition to 10% PRN premium; depending on number of years of transferrable experience and internal equity

RiverStone Health:

Serving the Yellowstone County community and south-central Montana for nearly 50 years, RiverStone Health is an essential provider of personal and public health services. Health, Education, Leadership and Protection – HELP is what we do.  From medical, dental and behavioral healthcare; home care and hospice; public health services like immunizations, WIC, health promotion and restaurant inspections; and educating the next generation of health professionals, our expertise spans all ages and stages of life. 

Hospice Overview: 

The RiverStone Health Hospice Services care for terminally ill patients who want to receive comfort-oriented care rather than continue to seek a cure. Hospice care emphasizes quality of life. Care and grief support services are provided wherever home is. Most hospice patients receive care in their home, or the home of a relative or friend.  Hospice care can also be provided in nursing homes or other facilities.  Working together with patient and family, our team of hospice professionals and volunteers help relieve physical symptoms and decrease psychological, social, emotional, or spiritual distress of patients and their caregivers. Our 24 hour on-call nursing services are available to meet urgent needs.

Job Summary:

Provide direct care of patients.  Assess patient health problems and needs, develop and implement care plans, and maintain medical records. Administer nursing care to ill, injured, convalescent, or disabled patients. May advise patients on health maintenance and disease prevention or provide case management. Must keep all information confidential.  Licensing or registration required.

Essential Functions/Major Duties and Responsibilities:

Nursing Services 95%

• Ability to work independently and collaboratively to provide end of life care and instruction for patients and families based on established clinical nursing practice standards. 
• Directing end of life care, symptom management, medication administration in compliance with physician’s orders and plan of care and informs the primary medical provider of any changes in patient’s condition or needs and coordinates any modifications in treatment with other appropriate personnel.
• Monitoring and interpreting symptoms and treatments and developing a plan of care in collaboration with an interdisciplinary team.
• Providing education and support to patients and families. 
• Assesses and determines the physical, social, and environmental needs of clients and develops a plan of treatment with other team members.
• Responsible for evaluating patient referrals and doing admissions and nursing visits as assigned.
• Initiating the plan of care and priority setting to ensure effective and efficient patient care deliver and achievement.
• Consulting and coordinating with the interdisciplinary team members to assess, plan, implement and evaluate patient’s plan of care.
• Following a plan of care that assures the patient and family needs are identified, prioritized, and met in order to achieve desired clinical outcomes/goals.
• Regularly reevaluates the patient’s nursing needs and makes the necessary revisions in the plan of care.
• Assures that care, educational and end of life planning needs of patients are met.
• Directs and supervises, including supervisory visits, within the area of responsibility including Licensed Practical Nurses (LPN) and Certified Home Health Aides (CHHA).
• Communicates a report to the appropriate team members for the continuation of care, including reporting any changes in patient’s condition to the physician and family as needed.
• Demonstrates the knowledge and skills necessary to provide care appropriate to patients of all age groups–must demonstrate knowledge of the principles of growth and development through the life span, possess the ability to assess data reflective of the patient’s status, and interpret the appropriate information needed to identify each patient’s needs. 
• Documents care provided for the patient encounter in the electronic medical records (per documentation standards) in a timely manner. Must document/chart observations, activities and other data related to the clinical condition of the patient and palliative care. 
• Provides hygiene/personal care to patients.
• Maintain knowledge of and compliance with current Medicare/Medicaid, state regulations and rules, Health Insurance Portability and Accountability Act (HIPAA) compliance and accreditation regulations for hospice services.
• Communicates and coordinates regularly with appropriate others to maximize the effectiveness and efficiency of interagency operations and activities. Participate in program quality improvement projects
• Keeps immediate supervisor and designated others accurately informed concerning work progress, including present and potential work problems and suggestions for new or improved ways of addressing such problems.
• Attends meetings, conferences, workshops, and training sessions and reviews publications and audio-visual materials to become and remain current on principles, practices, and new developments in assigned work areas.

Non-Essential Functions/Other duties as assigned                                        5%

• Perform other duties as assigned in support of RiverStone’s mission and goals.

Education and Experience:

Minimum Qualifications

• Associate degree in Nursing.

• Any combination of experience and training which provide the equivalent scope of knowledge, skills, and abilities necessary to perform the work.

Preferred Qualifications:

• Bachelor of Science in Nursing

• Experience with hospice/palliative care

• Knowledge of nursing process and hospice and palliative care regulations preferred.

Certificates, Licenses, Registrations:

• Current license as a Registered Nurse in Montana.

• Valid State of Montana Driver’s License and vehicle insurance (if Hospice, Home Health, and/or Public Health)

• Current BLS certification

Knowledge, Skills, and Abilities:

• Computer literacy, in Microsoft Office Suite.

• Ability to maintain a calm and positive demeanor during difficult interactions.

• Ability to display non-judgmental and empathetic listening skills.

• High degree of detail-oriented skill level.

• Knowledge and understanding of protected sensitive patient health information (HIPAA) and confidentiality.

• Ability work collaboratively to maintain a positive work environment.

• Ability to prioritize and perform a wide range of tasks under pressure of continuous interruptions.

• Ability to perform job duties with integrity and innovation to ensure completion and a high level of quality.

• Ability to understand and adhere to required administrative policies and procedures.

• Excellent communication skills to ensure efficiencies and quality customer services.

Customer Service Excellence: 

• Doing things right the first time

• Making people feel welcome

• Showing respect for each customer

• Anticipating customer needs and concerns

• Keeping customers informed

• Helping and going the extra mile

• Responding quickly

• Protecting privacy and confidentiality

• Demonstrating proper telephone etiquette

• Taking responsibility for handling complaints

• Being professional

• Taking ownership of your attitude toward Service Excellence.

Supervision: 

• None

Physical Demands and Working Conditions: 

• Required to stand, walk and sit; talk or hear, both in person and by telephone; use hands to finger, handle or feel objects or controls; reach with hands and arms.
• Regularly required to stoop, kneel, bend, crouch and lift up to 25 pounds frequently and 50 pounds occasionally; expected to ask for help from a colleague or utilize a lift when assistance is needed.
• Specific vision abilities required by this job include close vision, distance vision, depth perception, color vision and the ability to adjust focus.
• Ability to travel and use own personal vehicle. Expected to drive a vehicle which requires sitting, seeing and reading signs, traffic signals, other vehicles, etc. Travel occurs in all weather conditions, including extreme heat and cold.
• Risk of needlestick injury is possible. 
• Position is regularly exposed to biological pathogens and contagious diseases where Personal Protective Equipment (PPE) and special precautions must be taken due to reduce exposure and mitigate risk.
• Will be exposed to home environments that may include allergens such as smoke, pets, etc.
• Create and maintain a safe/secure working environment by adhering to safety, security, and health requirements. Integrate injury, illness, and loss prevention into job activities by attending any necessary training and implementing best practices.

Freedom to Act & Decision Making

• Uses independent judgement

• Work is structured by public health regulations and established medical practices.

• Decisions directly affect the quality of services provided to the public.

Communications & Networking:

• Contacts occur both inside and outside RiverStone Health and typically are for the purposes of rendering services to patients to gather information and provide education and instruction.
• Communication with others is a critical element of the position because the purpose of the contact may be to negotiate matters involving significant issues of importance.
• Communicate and coordinate with others to maximize the effectiveness and efficiency of interagency operations and activities.

Budget & Resource Management:

Responsible for the maintenance of equipment and management of resources pertaining to the program budget.