Advertised TitleRegistered Nurse, Hospice

Registered Nurse, Hospice

Full Time, 80 Hours Per Pay Period, Day Shift

Homecare and Hospice Overview: 

Covenant Health HomeCare and Hospice is the area’s largest locally owned home health and hospice provider, with one of the largest rehabilitation departments in East Tennessee. Our HomeCare and Hospice services are part of Covenant Health, East Tennessee’s largest nonprofit health system and a Becker’s “Top 150 Places to Work in Healthcare.” Covenant Health includes nine hospitals and nearly 150 service locations, offering employees a comprehensive benefits package with tuition reimbursement, student loan assistance, certification bonuses, and leadership development programs. 

Position Summary:

Provides professional nursing care to an assigned group of terminally ill patients within an assigned unit; coordinates care planning working in conjunction with the interdisciplinary team to ensure the best possible outcomes for patients’ duration of life. The Hospice RN reports to the assigned Hospice Clinical Supervisor.

• Correlates patient history and support systems within hospital care/nursing home care.
• Conducts initial and ongoing assessment of the impact of the terminal illness on the patient’s physical, functional, psychosocial and environmental needs and activities of daily living.
  • Facilitates a palliative Milieu within facility that promotes a smooth transition at time of death.
  • Risk for pathological grief
  • Cultural and spiritual implications
  • Verbal and non-verbal communication patterns
• Develops and implements the individualized plan of care, involving patient and family, and recommends interventions/revisions to the plan as necessary.
  • Symptoms management focused care prioritizing comfort at end of life by reducing pain and suffering.
  • Specialized nursing skills related to palliative and end-of-life care
• Consults with and educates the patient/family regarding:
  • The terminal dx disease process
  • Self-care techniques
  • End-of-life care
  • The processes for dealing with issues of ethical concern
• Initiates appropriate preventive and rehabilitative nursing procedures.
  • Pressure ulcer prevention
  • Pain crisis prevention
  • Bowel impaction prevention
  • Care of bed confined patient
• Prepares clinical and nursing notes, in both facility and hospice documentation systems that reflect the progression of disease process at the end of life as it takes its normal course.
• Coordinates all patient/family services and prioritizes needs with the members of the interdisciplinary team thru daily communication prn and/or bi-weekly IDG.
• Uses case management approach and referring to other services as needed.
• Acts as liaison between the provider and patient/family. Communicates to provider, orders received and processed and communicated to family. Informing the Provider and other staff of changes in the patient’s needs.
• Determines scope and frequency of services needed based on acuity and patient/family needs. Updates plan of care as needed and adjusts visit calendar frequency. Develops and oversees home health and/or facility aide plan of care individualized to the specific needs of the patient.
• Clinical expertise and knowledge is such that individual can resolve complex patient/management/physician problems without supervision.
• Supervises LPNs and Aides providing services.
• Provides specialized hospice training to other staff, family members, and informal caregivers to insure adequate care.
• Performs on-going evaluation of patient/family response to education and care provided.
• Precepts new employees/students or attends formal preceptor workshop and is willing to precept. Reviews clinical performance of preceptee with unit leader, clinical supervisor or clinical instructor.
• Provides four contact hours of educational activities, excluding basic patient education.
• Contributes to development and evaluation of unit or hospice orientation program.
• Has working knowledge of Medicare guidelines, and performs in compliance with such guidelines.
• Follows appropriate admission, discharge, on-call, and death procedure as outlined by Covenant policy.
• Demonstrates competence in performing critical skills to include appropriate delivery of care according to the age-specific needs of the population served.
• Leads process improvement initiatives in their own unit or participate in facility team.
• Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.
• Performs other duties as assigned.

Minimum Education:

Graduation from an accredited school of nursing.

Minimum Experience:

One (1) year of profession experience in hospital or prior home health experience. Clinical experience pertinent to Hospice, including oncology, palliative, end of life care, etc. preferred.

Licensure Requirement:

Must have and maintain Tennessee State RN licensure. CPR required. Employee must have a valid Tennessee driver’s license Class D and state mandated minimum insurance coverage. Driving record must meet Covenant Health minimum standards at the date of hire and throughout employment tenure.