Job Responsibilities:

• Utilizes basic physical and psychosocial skills by identifying actual/potential nursing/clinical problems based on bio-psycho-social- spiritual assessment data of the client and their families or caregivers and documents findings.
• Initiates and establishes comprehensive individualized nursing plan of care within 24 hours, reflecting admission through discharge planning;
• Demonstrates critical thinking in application of the nursing process.
• Develops patient centered goals , in collaboration with clients, their families and the rehabilitation team that are oriented to wellness behavior, are reality based, encourage socialization with others and promote maximal independence for patients with disabilities or chronic conditions .
• Recognizes and documents subtle changes in patient’s condition, including complex patient care situations, and follows through with appropriate nursing action.
• Functions independently and effectively in emergency situations. Acts as a resource to other members of the health care team.
• Completes documentation according to guidelines and regulations
• Evaluates the outcome of care and revises the plan of care appropriately to achieve desired outcomes.
• Plans own work and the work of assigned staff in appropriate priorities and sequences; delegate’s tasks as appropriate; coordinates patient care efforts to be complete during the designated shift in a timely manner.
• Completes a medication reconciliation at each skilled nurse visit and updates clinical team and physician of any changes, noncompliance, and or side effects
• Administers medications and treatments as ordered, evaluates patient response and documents appropriately. Anticipates adverse reactions.
• Demonstrates professional communication skills.
• Develops and documents the teaching and discharge plan including complex and needs of patient and family. Documents progress according to outcomes.
• Designs and implements the nursing plan of care and treatment strategies based on scientific nursing theory related to self-care and that promote physical, psychosocial and spiritual health.
• Applies nursing research to clinical practice and utilizes evidence based practice guidelines and interventions that are patient/family centered.
• Independently completes all appropriate nursing skills and interventions according to specialty competency based skills checklist. Updates skills. Teaches new skills.
• Intervenes and attempts to resolve patient and family problems by providing psychosocial and emotional support; contacts other resources as necessary and documents appropriately.
• Consistently delivers patient care according to the established plan of care; modifies plan of care in response to actual and anticipated changes in patient needs.
• Completes all OASIS according to guidelines in timely and effect manner. Holds self-accountable for being proficient in OASIS and remaining competent through all updates.
• Demonstrates therapeutic communication skills when interacting with patients and families;
• Functions as a patient advocate with other members of the health care team.
• Maintains professional communication skills when interacting with others; facilitates a harmonious working environment.
• Initiates formal/informal patient care conferences as needed to coordinate direct patient care efforts and optimize outcomes.
• Collaborates with the interdisciplinary team in care planning and care delivery
• Participates in the interdisciplinary team process at team conference/case conference and other team meeting
• Identifies and intervenes for peer, patient and family education needs.
• Professional development; maintains skills appropriate to practice and experience.
• Promotes professionalism based on the established scope and standards of Rehabilitation Nursing Practice and the American Nurses Association
• Participates in team-based committees.
• Participates in staff meetings.

Qualifications:

• Registered Nurse licensed in the state of Florida
• 1 year of Home Health experience required
• Current hands-on CPR/BLS Certification

• English proficiency