St. John's Medical Center

Hours Per Pay Period/Hours Per Week: Full Time (72 to 80 hpp/36 to 40 hpw)
Hours per day (shift): 8 hours per shift
Working days of the week (S/M/Tu/W/Th/F/Sa): S/M/T/W/TH/F/SA

***Up to $10000 sign on bonus DOE***
This position will serve Sublette Co, WY patient population, ideal candidate lives in or near Sublette County.
Provides skilled nursing care to individuals and families in neonate thru geriatric populations in the home setting based on the nursing process. Plans, implements, & evaluates nursing care through systematic assessment of health needs and optimal use of personnel. Provides supportive care to terminally ill patients and families before and after death while using the interdisciplinary team concept. Delivers patient care according to the Scope of Service for Home Based Services. Adheres to and practices the SJMC Corporate Compliance Program and participates in Performance Improvement activities.
Patient Care
Obtains & reviews all patient data using observational, interviewing, interpretation & critical thinking skills in an age, population specific and developmentally appropriate manner. Organizes & prioritizes care of multiple patients with varying levels of acuity in a timely & efficient manner.
Identifies risk factors & provides for patient safety. Implements measures to prevent injury from environmental hazards.
Practices autonomously & consistently with professional nursing standards.
Identifies changes in patient status & responds appropriately.
Exercises critical thinking & independent judgment within the context of a multidisciplinary approach to patient care.
Utilizes proper techniques in assisting physician or for a nursing intervention. Demonstrates appropriate preparation of patient for exam/procedure.
Carries out physician orders accurately and on a timely basis.
Develops a plan of care that is unique to each patient’s needs,reflecting measurable goals that are mutually set with the patient and family.
Evaluates patient response to the plan of care & evaluates the effectiveness of interventions towards established goals.
Evaluates response to pain management interventions. Demonstrates knowledge & awareness of medication action,side effects & protocols for use. Gives medications safely & accurately according to policy & procedure.
Utilizes the appropriate unit specific documentation system. Updates & completes all documentation thoroughly & in a timely manner.
Manages specimen collection, handling & disposition according to hospital policy.
Addresses patient & family’s spiritual & emotional needs utilizing a holistic approach.
Uses two patient identifiers consistently. Provides a clear & concise report when “handing off” a patient to another caregiver according to SJMC policy. Improves safety of medication use (i.e., correct labeling of meds/solutions/syringes/basins). Reconciles medications across continuum of care. Washes hands in accordance with CDC guidelines. Follows Universal Protocol policy consistently. Assesses patient for fall risk. Encourages patients’ active involvement in their care. Identifies safety risks inherent in patient populations served.
Uses supplies & equipment within safe parameters. Ensures equipment is functioning properly before use. Reports equipment malfunction following reporting procedure.
Initiates & completes Event Reports for unusual events consistently
Patient/Family Education
Assesses age/population specific and developmentally appropriate patient and family education needs.
Initiates & incorporates patient/family education into plan of care.
Identifies continuity of care needs for discharge & follow-up using appropriate resources.
Incorporates teaching/education into all aspects of patient care & nursing practice.
Communicates status report to patient and family as appropriate.
Assesses readiness to learn based on patient perception, educational level & expectation of care.
Assesses patient understanding of plan of care, available coping mechanisms & outcome expectations. Knows & articulates Hospice/palliative care philosophy. Educates families/patients/caregivers in supportive & comfort measures.
Provides clear information to assist the patient to make informed decisions
Unit Specific Performance
Participates in the Performance Improvement Process to improve care & professional nursing practice. Performs quarterly audits of charts & actively serving on PI committees to improve outcomes.
Adapts clinical skills to the Home situation. Creatively uses supplies, equipment & medications for the patient comfort & safety along with nursing interventions.
Anticipates possible negative outcomes, deterioration of condition as expected or crises & provides education, materials, & tools to assist patient/caregivers to cope. Plans care to provide monitoring of medical condition & a sense of security that patient is able to continue at home.
Coordinates & delivers care as ordered from all disciplines as the case manager, makes appropriate referrals, ensures visits are made as ordered, completes recertification, & assures appropriate discharges. Intervenes independently by changing the care plan if outcomes are less than desirable.
Charges supplies taken into patient home accurately. Checks medications delivered, returns signed receipts & disposes of medications when no longer being used.
Considers travel when making assignments & scheduling daily patient visits. Schedules patients appropriately for future visits.
Considers patients/caregivers as partners in their healthcare, teaches/instructs them in self-care techniques to foster a sense of responsibility & accomplishment for favorable outcomes. Plans future needs with patients considering living situation, financial factors & family dynamics.
Demonstrates proficiency with software/IS to assist in nursing practice.
Demonstrates equipment proficiency (oxygen sat monitors, Kangaroo pumps, CADD pumps, glucometers, gait belts, IV home pumps, portacaths, Hickman’s, PICC’s) 10. Provides resources, information & seeks info from HHA’s, MSW, Medical Director, M.D.’s & therapists. Collaborates with healthcare team to ensure a multidisciplinary approach to patient care
Professional Development
Maintains, develops & updates nursing skills to implement ideal patient care in the department.
Self-evaluates professional knowledge & actively seeks out educational opportunities for development.
Assists, teaches & answers questions for colleagues. Presents self as a resource at 1) the unit level and 2) at the organizational level. Mentors & precepts new staff at 1) the unit level and 2) at the organizational level.
Develops & provides educational instruction at the unit level (conducts in-services & is involved with competency review) & at the organizational level (teaches certification classes, i.e., BLS, ACLS, TNCC, ENPC; teaches & participates in the Code Blue Class; Identifies need & conducts mock codes).
Participates in development & updating of unit policies.
Attends & participates in committees or special projects at the unit level and at the organizational level.
Completes hospital wide & unit specific competencies in a timely manner.
Identifies need & completes national certification pertinent to unit. Applies to patient practice & standards
Minimum Education
BSN Preferred.
Minimum Work Experience
Required: Desire to work with chronically ill individuals and terminally ill persons and their families. Excellent communication, interpersonal, phone and customer service skills. Basic computer skills.
Preferred: At least two years acute care or home care experience preferred.
Required Licenses
Current Wyoming RN or valid multistate license required. Valid Driver’s License and reliable vehicle. Current BLS required.
Working Conditions
Care provided in patient’s place of residence which may present unsafe conditions. May encounter animals/pets and/or smoking environment. Office setting when not in field. Exposure to adverse weather conditions.
Physical Requirements
Driving to and from patient homes 20% of shift. Must be able to lift 50 pounds. Sitting, computer and phone use 40% of shift. Intermittent standing, walking, bending, reaching, pushing, pulling.
Direct Reports
None. SUPERVISES: Home care aides, nurse volunteers, Hospice direct care volunteers
Reports to
Director Home Care Services

Internal & External Contacts
Patients and their families, home care personnel, volunteers, hospital personnel, physicians, DME suppliers, clergy and other community agency staff.

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