Covenant Health

Registered Nurse, Hospice

Full Time, 80 Hours Per Pay Period, Day Shift

Weekday and holiday on call requirements. Local travel required.

Homecare and Hospice Overview: 

Covenant Health HomeCare and Hospice is the area’s largest locally owned home health and hospice provider, with one of the largest rehabilitation departments in East Tennessee. Our HomeCare and Hospice services are part of Covenant Health, East Tennessee’s largest nonprofit health system and a Becker’s “Top 150 Places to Work in Healthcare.” Covenant Health includes nine hospitals and nearly 150 service locations, offering employees a comprehensive benefits package with tuition reimbursement, student loan assistance, certification bonuses, and leadership development programs. 

Position Summary:

Provides professional nursing care to an assigned group of terminally ill patients; coordinates care planning working in conjunction with the interdisciplinary team to ensure the best possible outcomes for patients’ duration of life. The Hospice RN reports to the assigned Hospice Clinical Supervisor.

• Conducts initial and ongoing assessment of the impact of the terminal illness on the patient’s physical, functional, psychosocial and environmental needs and activities of daily living.
  • Facilitates a palliative Milieu in the home that promotes a smooth transition at time of death.
  • Risk for pathological grief
  • Cultural and spiritual implications
  • Verbal and non-verbal communication patterns
• Implements the individualized plan of care and recommends revisions to the plan as necessary.
  • Symptoms management focused care prioritizing comfort at end of life by reducing pain and suffering.
  • Specialized nursing skills related to palliative and end-of-life care
• Consults with and educates the patient/family regarding:
  • The terminal dx disease process
  • Self-care techniques
  • End-of-life care
  • The processes for dealing with issues of ethical concern
• Initiates appropriate preventive and rehabilitative nursing procedures.
  • Pressure ulcer prevention
  • Pain crisis prevention
  • Bowel impaction prevention
  • Care of bed confined patient
• Prepares clinical and nursing notes that reflect the progression of disease process at the end of life as it takes its normal course.
• Coordinates all patient/family services and prioritizes needs with the members of the interdisciplinary team thru daily communication prn and or bi-weekly IDG.
• Uses case management approach and referring to other services as needed.
• Act as liaison between the provider and patient/family. Communicates to provider, orders received and processed and communicated to family. Informing the Provider and other staff of changes in the patient’s needs.
• Determines scope and frequency of services needed based on acuity and patient/family needs. Updates POC as needed and adjusts visit calendar frequency. Develops and oversees HHA POC individualized to the specific needs of the patient.
• Supervises LPNs and Hospice/Home Health Aides providing services. Assists in orienting new employees.
• Provides specialized hospice training to other staff, family members, and informal caregivers to insure adequate care.
• Performs on-going evaluation of patient/family response to education and care provided.
• Assesses the ability of the caregiver to meet the patient’s immediate needs upon admission and throughout care. Advocates for respite care as needed.
• Has working knowledge of Medicare guidelines, and performs in compliance with such guidelines.
• Follows appropriate admission, discharge, on-call, and death procedure as outlined by Covenant HomeCare policy.
• Performs basic infection control techniques according to Covenant HomeCare policy; examples are proper Bag technique, proper hand-washing, glove usage, appropriate handling and disposing of wastes, body fluids, contaminated trash, and needles, proper handling of soiled or contaminated linens or garments, cleaning all equipment used in the home properly.
• Preplans appropriately including scheduling with patient/care giver ETA to the home.
• Demonstrates knowledge and competency in providing for age-specific, culture-specific, and religious-specific needs of the population served.
• Demonstrates ability to perform skills on annual skills check list.
• Required travel all counties served by Covenant Hospice
• Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.
• Performs other duties as assigned.

Minimum Education:           

Graduation from an accredited school of nursing

Minimum Experience:         

One (1) year of profession experience in hospital or prior home health experience. Clinical experience pertinent to Hospice, including oncology, palliative, end of life care, etc. preferred.

Licensure Requirement:      

Must have and maintain Tennessee RN licensure. CPR required. Employee must have a valid Tennessee driver’s license Class D and state mandated minimum insurance coverage. Driving record must meet Covenant Health minimum standards at the date of hire and throughout employment tenure.