Nurse Practitioner - Palliative Care - Full Time - 32hrs Week - Rotating

At Nebraska Methodist Health System, we focus on providing exceptional care to the communities we serve and people we employ. We call it The Meaning of Care – a culture that has and will continue to set us apart. It’s helping families grow by making each delivery special, conveying a difficult diagnosis with a compassionate touch, going above and beyond for a patient’s needs, or giving a high five when a patient beats a disease or conquers a personal health challenge. We offer competitive pay, excellent benefits and a great work environment where all employees are valued! Most importantly, our employees are part of a team that makes a real difference in the communities we live and work in.

About the role

Location: Methodist Palliative Care, 8303 Dodge Road, Omaha.

Responsibilities

• Perform primary health care for patients by utilizing the processes of assessment and diagnosis of health status.
  • Obtain patient's medical and history information, data collection is prioritized according to immediate condition or needs.
  • Perform physical exam and determine patient's mental status.
  • Develop and implement treatment, follow-up and evaluation plans for patient outcomes.
  • Collaborate with physicians and other disciplines as appropriate and provides regular and consistent feedback.
  • Use appropriate assessment techniques & diagnostic information.
  • Performs tests relevant to patient condition and record findings.
  • Order appropriate ancillary tests.
  • Derive diagnosis from the assessment data and diagnostic information as data becomes available.
  • Use new or additional data to form a treatment plan.
  • Perform telephone triage to determine patient condition and provides appropriate consultation scheduling appointments when needed.
  • Incorporate research into clinical practice as appropriate.
  • Provides timely initial patient and family assessments for palliative care consults.
• Implement interventions consistent with the established plan of care in a safe and appropriate manner.
  • Apply established therapeutic practices to patient's problem.
  • Administer medications and immunizations using the appropriate method and with physician oversight if applicable.
  • Prescribe medications according to Controlled Substance Registration Certificate issued by the DEA.
  • Generate referrals to appropriate services as needed to further diagnose and/or progress of care.
  • Prescribes medications and other non-pharmacologic interventions, including controlled substances, to promote comfort and symptom management.
    • Safely selects and manages medications/dosages for ongoing treatment of symptoms.
    • Pain-oral, parenteral, IV, IM, subg, bolus, PCA
    • Nausea and vomiting
    • Constipation
    • Breathlessness
    • Delirium
    • Other
  • Appropriately converts medications using equianalgesic/equipotency formulas (e.g. opioids, steroids).
  • Manages and preempts common side effects of pharmacologic intervention.
  • Recommends and facilitates non-pharmacologic strategies into the plan of care.
  • Consults other team experts as needed (e.g. Chaplains, Behavioral Health).
  • Collaborates with palliative care collaborating providers as needed, recognizing abilities and limitations.
  • Conducts, leads and facilitates palliative care consultation meetings and decision making using theoretical principals, skills, and competencies of advanced nursing practice and palliative care.
  • Communicates effectively with patient and family understanding of diagnosis, prognosis care and treatment options.
• Evaluate patient care to determine response to care/interventions for optimal patient outcome.
  • Evaluate the patient's capabilities and/or limitations related to nursing and medical interventions.
  • Recognize and address patient and family capabilities and limitations (physical and mental), including assessment of capacity.
  • Return patient telephone calls.
  • Monitor outcomes and documents patient response to interventions.
  • Seek out new treatment methods necessary to ensure patient progress.
  • Discusses findings and recommendations for plan of care with attending and consulting physicians and other team members as needed to assure continuity of care.
  • Implements actions and provides for communication that promote continuity of care and optimal transition within and outside the hospital setting.
  • Collaborates with other disciplines for discharge planning inclusive of financial needs and functional status.
• Provide patient and family teaching and education specific to the patient's health care.
  • Proper use of medication and health/illness prevention to ensure adequate knowledge/awareness.
  • Interview and advise specific to patient needs.
  • Demonstrate sensitivity to family regarding need for patient information on a timely basis.
  • Work collaboratively with physicians and other team members to provide appropriate patient education geared to the patient's needs and family's ability to provide care.
  • Use adult learning principles for teaching purposes being careful to check for understanding and being available for follow-up questions.
  • Recommend references and resources such as printed materials, online, community and other information sources to fulfill the family's need for education.
• Maintain a professional behavior in attitudes, demeanor, and interactions to achieve organization's mission.
  • Communicate effectively with physicians, staff and patients.
  • Is approachable and professional in working with other health professionals, patients and their family.
  • Maintain a professional appearance, behavior, and work environment.
  • Initiate action to correct, prevent, and/or minimize risk(s) to the patient, family or hospital/clinic employees (i.e., falls, needle sticks, patient concerns).
  • Communicate to appropriate personnel regarding unresolved issues.
  • Serve as a role model in the provision of emerging care.
  • Serve as a reliable/knowledgeable resource for staff.
  • Participate in meetings, research on special projects and professional organizations.
• Comply with the bylaws, rules and regulations of the organization as they pertain to Nurse Practitioners or Physician Assistants.
  • Know and follow organization policy & procedures.
  • Follow Medical Protocols for professional discipline.
  • Maintain certification/licensure.
  • Follow guidelines of regulatory bodies (FDA etc.).
• Maintain complete patient records.
  • Document data appropriately.
  • Document treatment plan of care that is individualized, appropriate and reflects patient's needs.
  • Document interventions.
  • Document consultations with other practitioners/physicians.
  • Completes accurate patient records in a timely manner.
  • Documentation includes information to support sound medical/nurse practitioner practice.
  • Completes timely documentation and dictations for new consults/follow up visits.
  • Documents as needed to support billing and reimbursement for services provided.
  • Initiates reimbursement billing for services rendered (submits billing).
  • Completes adequate number (or %) of palliative care patient/family consults and follow up visits given team workload.
• Participate in performance improvement and outcome management.
  • Meet regularly with medical director for chart reviews.
  • Identify concerns in patient care & follows up according to hospital policy.
  • Participate in patient satisfaction and other quality improvement initiatives.
  • Participate in tracking of variances in care.
  • Develops and maintains knowledge of current research related to clinical practice specialty.
  • Uses knowledge of research review to analyze research findings.
  • Contributes to PI data collection for the specialty area.
  • Assists in analyzing PI data to determine opportunities for improvement.
  • Initiates and/or contributes to changes in protocols, standards, policies and practices based on current research and PI data.
  • Conducts research as needed based on hospital clinical priorities.
  • Completes manuscript for publication on periodic basis.
• Provide appropriate care specific to the age of the patient to ensure understanding and comfort level of treatment as outlined in the "Age Specific Criteria".
  • Demonstrates ability to identify opportunities for and give individualized customer service/patient care according to customer/patient needs.
  • Right Task
  • Right Person
  • Right Communication (clear, concise, correct, complete)
  • Right Feedback
• Staff/Multidisciplinary Team Resource
  • Serves as a resource for staff within expertise area on content for clinical patient care and outcomes.
  • Demonstrates knowledge of EBP and research as it applies to area of expertise.
  • Participates in the evaluation and development of evidence-based patient education.
  • Contributes to education of staff relevant to clinical area of expertise.
  • Assists in the development of clinical practice guidelines/standards that support implementation of EBP and current research in the specialty area.
  • Serves in leadership roles that promote continued improvement of services for palliative care patients (e.g. chairs committee, develops standards, policies, etc.).
• Patient Care – Care and Consultation
  • Provides timely initial patient and family assessments for palliative care consults.
  • Conducts, leads and facilitates palliative care consultation meetings and decision making using theoretical principals, skills and competencies of advanced nursing practice and palliative care.
  • Collaborates with other team members as appropriate in patient/family conferences.
  • Communicates effectively with patient and family for understanding of diagnosis, prognosis, care options and treatment plans.
  • Discusses assessment data, diagnostic and prognostic information with other team members and includes content as needed in goal setting discussions and care planning.
  • Performs relevant assessments, develops plans, assists in implementation and evaluates palliative care interventions.
  • Collaborates with other team members in the development and implementation of individualized plans of care.
  • Discusses findings and recommendations for plan of care with attending and consulting physicians and other team members as needed for continuity of care.
  • Consults with palliative care collaborating physician as needed, recognizing abilities and limitations.
  • Collaborates with other disciplines for discharge planning inclusive of financial needs and functional status.
  • Implements actions and provides