Responsible for providing continuity of care to all Hospice patients and their families after normal operating hours. Responds to incoming calls from patients/families/caregivers, assesses and addresses needs within context of patient's Interdisciplinary Plan of Care and Hospice Care mission, objectives, policies and procedures. Documents and reports to team patient's needs, significant events, plan of care and other issues. Evaluates effectiveness of clinical directions. Works under general supervision.
- Assesses the physical, emotional and medical needs of hospice patients and their caregivers through after hours telephone consult. Provides support and direction to families in accordance with the patient’s Interdisciplinary Plan of Care and Hospice Care mission, objectives, policies and procedures. Takes referral information and triages for immediate response, dispatches the on call nurse to do the evaluation/ admission. Contacts Physician for verification of prognosis and appropriateness for Hospice/Palliative care. Contacts and interface with team members, primary physician, team physician, administrator and other staff to ensure patient’s and family’s needs are met.
- Provides clinical directions to patients/caregivers in accordance with Hospice guidelines. Obtains and receives verbal orders from team/physician and documents care using standard form. Evaluates and documents effectiveness of directions through telephone follow-up with patients/caregivers. Provides team/physician with documentation and implements any changes, as directed.
- Obtains and reviews daily report from each team on significant patient care situations that may require contact/follow-up during course of shift. Documents all calls received using high degree of accuracy and detail to ensure team/physician is provided with all relevant and necessary information. Completes case conference form on all calls received and faxes to respective team.
- Supervises on-call Nurses. Monitors/evaluates performance, provides guidance, recommends hiring and termination, as needed. Determines/Deploys on-call Nurse for home visits, provides necessary information and follows-up regarding status of visit and to obtain necessary report.
- Provides verbal report on significant events, plan of care changes and other patient/caregiver issues requiring further action and/or follow-up to each respective team.
- Participates in Interdisciplinary Hospice Team meetings, management meets and serves on relevant committees for the purposes of information exchange, team collaboration, development of procedures and documentation tools, development of quality and training.
- Understands/implements/complies with Hospice Care Mission, objectives, policies and procedures to ensure Hospice Care/patient/caregiver needs are met.
- Participates in special projects and performs other duties as assigned.
Licensure: License and current registration to practice as a registered professional nurse in New York State required.
Education: BSN and/or HPNA certified preferred.
Experience: Minimum of two years of clinical nursing experience in Acute Care (Med Surg, ICU), Clinical Crisis Management, Hospice or Palliative Care required. Administration or management experience preferred. Excellent oral, written and interpersonal skills required. Attention to detail, excellent follow-up and follow through skills required. CA 2020
The Visiting Nurse Service of New York (VNSNY) is the nation's largest not-for-profit home- and community-based health care organization, serving the five boroughs of New York City, and Nassau, Suffolk, and Westchester Countries. For over 125 years, VNSNY has been committed to improving the health and well-being of people through high-quality, cost effective healthcare in the home and community. We offer a wide range of services, programs, and health plans to meet the diverse needs of our patients, members, and clients from before birth to the end of life. Each day, more than 13,000 VNSNY employees - including nurses, rehabilitation therapists, social workers, other allied professionals, and paraprofessionals - deliver compassionate care, unparalleled medical expertise, and 24/7 solutions and resources to more than 44,000 patients and members, helping them to live the best lives possible in their homes and communities.