Registered Nurse, Hospital at Home, 24 Hours (Nights / Every Other Weekend)

POSITION SUMMARY:

The Hospital at Home Registered Nurse works in the Hospital at Home program and is responsible for delivering high-quality patient care across diverse populations. They employ their monitoring, assessment, planning, and critical thinking skills to provide acute care within this framework. This role involves conducting virtual patient care visits as directed by the care team and protocol.

The RN utilizes their nursing knowledge to solve complex patient problems and collaborates with the Medically Home team and service providers to ensure evidence-based care with clinical protocols. Delegating patient care activities is part of their responsibility, with a focus on maintaining patient safety and adherence to institutional standards and documentation guidelines.

They establish therapeutic relationships with patients and caregivers, guiding them through the Hospital at Home care phases. This role acts as a professional nursing practice role model, promoting a culture of safety and participating in quality and safety investigations. Compliance with state and hospital regulations, along with participation in quality improvement and chart review audits, are also essential aspects of this role.

Position: Registered Nurse

Department: Hospital at Home

Schedule: 24 Hours (Nights / Every Other Weekend)

ESSENTIAL RESPONSIBILITIES / DUTIES:

Core Responsibilities

• Responsible for providing high-quality patient care to various patient populations within the framework of Hospital at Home and includes the following key elements:
• Utilizes monitoring, assessment, planning, intervention, and critical thinking skills to care for acute care patients in the Hospital at Home program
• Conducts virtual patient care visits for diverse patient populations as directed by the care team and protocol 
• Utilizes nursing knowledge to identify, solve, and prevent complex patient problems 
• Leverages the resources and expertise of the Medically Home team and service provider network to implement collaborative workflows, policies, protocols, and guidelines that support safe, reliable, high-quality, evidence-based care with clinical protocols as the foundation 
• Delegates activities or tasks related to patient care while retaining accountability for the outcome and responsibility for the delivery of nursing care Monitors and responds to biometric data per health system protocols 
• Promotes adherence to institutional standards and documentation guidelines
• Ensures all interventions in the patient’s care plan are implemented efficiently and with a patient-centered approach.
• Takes appropriate action to ensure patient safety  
• Establishes therapeutic relationships with patients and caregivers. Guides patients and caregivers across the continuum of the Hospital at Home phases of care 
• Serves as a role model for professional nursing practice  
• Promotes a culture of safety, participates in quality and safety investigations, root cause analyses, and other process improvement efforts 
• Ensures compliance with reporting requirements for Sentinel Events and Serious Incidents  
• Actively facilitates new patient admissions to Hospital at Home; assumes additional patient intake responsibilities as directed by program leadership; implements Medically Home guidelines throughout intake process 
• Shares expertise with the multidisciplinary team and serves as a resource to staff in area(s) of expertise 
• Supports research efforts to advance knowledge and promote evidence-based practice 
• Maintains and practices in accordance with nursing guidelines per state and hospital regulations 
• Performs other duties and responsibilities as assigned by the Director of Nursing 

Quality & Safety Responsibilities

• Ensures compliance with reporting requirements for all levels of safety events (those which resulted in harm, and those where harm was not present) 
• Participates in quality and safety investigations and root cause analyses as required by leadership
• Takes appropriate action to ensure patient & family safety 
• Participates in quality improvement processes activities
• Participates in chart review audits.

Standards of Professional Performance

• Systematically evaluates the quality, cost, and effectiveness of nursing practice.
  • Participates/leads quality improvement and/or research activities as appropriate to the individual’s position, education, skills, and practice environment.
• Uses the results of patient satisfaction, quality improvement and/or research data to initiate changes in practice.
• Accounts for completing daily patient classification data and incident reports in a timely manner.
• Participates in cost containment initiatives and practices.
• When two or more practice options exist that achieve the same quality of expected patient outcome, evaluates factors related to safety, effectiveness and cost when selecting the appropriate option.
• Acts in a professional manner relative to practice standards, statutes, and regulations.
  • Practices in compliance with established practice standards, policies, procedures, protocols, guidelines, statutes and regulations (example: DPH, JCAHO, Fire Code, OSHA, and DEA).
  • Functions without supervision in a manner appropriate for level of experience and education.
  • Responsible for seeing things through to completion and for informing appropriate staff of outcomes.
  • Offers, seeks out and acts upon constructive feedback regarding professional practice to improve daily practice and to achieve goals identified during performance appraisal.
• Takes appropriate steps to effectively resolve peer conflicts or investigate questionable activities. Discusses such with individuals involved and seeks assistance from nurse manager when appropriate.
• Maintains accurate annual professional development record.
• Demonstrates flexibility and ability to positively adapt to changing staffing/clinical/patient census needs including but not limited to offering assistance to others, adjusting patient assignments, floating to other areas/units, etc.
• Demonstrates reliability in regard to attendance and punctuality standards.
• Maintains a presentable appearance in accordance with dress code requirements including wearing a visible identification badge that identifies one’s self as a registered staff nurse.
• The nurse acquires and maintains current knowledge in nursing practice.
  • To maintain clinical competence in appropriate practice area, participates in ongoing educational activities to enhance clinical knowledge and update requisite skills.
  • Independently identifies need for in-service/educational sessions and seeks experience to meet such needs and to maintain clinical skills.
  • Completes the following mandatory requirements: annual BLS certification, institutional mandatory education, e.g., safety regulations, infection control standards, etc., and departmental/unit specific competencies.
  • Actively participates on unit or departmental based task forces, councils, or committees.
• The nurse contributes to the professional development of peers, colleagues, and others.
  • Takes initiative to share knowledge and skills willingly with colleagues, students, and novice practitioners in a collegial manner.
  • Provides peers with constructive feedback regarding their practice and professional skills.
  • Acts as a resource for new employees, float staff, and other unit team members.
  • Assists in the orientation and/or acts as preceptor for new employees and/or nursing students.
• The nurse’s decisions and actions on behalf of patients are determined in an ethical manner.
  • Delivers care in a manner that preserves/protects client autonomy, dignity, confidentiality, and rights.
  • Acts as a patient advocate in order to facilitate meeting identified patient needs.
  • Delivers care in a non-judgmental and nondiscriminatory manner that is sensitive to and demonstrates respect for patient diversity.
  • Seeks available resources to help formulate ethical decisions.
• The nurse collaborates with client, significant others and health care providers in delivering client care.
  • Communicates and consults with client, significant others and members of the health care team regarding required patient care.
  • Works cooperatively and constructively with all departments and health care team members to establish an environment that supports the process of collaboration.
  • Participates as an integral member of the health team during family/staff meetings, formal/informal shift rounds/reports, and medical/grand rounds.
  • Coordinates appropriate internal and external referrals to assist patients to gain access to services, pre-approvals, etc.
  • Coordinates discharge activities including arranging for home/agency referrals when necessary.
• Other duties
  • Interprets/translates for patient/family/visitors when conversant in their native language as needed.
  • Acts as a shift charge nurse when requested/ne
  • Performs all other related duties as assigned.

(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job.  The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).

JOB REQUIREMENTS

EDUCATION:

• Nursing degree: Diploma, ASN or BSN (preferred), Ability to obtain BSN within 4 years

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:

• Active Registered Nurse License (BSN & current license)
• Active Basic Life Support (BLS) certification

EXPERIENCE:

• Three (3) years RN experience in specialty fields such as acute care, medical/surgical, home-based care, ER, oncology, or geriatrics desirable.

KNOWLEDGE AND SKILLS:

• Clinical knowledge
• Able to promote patient safety and positive patient experience
• Flexible and comfortable with a changing and dynamic work environment and schedule across all shifts and days
• Team player who also works well independently
• Participates in ongoing learning and continuing education to care for a variety of patient populations
• Model collaborative, respectful team relationships with colleagues and customers; lead by example 
• Experience with telemedicine, nursing informatics, and/or clinical trials desirable