Hybrid Telehealth Registered Nurse (Experience Rn) Home Health

Duke Homecare & Hospice Duke Homecare & Hospice offers hospice, home health and infusion services as well as serves as the home for the Duke Caregiver Support Program. Our Hospice team works closely with a patient's physician to provide comprehensive, individualized care in the comfort their home or at our inpatient hospice facility located in Durham. Our team of nurses, therapists, social workers, counselors, and chaplains help patients and their families manage advanced medical conditions. Duke Home Health provides services in a patient's home that include skilled nursing, physical therapy, occupational therapy, speech therapy, social service, home health aides, and pain and wound management. Our infusion team comes to a patient's home to administer intravenous medications, including antibiotics and chemotherapy, to children and adults. Our nurses, pharmacists, dietitians, and patient services coordinators work under the direction of a patient's doctor to monitor needs and treatment.

Duke Nursing Highlights:

• Duke University Health System was awarded the American Board of Nursing Specialties Award for Nursing Certification Advocacy for being strong advocates of specialty nursing certification.
• Duke University Health System is designated as a Magnet organization
• Quality of Life: Living in the Triangle!
• Nurses from each hospital are consistently recognized each year as North Carolina's Great 100 Nurses.
• Duke University Health System has 6000 + registered nurses
• Relocation Assistance (based on eligibility)

To have the opportunity to speak to someone further about this position, please click this link to schedule with a recruiter: https://calendly.com/jacqueline-huff/homecare-hospice-information

**Eligible for Sign-On Bonus

Shift: 40 hour work week M-F 8AM-5PM

JOB SUMMARY:

Perform Telehealth visits for patient’s high risk for hospitalization. This nurse will work with the interdisciplinary team to prevent patient hospitalizations, improve medication compliance and address medication discrepancies.

Nurse would perform minimum of 8 telehealth/video visits per day which may include the following:

• Telehealth/Video Visits reimbursed by payor
• Nurse would Utilize Doximity for Video Visits/Can do telephone visits if patient unable to do video visit
• Communicate with care team regarding high risk patients
• Nurse would be back up for Teleheath/Triage nurse when on PTO
• Referral HHR confirmation calls
• Thursday Friday HHR patients for first Month on service
• Nurse would work remotely, but may need to come to office for meetings/education
• Review Therapy Admission Clinician Medication Lists
• Next day HHR admissions/ROCs
• Assure Follow-up for patients with medication discrepancies at admission

General Job Responsibilities of Home Health Nurses (not all applicable to Telehealth Nurse):

• Delegate and supervise care given by NCA’s/LPN’s.
• Plan, provide, supervise and document professional nursing care utilizing the nursing process for patients in accordance with the NC nurse practice act, physician orders and established policies and procedures. Uses professional nursing judgment to individualize the plan of care based on assessment of the patient’s baseline needs and response to care.
• Obtain or develop appropriate educational resources for patients/families; plan and implement appropriate educational interventions; evaluate effectiveness and outcomes of patient/family teaching.
• Document care and services provided in accordance with DHCH Policy and Procedures and regulatory standards.
• Perform other duties as assigned.
• Medication reconciliation and education to prevent adverse events and readmission to hospital
• Maintain confidentiality of employee and patient information.
• Develop and implement an effective discharge plan for patients to begin at the initiation of services.
• Work closely and collaboratively with agency billing staff to ensure accuracy of billing.
• Assesse the severity of patient symptoms, communicate to the physician and record significant findings, intervenes as appropriate.
• Role model professional nursing through conduct, appearance, communication, mutual respect, ethical decision-making, critical thinking, and problem-solving skills.
• Follow infection control standard precautions and uses personal protective equipment as required.
• Assess educational needs of patients/families concerning alterations in health, the disease process, and plan of care.
• Develop plan of care for aides, assign care to aides based on the skills of the aide, the availability of the aide for patient care continuity, patient preference (when possible), and other considerations as determined by the patient’s care needs.
• Participate in weekly interdisciplinary team meetings and case conferences, as necessary, to assure appropriate care and service are provided to the patient.
• Communicate regularly with team members, caregivers, and physicians.
• Maintain up to date knowledge of Medicare/Medicaid/JCAHO standards thru inservices and workshop attendance.
• Complete documentation accurately, timely, concisely.
• Participate in own professional development by maintaining required competencies, identifying learning needs and seeking appropriate assistance or educational offerings.
• Utilize comprehensive assessment skills to plan priorities and to set realistic outcomes; collaborate with healthcare team in the evaluation and cost effectiveness of patient care.
• Implement agency policy, procedures and objectives.
• Exhibit an attitude which promotes harmony and goodwill in the workplace.
• Promote quality, comprehensive services through a team approach.
• Identify personal learning needs and implements corrective action: assists in planning and conducting staff development programs to improve DHCC effectiveness.
• Participate in Performance Improvement Program.
• Display a clean, neat, professional appearance.
• Observe patient’s reactions to medications and reports significant incidents to the physicians.

Home Health

• Case manage interdisciplinary team of clinicians caring for patients in the home.
• Appropriate utilization of resources for patient including visit and supply utilization.
• Complete required OASIS Comprehensive assessments at admission, recertification, Resumption of care and discharge. This assessment determines patient reimbursement for Medicare and other episodic payors and also results in publicly reported patient outcomes and additional payment impacts related to value based purchasing
• Be aware of patient insurance requirements and assures authorization for all services have been obtained.
• Work with interdisciplinary team and patient providers to prevent re-hospitalization of the patient.

WORK ENVIRONMENT AND REQUIREMENTS:

• Prior home health experience
• Excellent phone and customer service skills
• Knowledgeable on medications and disease process and addressing patient change in conditions
• Excellent critical thinking skills
• Able to communicate and work with providers to address patient changes in condition

Education and Formal Training

• Associate Degree or Diploma, Nursing required
• Registered Nurses are not required but encouraged to enroll in a DUHS approved BSN program after completing two years of service of their start date.
• BSN is not required for Duke University Clinical Ladder

Licensures, Certifications

• Must have a current or compact RN licensure in the state of North Carolina
• Current State of North Carolina Cardio-Pulmonary Resuscitation Certificate (CPR) (American Heart Association only)

Professional Work Experience & Requirements

• Two years of med-surgical, critical care or home health/hospice/infusion
• Prior OASIS and PDGM experience preferred for home health
• Prior experience in Home Health, Hospice or Infusion preferred
• Valid driver’s license and current automobile insurance coverage

Knowledge, Skills & Abilities

• Ability to record activities, document assessments, plan of care, interventions, evaluation and re-evaluation of patient status
• Knowledge in wound identification and treatments, infusion and other advanced nursing skills
• Excellent rapport, understanding, and communication with the patients and their family members
• Able to withstand driving long distances, stooping, bending, lifting 20 plus pounds, and climb stairs
• Ability to work autonomously and independently in varying environments.
• Ability to assess nursing needs of acute and chronically ill patients and their families
• Ability to teach patients and families in accordance with the nursing plan of care
• Strong computer skills including MS Outlook, Word, Excel, preferred
• Working knowledge of Medicare and Medicaid regulations, including JCAHO and DFS standards, ICD-9 Coding.
• Ability to independently seek out resources and work collaboratively
• Critical thinking skills and organization skills
• Able to document and communicate pertinent information using computer and/or paper documentation tools
• Working knowledge of infection control procedures and safety precautions
• Knowledge of scope of the registered nurse, licensed practical nurse and NCA
• Ability to establish and maintain effective working relationships
• Ability to use fine motor skills
• Ability to use sensory and cognitive functions to process and prioritize information, treatment, and follow-up
• Ability to communicate clearly with patients, families, visitors, healthcare team, physicians, administrators, leadership and others
• Knowledge of and appropriate application of the nursing process
• Ability to use computer and learn new software programs and technology

Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.

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Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.