APRN/PA - Palliative Care

Summary

Serves in his/her professional capacity as a staff member at Concord Hospital. Advanced Nurse Practitioner shall be responsible for the following: Providing palliative medicine consultative services for patients primarily in long-term care facilities according to training, experience, license, standards of care, and department policies. Advances Nurse Practitioner will provide adequate record patient encounters to meet documentation standards and to allow proper billing of patient visits. Patient care must be provided pursuant to the policies, values, regulations and objectives of Concord Hospital the facilities in which services are provided, as well as those professional societies and any other applicable standards, rules, and regulations to include those of DNV. Meet quality of care standards as established by the Medical Director and/or quality and Patient Safety committee. Confers with physicians as necessary regarding care and treatment of patients. Serve as an Interdisciplinary Team member. Works with a team of physicians, residents, nurses, social workers, care managers, chaplains, faculty, and support staff. Participate with the team and department director in problem solving and system development to improve efficiency and quality of care. Assist in establishment, refinement, and monitoring of policies and procedures and operations assigned. Participate in committees as requested by the Medical Director. Participate in planning and implementation of initiatives necessary for meeting the requirements of various accrediting and certifying bodies such as DNV, OSHA, CLIA and CMS. Maintain New Hampshire Advances Nurse Practitioner license, New Hampshire Registered Nurse license and DEA number. Implements care/services that recognize age/diversity specific needs/issues of patients service. Determines the necessity for and interprets laboratory reports. Acts in a consultant role to health care providers or others to influence the plan of care for the patients and enhance the ability of others to provide health care and effect change in the health care system. Provides education to all levels of health care professionals. Determines the necessity for and interprets laboratory reports. Evaluates patient progress in attaining optimal quality of life. Evaluates current standard of care including policy and procedures related to Palliative Care. Collaborates closely with Concord Regional VNA and hospice and provides cross-coverage if needed. Performs other related duties required by Medical Director. Core competencies are listed below.

Education

Completion of Master's degree in Advanced Practice Nursing.

Certification, Registration & Licensure

Licensure required: New Hampshire license as Advanced Practice Registered Nurse and DEA license.

Experience

At least one year of palliative care or hospice experience required.

Responsibilities

• Obtains patient health history and performs physical examination.

• The nurse practitioner, as a member of the Hospice interdisciplinary team, will provide family centered

  care that includes the family and family as one unit of care, respecting individual preferences, values, and cultural beliefs, with the patient and family active in decision making regarding goals and plan of care.

• Communicate effectively with patients and families across a broad range of socioeconomic and cultural backgrounds. Specific communication competencies may include: Giving Bad news Discussing transitions in goals of care from a curative and/or life prolonging focus to palliative care. Discussing patient wishes for inappropriate or futile care at the end of life Discuss goals of care including advance care planning and resuscitation status. Discuss appropriate care settings. Withholding or withdrawing life-sustaining therapy. Discussing artificial nutrition. Pronouncing death in presence of patient’s family. Discussing enrollment into hospice. Referring to tasks of life review, completion of personal affairs, including relationships and sexuality, and social and spiritual aspects of completion and closure.

• Prescribes and manages medications as related to palliative and hospice pharmaceuticals.

• Provides advance care planning and patient education.

• Communicates effectively with physicians, other health professionals, and health related agencies.

  Provide a concise history and physical exam for a new hospice care patient, with a communication to

  referring and consultant clinicians about the care plan / recommendations for patient and family.

  Summarize the active hospice care issues and treatment recommendations for a known patient in signing out to or updating a colleague. Work toward consensus building about treatment plans and goals of c