The Nurse Practitioner is a member of the interdisciplinary team providing face-to-face visits, symptom management, and palliative care to hospice patients. The Nurse Practitioner serves as a role model, educator, and clinical resource to various healthcare disciplines in hospice and palliative care. The NP participates in ongoing education of patients, families and other community healthcare providers. The Nurse Practitioner respects and promotes the mission, values and vision of VNA Health.

SCOPE OF PRACTICE

The Hospice Nurse Practitioner focuses on and demonstrates competency in the care of the individual patient and family for pain and symptom management, physical care, informed decision making, psychosocial support, and advanced care planning. The NP will be competent in clinical management and education regarding hospice and palliative care. Work is performed with general independence and decision-making responsibility in accordance with hospice and palliative care clinical guidelines, scope of practice, and the patient’s attending physician. The Hospice Nurse Practitioner will maintain a collaborative practice relationship with the hospice physicians as outlined in the Collaborative Practice Agreement and in accordance with California State Law and the Nurse Practitioner scope of practice.

1. Completes a face to face assessment for all hospice patients prior to recertification. The NP provides the clinical findings to the physician who will be certifying the terminal illness for use in determining continued eligibility for hospice care. The NP provides a complete physical assessment and history of current and previous illness(es) including objective data to support a life expectancy of 6 months or less.
2. Assesses and evaluates hospice and palliative care patients by:
   1. Completing physical assessments
   2. Writing, initiating, and revising the plan of care in conjunction with the patient and family.
   3. Regularly re-evaluating patient and family/caregiver needs.
   4. Participating in an Interdisciplinary team including Medical Director collaboration
   5. Documenting in the Electronic Medical Record
3. Has appropriate knowledge of nursing, medical, and scientific principles, and appropriately applies those principles to symptom management in coordination with the patients attending physician and hospice team.
4. Initiates, facilitates, and maintains collaborative relationships with peers, staff, administration, and interdisciplinary health teams across healthcare settings.
5. See patients when they are identified as transitioning or actively dying, assess and evaluate their care and make any changes as needed.
6. Identifies current trends in healthcare and promotes evidence-based practice.
7. Performs palliative care consults as requested.
8. Provides training and continuing education for VNA Health staff, community members, and other health care providers as requested.
9. Participates in developing policies, procedure, and standards of care.
10. Initiates quality improvement activities as identified

The above statements are intended 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. All clinical staff are expected to participate as needed in variable shifts, including weekend rotation per staffing needs and departmental holiday rotation.

POSITION QUALIFICATIONS

1. Current Registered Nurse licensure in California in Advanced Practice Role as Nurse Practitioner
2. Master’s degree from an accredited school of nursing as a Family Nurse Practitioner
3. Board certification as an Advance Certified Hospice and Palliative Nurse by National Board for Certification of Hospice and Palliative Nursing or the ability to sit for exam within 1 year of employment.
4. Current DEA licensure without any holds or censures.
5. Knowledge of end-of-life care, including advanced care planning, pain and symptom control of the terminally ill, and bereavement care issues.
6. Current CPR certification.
7. Licensed driver with insured automobile - in accordance with state and/or organization requirements.

EXPECTATIONS

1. Integrates theoretical knowledge base and clinical expertise in decision making.
2. Advocates for patients, their significant others, coworkers, the community, and the nursing profession.
3. Consistently demonstrates accountability.
4. Champions collaborative practice with coworkers and other disciplines, and departments.
5. Consistently demonstrates compassion to internal and external customers.
6. Dynamically represents the program and nursing profession in internal and external forums.
7. Exemplifies professional behavior.

PHYSICAL REQUIREMENTS

1. Ability to lift 50 lbs.
2. Ability to push/pull 50 lbs.
3. Ability to stoop, bend, and squat.
4. Ability to walk up one flight of stairs.
5. Ability to walk one mile.
6. Ability to sit for one hour, minimum.
7. Visual and audio acuity.

STANDARD OF PERFORMANCE:

VnA Health Evaluation tool.