Department Name: PALLIATIVE CARE

Reports to: Director of Palliative Care

General Purpose:

The advance practice nurse (APN) serves as a professional, and qualified provider, with the responsibility to practice his/her profession commensurate with his/her licensure, training and experience in accordance with the laws and regulations governing the practice of an APN of the state in which services are performed, and all guidelines of applicable professional and accreditation agencies.  The APN is responsible to work in collaboration with patients, their families and other caregivers, the patients primary care physician, and other specialists as appropriate, in an active practice to deliver episodic acute care and chronic medical management for patients with progressive illnesses.

Delegation of Authority:

The APN performs medical services in collaboration with a physician to diagnose and manage health care problems.  The APN also serves as a healthcare resource, interdisciplinary consultant and patient advocate.

Essential Functions:

APN Practice Guidelines

  • Upon hire, annually and as needed for revisions at times other than the annual review; signs, dates and complies with the Delegation Protocol Agreements and protocols that describe prescribing privileges, treatments, tests and procedures that define the scope of APN practice.
  • Uses the nursing process as the framework for managing patient care
  • Obtains Medicare and Medicaid provider status with the respective state carriers
  • Meets with collaborating physician in accordance with applicable state and federal law

Physical Assessment and Treatment:

  • Provides and documents medically necessary services in accordance with mutually acceptable physician/APN protocols
  • Develops the appropriate treatment plan that maximizes the health potential of the patient including, but not limited to:
    • Ordering and interpretation of appropriate diagnostic tests within scope of practice
    • Identifying appropriate pharmacologic agents
    • Identifying appropriate non-pharmacologic interventions
    • Developing an educational plan as appropriate
    • Interpretation of laboratory and radiology tests within scope of practice
    • Ordering of durable medical equipment
  • In collaborations with PCP, refers patients to medical specialist as indicated 
  • In collaborations with PCP, refers patients to other healthcare services as medically indicated
  • Consult with collaborative physician, consulting practitioner(s), primary care physician and other specialist physicians as appropriate 
  • Assists in all facets of care coordination for referrals
  • Provides disease management instruction and education to patients and their families
  • Provides clinical guidance to facility staff relative to patient care issues, assessments and interventions.
  • Performs reasonable on-call services when applicable

Administrative:

  • Participates with care setting’s interdisciplinary team as appropriate (i.e. clinical stand up, QAPI, care coordination, clinical instruction, utilization committee, re-hospitalization committee, etc.)
  • Prepares and maintains accurate patient records, charts and documents to support sound medical practice and reimbursement for services provided, and support of appropriate medication uses.
  • Acts as a clinical resource to coordinate complex cases for safe and appropriate transitions to other care settings.
  • Comply with applicable laws and regulations with respect to Delegation Protocol Agreements, prescriptive authority, and APN scope of practice.  
  • Reviews of Pathway’s policies and procedures and services with referred patients and/or family caregivers or authorized patient representatives, and obtains consent for medical care
  • Provides training and continuing education to staff
  • Assists in development of clinical practice guidelines/standards in support of quality care

Integrity:

  • Follows policy and procedures as directed
  • Brings concerns forward appropriately to supervisor

Compassion:

  • Promotes an environment of high integrity and teamwork
  • Works collaboratively with patients and the family caregivers, physicians, supervisors and other staff to facilitate effective transitions from 1 care setting to another.

Customer Focus:

  • Takes appropriate and timely measures to meet the needs of the patient, their family and care setting staff
  • Maintains a mature problem-solving approach under stressful circumstances

Innovation:

  • Assists in problem solving strategies with the patient, family, PCP, and setting staff to facilitate safe care of the patient

Financial Responsibility: 

  • I am aware of reimbursement for services rendered; and am billing at the highest possible rate allowed
  • Maintains productivity for his/her practice as defined by Pathway.  We expect a provider to see 6-8 patients daily and complete documentation with in 24 hours of visit.

Minimum Education and Experience Requirements: 

  • Graduate of an accredited Geriatric, Adult or Family Nurse Practitioner Master’s program.
  • Board Certified APN (as a Geriatric, Adult for FNP preferred)
  • 2 years of experience as a nurse practitioner in clinical nursing care of geriatrics, adult/family practice or oncology preferred
  • Advance certification in hospice and palliative nursing care (ACHPN) preferred; required within 18 months of hire
  • Experience with home health, hospice and palliative care strongly preferred

Knowledge, Skills & Abilities Required:

Professional requirements:

  • Maintain appropriate licensures and certifications, including current Department of Public Safety (DPS) and Drug Enforcement Agency (DEA) registrations
  • Practice within established protocols for prescriptive authority, including prescribing of scheduled drugs.
  • Adhere to state regulations regarding practice agreement with physician
  • Maintain a broad base of technical knowledge and skills to perform all assigned clinical/administrative duties.
  • Knowledge of home/hospice regulations, clinical practice, end of life care services, and advance care planning
  • Demonstrate excellent communication skills to relate medical information to the patient, family and nursing staff.  Some of this will be done during staff meetings
  • Possess excellent communication, interviewing and counseling skills, and the ability to explain medical problems and treatments in accurate and understandable lay terms
  • Must be able to coordinate and communicate effectively with colleagues, managers, and medical staff and be able to teach and develop others
  • Must have the ability to prioritize, make decisions and set clear expectations for others
  • May have access to personal health information necessary to fulfill the above duties and responsibilities   Access to use and ability to disclose PHI is further defined by each organization/department.  You are required to maintain confidentiality according to all HIPPA laws.

Other requirements:

  • Computer proficiency including the ability to utilize software programs used by the organization
  • Able to perform and prioritize multiple functions or tasks
  • Able to read and interpret technical instructions related to the care of the patient
  • Able to effectively deal with multiple changes
  • Able to engage in moderate amount of local travel
  • Able to provide proof of valid driver’s license
  • Able to provide proof of valid liability insurance if assignments include driving own vehicle
  • Evidence of annual TB test and other state required tests

Working Conditions & Physical Requirements: 

  • Works in community care settings (home, SNF, ALF)
  • Able to stand, bend, stoop, squat, kneel and reach freely
  • Able to freely lift up to a maximum of 50 pounds
  • Able to assist patient/client with standing, walking, sitting, and rolling in bed
  • Visual/hearing ability must be sufficient enough to communicate written and verbally

To Apply:

Send CV to Tawnya Pugh, CMA, Director of Palliative Care:

tpugh@pathwayhospicecares.com

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