2. Under the supervision of a registered nurse, coordinates patient care activities, including patient/family education, for an assigned group of patients and assumes the role of care coordinator for uncomplicated patients; utilizes available clinical pathways and protocols; incorporates discharge planning into the care plan at the time of admission; evaluates variance and progress towards goals; modifies plans to achieve desired patient outcomes. - Identifying learning needs of patients and families regarding present health status, ongoing health care needs and home care requirements if necessary; initiating and coordinating interdisciplinary teaching and discharge planning; and providing instruction for patient and family upon discharge regarding treatment, follow-up care plans, medications, etc.*.