- Conducts rounds on patients of Med/Surg Acute floor and residents of Long-Term Care Facility. Rounds on residents of at least one-half patients in each LTC facility for monthly visits, MD to perform on other half of census. Also evaluate patients as needed/requested by nursing for acute medical, social, behavioral problems or change in condition.
- Documents all encounters, orders, changes, progress notes, monthly notes in hospital electronic medical record.
- Rounds regularly on residents of the skilled nursing facility and patients in Acute and participates in the on-call coverage of the unit.
- Demonstrates the ability to perform physical exams on all patients.
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- Obtains and documents patient’s medical history. Identifies health risk factors.
- Demonstrates the ability to assess patient/resident needs and provide the appropriate level of care through the ordering and interpreting of diagnostic and laboratory tests, diagnosing illness and disease, prescribing medication and formulating treatment plans.
- Demonstrates the ability to diagnose and treat acute and chronic illnesses.
- Performs all aspects of patient care in an environment that optimizes patient safety and reduces the likelihood of medical/ health care errors.
- Demonstrates the ability to prescribe medications and IV fluids (see individual state laws) and non-pharmacological therapies based on the patient’s diagnoses, health history and age.
- Encourages positive health behaviors for the maintenance of health and the prevention of disease. This is done through education and counseling.
- Always applies standardized care guidelines in clinical practice.
- Provides patient and/or family with health education, counseling and referrals to other healthcare professionals and community resources within appropriate.
- Assesses and documents patient and/or family psychosocial issues.
- Treats patients, families, and other members of the care team with respect and dignity.
- Collaborates with physicians and other members of the health team to plan optimal care for the patient/ resident.
- Works with the patient and family and staff to formulate a treatment and education plan.
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- Functions as a patient advocate.
- Demonstrates the ability to be flexible, organized and function under stressful situations.
- Participates in performance improvement and continuous quality improvement (COI) activities.
- Stays current with medical advancements, new technology, new drugs through continuing education classes, society meetings, professional journals, etc.
- Follows the five medication rights and reduces the potential for medication errors.
- The FNP will practice as part of a team under the direction of their supervising physician.
- In depth knowledge of patient care clinical standards, systems, external regulations, and internal policies.
- Examines patients, performs comprehensive physical examinations, and compiles patient medical data, including health history and results of physical examination.
- Administers or orders diagnostic tests, such as imaging studies, electrocardiogram, and laboratory tests, and interprets test results for deviations from normal.
- Performs therapeutic procedures such as injections, immunizations, suturing and wound care, and managing infection.
- Performs other department specific diagnostic or therapeutic procedures.
- Develops and implements patient management plans, records progress notes, and assists in provision of continuity of care.
- Instructs and counsels patients regarding compliance with prescribed therapeutic regimens, emotional problems of daily living, and health maintenance and other relevant patient education.
- Facilitates admissions, transfers, and discharges for both the acute and long-term care units.
- Rounds on residents of the skilled nursing facility and participates in the on-call coverage of the unit.
- Performs admission evaluations on patients to include obtaining basic medical information and history, reviewing patient's medical record, performing physical exam, documenting findings into patient medical record, and reporting deviations from normal findings to attending physician.
- Reviews patient chart noting allergies, pertinent medical history, and abnormal physical findings.
- Facilitates patient discharge; dictates discharge and transfer summaries in a timely manner.
- Communicates effectively with patients, physicians, nurses, therapists, social workers, and other staff as necessary to assure proper diagnosis and treatment.
- Obtains, compiles, and records patient medical data, including health history, progress notes and results of physical examination.
- Ensures efficient and thorough documentation of visits as required per regulatory guidelines.
- Signs care plans, gives nursing orders and PT orders, orders the use of appropriate medical equipment, and signs all required documents such as face-to-face encounter forms, plan of care forms, etc.
- Attends all departmental, organizational, and medical staff committee meetings as appropriate.
- Serve as an effective member on departmental and multidisciplinary committees which impact or determine policies affecting nursing practice.
- Assists with development and implementation of specific policies and procedures.
- Implement educational programs and act as a resource to staff
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