The Registered Nurse is responsible for providing skilled nursing services to patients in the home setting. The Registered Nurse plans, coordinates, provides and documents care for patients in compliance with applicable laws, regulations and standards and agency policies and procedures. The Registered Nurse adheres to Medicare and Medicaid regulations.
PRIMARY JOB DUTIES & RESPONSIBILITIES
· Provides case management as described in state regulation for all cases involving nursing and therapy services
· Performs initial and ongoing patient assessments in response to patients’ needs and in accordance with physician orders.
·Re-evaluates patient’s nursing needs on a regular basis.
· Initiates a written plan of care, re-evaluates and updates the plan as necessary.
· Participates in in-service programs, agency meetings, trains, and teaches other nursing personnel.
· Assumes responsibility for each patient receiving nursing or personal care.
Develops and implements the nursing care for the patient under the direction of the physician.
· Provides nursing services, treatments and diagnostic procedures requiring specialized skills within the nursing scope of practice.
· Observes and reports symptoms, reaction to treatments, drugs, and changes in the patient’s physical or emotional condition.
· Initiates preventative and rehabilitative nursing procedures as appropriate for the patient’s care and safety.
· Assumes responsibility for clinical and progress notes for each patient receiving care.
· Coordinates patient care and services as needed for the patient.
· Participates in on call rotation as applicable.
· Participates in case conferences to discuss multidisciplinary team responsibilities, patient progress, and plans for continued care.
· Assures that progress reports are made to the physician for patients under medical care describing patient activities and or changes in condition.
· Documents skilled care and/or services provided in compliance with federal and state laws and regulations, and agency policies and procedures.
· Counsels the patient and family in meeting nursing and related needs and provides patient/family/caregiver education using various verbal and written communication techniques that take into account the patient’s/family’s cultural, ethnic, and/or personal needs or preferences.
· Provides supervision of home health aide services and LPN employees.
· Prepares written instructions for care provided by home health aides.
· Assigns selected portions of patient care to Licensed Practical Nurses, but always retains the full responsibility for the care given and for supervisory visits to the patient’s home.
· Notifies the physician and the Director of Nursing of any changes in the patient’s condition and the need to modify the plan of care.
· Plans patient discharge appropriately; provides information about community resources to address patient ongoing needs.