APRN/PA-C - Palliative Care

Summary

Provider shall be responsible for the following: Providing palliative medicine consultative services for patients in and outpatient. Coverage will be primarily in the Concord community and will assist with coverage as needed in Laconia. Provider will provide adequate record of 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. 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. 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. 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

Certification, Registration & Licensure

Licensure required: New Hampshire license as APRN or PA-C 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 care. Elicit concerns from and provide emotional support and education to staff around difficult decisions and care scenarios.
  
• Documents care provided in the medical record.
  
• Work effectively as a member of the health care team or other professional group. Effectively utilize
  
  members of the IDT to create smooth and efficient transitions across settings for patients /families.
  
  Communicate with care mangers/appropriate staff across sites to enable seamless transitions across
  
  settings. Communicate with clinicians at the time of care transitions to clarify and coordinate care plan
  
  across settings.
  
• Nurse Practitioners must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Nurse Practitioners are expected to demonstrate Competencies:
  
  Compassion, integrity, and respect for others. Responsiveness to patient needs that supersedes self interest. Respect for patient privacy and autonomy. Accountability to patients, society, and the profession. Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation.
  
• Maintains professional development.
  

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Physical and Work Requirements

The physical demands and characteristics of the work environment described here are representative of those that will be encountered by an employee to successfully perform the essential functions of this job.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee is regularly required to hear. The employee is frequently required to bend, do repetitive motion, perform activities that require fine motor skills, reach, sit, speak, stand, and walk. The employee is occasionally required to climb, kneel, smell, and squat.

Specific vision abilities required by this job include color vision, depth perception, far vision, near vision, and peripheral vision.

The employee is rarely exposed to radiation. The employee is occasionally exposed to airborne contaminants, airborne pathogens, bloodborne pathogens, and bodily fluids.

The noise level in the work environment is usually moderate.