General Statement of Duties: Reporting to the Medical Director, is responsible for coordinating palliative care and consult service referrals at contracted hospitals; collaborates with hospice medical director and physicians, hospital and hospice management and staff, and palliative consult team members; receives clinical supervision from hospice Medical Director. The collaborating physician and Palliative Care Nurse Practitioner will complete palliative care consultations, evaluations and recommendations.
• Functions under the direction and supervision of the collaborating physician in the assessment, diagnosis, treatment, and evaluation of the patient with acute and/or chronic illness.
• The designated hospital physician will countersign the history and physical and consultation record and all orders on the medical record.
• Care of patients and families in critical care areas by the Palliative Care Nurse Practitioner will be limited to the palliative scope of practice; assessment and treatment planning in symptom management and end of life care.
• Promotes and provides education related to palliative and end of life care.
• Make rounds on palliative care patients and document the findings of those rounds in the medical record.
• Obtains and records a problem-oriented health history including chief complaint, history of present illness, past history, family history, social history, and review of systems.
• Performs and records a complete physical exam with assessment of normal and abnormal findings.
• May recommend and evaluate diagnostic studies as indicated by patient presentation. Examples include, but are not limited to, blood chemistries, cultures, x-rays, EKG tracing, and CT scans.
• Evaluate patients’ physical and emotional response to prescribed treatment.
• May recommend medications within the guidelines of the state of Maryland and as indicated in the written agreement presented to the Board. All medication orders must be reviewed within 24 hours by the responsible physician.
• May recommend referrals from the appropriate ancillary modalities to include, but not limited to, respiratory therapy, physical therapy, speech therapy, and occupational therapy.
• Participates in development of data collection tools, communication processes and other details of consult service implementation and evaluation.
• Performs patient and family teaching in prevention, promotion, and health maintenance especially related to symptom management and end of life care.
• Collaborates with Care Coordinators in assisting the patient and/or family in identifying community resources and making referrals for follow up care as needed.
• Collaborates with the hospital clinical director and palliative team regarding hospital processes and protocol.
• Acts as a resource person for hospital staff, patients, and families especially regarding palliative care.
• Dictates consultations.
• Consults as needed in the assessment and diagnostic work up of those patients presenting to the Emergency Department for palliative care.
• Initiates evaluation and management of emergency situations (e.g., cardiac arrest, respiratory distress, injuries, etc.) until a more qualified provider is available.
• Serves as a patient advocate.
• Prepares reports for management.
• Performs other duties as requested.
• Demonstrates excellent customer service to both internal and external customers.
The Palliative Care Nurse Practitioner will daily communicate directly with the designated hospital physician concerning each patient. In the event of a medical emergency, or a circumstance beyond the scope of practice of the provider, the Palliative Care Nurse Practitioner will immediately notify the designated hospital physician. The functions of the Palliative Care Nurse Practitioner role will be in accordance with a written agreement approved by the Board of Nursing for the state of Maryland.
1. Registered nurse currently licensed in Maryland.
2. Current licensure as a Nurse Practitioner, Adult or Family Practice, in Maryland.
3. Two (2) or more year’s hospice or home care experience preferred.
4. Excellent communication and interpersonal skills.
5. Demonstrated knowledge of home care, hospice, palliative care, advance directives, pain management, symptom control, and discharge planning.
6. CPR certified.
7. Understanding and acceptance of Coastal Hospice philosophy of care and policies.
8. Motivation to work for the dying and bereaved according to the hospice concept and Coastal Hospice policies.