The On-call RN is responsible for calls from referral sources, calls related to patient care, and any visits related to these calls including administrative workflow. This position works 7 consecutive days and is off 7 consecutive days. The work schedule includes: 1) Evening call, each weekday (Monday-Friday) beginning at 1630 and ending the following morning at 0800, and 2) Weekend call, beginning on Friday at 1630 and ending Monday at 0800. May also be responsible for any Holiday hours in their assigned week. Unless visiting a patient or completing weekend requirements (hospital list/transfer OASIS), the On-call RN has the flexibility of working from home. They determine patient eligibility for care, complete OASIS assessments, and develop evidenced-based individualized care plans following established professional standards of care, Agency policies, State laws, Federal laws and regulations. The On Call RN is integral to optimal quality and process outcomes.

1. Responds to all answering service calls:
   • Communicates with patient/family.
   • Establishes positive working relationships with physicians and physician’s office staff and keeps         them informed of patient’s problems and progress towards goals as appropriate
   • Assists patient/family (phone or visit) to prevent exacerbation of condition and/or prevent avoidable emergency room visit or hospitalization.
   • Provides the Clinical Managers with a summary of all activity, interventions, and recommendations.
2. Responsible for performing chart audit activities as assigned.
3. Provides skilled nursing care:

• Revises the plan of care as appropriate, based on patients identified needs and progress toward goals.
• Reviews and updates the medication list.
• Communicates activities related to patient care with the RN Care Manager.
• Assess patient’s outcomes and offer suggestions on ways to improve outcome scores.
• Completes all required documentation in the EMR.

4. Checks the DCH hospital list on weekends (Saturday and Sunday).
   • Completes a Transfer OASIS on patients admitted and remaining in the hospital for 24 hours.
   • Communicates all findings with the Administrative RN/Manager on-call.
5. Provides Clinical Manager with a summary each morning by 0800.

• Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation.
• Performs compliance requirements as outlined in the Employee Handbook
• Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self.
• Requires use of electronic mail, time and attendance software, learning management software and intranet.
• Must adhere to all DCH Health System policies and procedures.
• All other duties as assigned.

6. Completes visits of any type assigned. Completes an initial assessment of patient and family to determine home care needs. Provides a complete physical assessment and history of current and previous illness/es.

• At the initial assessment, explains patient’s rights and expectations, HIPAA as it relates to confidentiality of medical information and OASIS data, advance directives, and informs the patient and family of expected disciplines and frequency. Reviews changes as they occur throughout the episode of care.
• Develops a plan of care that corresponds with physician orders, which establishes goals based on nursing diagnosis and incorporates therapeutic, preventive, and rehabilitative nursing actions. Includes the patient and family in the planning process. Makes revisions to the plan of care as patient status and needs change. Communicates as needed with and updates the primary physician when necessary.
• Re-assesses patients within 24-48 hours following a change in condition or discharge from an inpatient setting and updates the plan of care.

7. Provides supervision of LPNs and home health aides per regulatory requirements,
8. Supports and promotes Agency policies and practices.
9. Maintains communication with team members.
10. Maintains a continuing knowledge of competencies related to the Nursing profession by participation in Agency sponsored education and training as well as personal growth through independent study
11. Attends mandatory Agency meetings and in-services.
12. Participates in Quality Improvement and Corporate Compliance activities as assigned.
13. Performs chart audit activities as assigned.

DCH Standards:

• Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation.
• Performs compliance requirements as outlined in the Employee Handbook
• Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self.
• Requires use of electronic mail, time and attendance software, learning management software and intranet.
• Performs essential job functions in a manner that ensures the safety of patients, visitors, and employees.
• Identifies and reduces unsafe practices that may result in harm to patients, visitors, and employees.
• Recognizes and takes appropriate action to reduce risks and hazards to promote safety for patients, visitors, and employees.
• Must adhere to all DCH Health System policies and procedures.
• All other duties as assigned.

Registered Nurse with a current Alabama license.  Two years of registered nurse clinical experience required with at least 6 months of home health or hospice experience.  Prefer extensive clinical knowledge and experience in the care of patients with multiple and complex diagnoses, disease processes and care needs. Prefer Working knowledge of OASIS and working knowledge of computer systems. Excellent coordination and communication skills. Detail oriented and able to work with minimal supervision. Must be able to read, write legibly, speak, and comprehend English. Must have current BLS certification or be able to obtain within 60 days of employment and before first independent patient visit. 

WORKING CONDITIONS

Is able to lift 50 pounds, turn and position patients weighing over 200 pounds.  Ability to stand, walk, kneel, sit, crouch or stoop with good balance for extended periods of time.  Must be able to maneuver over a variety of uneven surfaces including fields, grass, ditches, gravel, concrete, wood, vinyl, or carpet.  Good manual finger dexterity.  Must have good communication skills.  Must be licensed and insured to operate a motor vehicle.  Must have tolerance in a variety of environments to include the presence of pets and infestation.

Physical presence onsite is essential.  Hearing and vision must be normal or corrected to within normal range.  Able to perform the duties with or without reasonable accommodation.