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Job Description Summary

The registered nurse plans, organizes and directs hospice care and is experienced in nursing, with emphasis on community health education/experience.  The professional nurse builds from the resources of the community to plan and direct services to meet the needs of individual and families within their homes and communities.

Essential Job Functions/Responsibilities

Patient Care

• Completes an initial assessment of patient and family to determine hospice needs.  Provides a complete physical assessment and history of current and previous illness(es).
• Provides professional nursing care by utilizing all elements of nursing process.
• Assesses and evaluates patient’s status by:
1. Writing and initiating plan of care
2. Regularly re-evaluating patient and family/caregiver needs
3. Revising the plan of care as necessary
• Initiates the plan of care and makes necessary revisions as patient status and needs change.
• Uses health assessment data to determine nursing diagnosis.
• Develops a care plan that establishes goals, based on nursing diagnosis and incorporates palliative nursing actions.  Includes the patient and the family in the planning process.
• Initiates appropriate preventive and rehabilitative nursing procedures.  Administers medications and treatments as prescribed by the physician in the physician’s plan of care.
• Counsels the patient and family in meeting nursing and related needs.
• Provides health care instructions to the patient as appropriate per assessment and plan.
• Assists the patient with the activities of daily living and facilitates the patient’s efforts toward self-sufficiency and optional comfort care.
• Acts as Case Manager when assigned by Clinical Supervisor and assumes responsibility to coordinate patient care for assigned caseload.

Communication

• Completes, maintains and submits accurate and relevant clinical notes regarding patient’s condition and care given.  Records pain/symptom management changes/outcomes as appropriate.
• Communicates with the physician regarding the patient’s needs and reports changes in the patient’s condition; obtains/receives physicians’ orders as required.
• Communicates with community health related persons to coordinate the care plan.
• Teaches the patient and family/caregiver self-care techniques as appropriate.  Provides medication, diet and other instructions as ordered by the physician and recognizes and utilizes opportunities for health counseling with patients and families/caregivers.  Works in concert with the other hospice Interdisciplinary Group Members.
• Provides and maintains a safe environment for the patient.
• Assists the patient and family/caregiver and other team members in providing continuity of care.
• Works in cooperation with the family/caregiver and hospice Interdisciplinary Team Members to meet the emotional needs of the patient and family/caregiver.
• Attends Interdisciplinary Group meetings.

Additional Duties

• Participates in on-call duties as defined by the on-call policy.
• Ensures that arrangements for equipment and other necessary items and services
  are available.
• Supervises ancillary personnel and delegates responsibilities when required.
• Assumes responsibility for personal growth and development and maintains and upgrades professional knowledge and practice skills through attendance and participation in continuing education and in-service classes.
• Fulfills the obligation of requested and/or accepted case assignments.
• Actively participates in quality management program.

Position Qualifications

• Graduate of an accredited school of nursing.  One (1) to two (2) years of recent acute care experience in an institutional setting, and/or one (1) to two (2) years of recent experience in home care or hospice preferred.
• Current licensure in State, CPR certification and valid driver’s license with automobile insurance.
• Bachelor’s or Associates degree, with one (1) year of hospice care experience preferred.
• Management experience not required.  Responsible for supervising hospice aides.
• Must exhibit the ability to interact well with a great diversity of individuals and the ability to organize and execute Wren Hospice policies and procedures.
• Excellent observation, verbal and written communication skills, problem solving skills, basic math skills; nursing skills per competency checklist.
• Be capable of prioritizing and handling multiple tasks of critical importance simultaneously and work well in a high-pressure environment.
• Must understand the issues related to the delivery of hospice care and be able to problem-solve effectively
• Prolonged or considerable walking or standing.  Able to lift, position and/or transfer patients.   Able to lift supplies and equipment.  Considerable reaching, stooping bending, kneeling and/or crouching.  Visual acuity and hearing to perform required nursing skills.
• Possess a valid state driver’s license and be able to drive in all types of weather conditions.

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Job Description Summary

The licensed medical social worker contracted or employed through the organization is responsible for the implementation of standards of care for medical social work services and for adherence to all conditions in the Service or Employment Agreement.

Essential Job Functions/Responsibilities

• Assesses the psychosocial status of patients and families/caregivers related to the patient’s terminal illness and environment and communicates findings to the registered nurse and other members of the interdisciplinary group.  Provides an assessment in the patient’s identified residence and assistance when this is not safe and another plan is required.
• Carries out social evaluations and plans intervention based on evaluation findings.  Counsels patient and family/caregivers as needed in relationship to stress, and other identified coping difficulties.
• Maintains clinical records on all patients referred to social work.
• Provides information and referral services for organization patients and families/caregivers regarding practical and environmental needs.
• Provides information to patients and families/caregivers and community agencies.
• Serves as liaison between patients and families/caregivers and community agencies.
• Maintains collaborative relationships with organization personnel to support patient care.
• Maintains and develops contracts with public and private agencies as resources for patient and personnel.
• Participates in the development of the plan of care and attends regularly scheduled interdisciplinary group meetings.
• Assists physician and other team members in understanding significant social and emotional factors related to health problems and death/dying issues.
• Participates in discharge planning when needed.  Assists patient and family/caregiver with securing durable power of attorney and with funeral arrangements, as needed.
• Other duties as delegated by the Clinical Supervisor.

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job.  The incumbents may be requested to perform job related tasks other than those stated in this description.

Position Qualifications

• A graduate of a Master of Social Work (MSW) degree from a school of social work accredited by the Council on Social Work Education (preferred) or has a Bachelor’s Degree in social work accredited by the Council on Social Work Education or a baccalaureate degree in psychology, sociology, or other field related to social work; and has 1 year of social work experience in a healthcare setting and is supervised by an MSW and possess a current license in South Carolina
• Minimum of one (1) year’s experience in health care, hospice experience preferred. Understands hospice philosophy, and issues of death/dying.
• Experience in a hospice care preferred.
• Knowledge of terminally ill patients and their families along with Understanding of hospice and the psychosocial dynamics of illness, loss, and death.
• Demonstrates good verbal and written communication, and organization skills. Sensitivity to the impact of life and death issues face by individuals with terminal illness; tact in dealing with these patients and their families. 
• Must exhibit the ability to interact well with a great diversity of individuals and the ability to organize and execute Wren Hospice policies and procedures.
• Be capable of prioritizing and handling multiple tasks of critical importance simultaneously and work well in a high-pressure environment.
• Must understand the issues related to the delivery of hospice care and be able to problem-solve effectively.
• Must be a licensed driver with an automobile that is insured, registered in accordance with State and/or Organization requirements and is in good working order. Must be able to drive in all types of weather conditions

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Job Description Summary

The hospice aide is a paraprofessional member of the interdisciplinary group who works under the supervision of a registered nurse and performs various services for a patient as necessary to meet the patient’s personal needs and to promote comfort.  The hospice aide is responsible for observing the patient, reporting these observations and documenting observations and care performed.

The hospice aide will be assigned in a manner that promotes quality, continuity and safety of
a patient’s care.

Essential Job Functions/Responsibilities

Responsibilities of the hospice aide include, but are not limited to, the following:

• Performing personal care needs after given a patient’s assignment and attending to his/her requests promptly.  If unable to perform a certain task, report to the primary care nurse immediately.
• Meeting safety needs of patient and using equipment safely and properly (foot stools, side rails, O2 etc.
• Giving personal care including baths, back rubs, oral hygiene, shampoos and changing bed linen as often as assigned.
• Assisting in dressing and undressing patients as assigned.
• Planning and preparing nutritious meals, including shopping, as assigned.
• Assisting in feeding the patient as assigned.
• Taking and recording oral, rectal and axillary temperatures, pulse, respiration and blood pressure when ordered with appropriate completed/demonstrated skills competency.
• Providing proper care and observation of patient’s skin to prevent breakdown of tissue over bony prominence.
• Reporting on patient’s condition and significant changes to the assigned supervisory nurse.   Also aware of the caregiver or other individuals living with the patient and interpersonal issues.
• Assisting in ambulation and exercise as instructed by the primary care nurse or therapist.
• Offering and assisting with bedpans and urinals.  Providing assistance as assigned with light laundry needs.
• Performing range of motion and other simple procedures as an extensional therapy service as ordered with appropriate completed/demonstrated skills competency.
• Providing respite for patient’s/family/caregiver when on-site, as appropriate.
• Keeping patient’s living area clean and orderly, as assigned.
• Adhering to the organization’s documentation and care procedures and standards of personal and professional conduct
• Respectful of patient and family/caregiver environment and patient’s personal needs.

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job.  The incumbents may be requested to perform job related tasks other than those stated in this description.

Position Qualifications

• Meets the training requirements of the State.
• Effective August 14, 1990, a person who has successfully completed a state established or other training program that meets the requirements of S 484.36(a) and a competency evaluation program, or state licensure program that meets the requirements of S 484.36(b), or a competency evaluation program or state licensure program that meets the requirements of S 484.36(b).
• At least 18 years of age.
• Ability to read and follow written instructions and document care given.
• Understands hospice philosophy, comfortable providing specialized care to the terminally ill.
• Satisfactory references from previous employers.
• Is self-directing with the ability to work with little direct supervision.  Secure with issues of death/dying.  Provides a calm manner when in a patient’s home.
• Must exhibit the ability to interact well with a great diversity of individuals and the ability to organize and execute Wren Hospice policies and procedures.
• Has empathy for the needs of the ill, injured, frail and the impaired
• Possess and maintains current CPR certification.
• Demonstrates tact, patience and good personal hygiene.
• Licensed driver with automobile that is insured in accordance with organization requirements and is in good working order and maintains current automobile insurance. Be able to drive in all types of weather conditions.

Job Limitations

The hospice aide will not function in any manner viewed as the practice of nursing according to the Nurse Practice Act.  Specifically, the hospice aide will not administer medications, take physician’s orders or perform procedures requiring the training, knowledge and skill of a licensed nurse, such as sterile techniques.

Skills Required

• Good oral and written communications 
• Good organizational skills

Working Conditions

• Community home environment 
• Exposure to infectious diseases
• In and out of automobile