The HospiceCare Registered Nurse Hospital Case Manager organizes and directs hospice care in the hospital setting 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.
- Completes an initial, comprehensive and ongoing comprehensive 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:
- Writing and initiating plan of care
- Regularly re-evaluating patient and family/caregiver needs
- Participating in 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.
