The Palliative Care Nurse Practitioner (NP) functions as the Hospice and Palliative Care (HPC) Coordinator for VA Northern California Health Care System HPC Program and works in conjunction with other members of the HPC team. This Program is designed to provide palliative care consultation to patients and their families, in the outpatient clinic setting and as needed in the inpatient setting, who are facing a life-threatening illness. Performs assessment/data collection in an on-going systematic manner focusing on physiologic, psychosocial, cultural, spiritual and cognitive status: also evaluates nutrition, pain, and symptoms, provides patient/family education, ensures family involvement and patient advocacy. The Hospice and Palliative Care Coordinator is a pivotal member of the Palliative Care Consult Team (PCCT) and has the major responsibilities of: 1) Development of the palliative care program through program coordination, staff education, and acting as liaison with the PACT and subspecialty teams at the various sites and community agencies, in conjunction with other Palliative Care Coordinator(s) and team members. 2) Serve as liaison with VISN Hospice and Palliative Care Program Manager, and keeps the field informed of VISN and VHA National HPC Program developments; 3) Serve as consultant to the HPC programs for development, implementation and monitoring of Quality Improvement activities as appropriate; 4) Evaluation for appropriateness and oversight of Non -VA Care (community) hospice referrals; 5) Completes Palliative Care consults, and accurately documents coordination and care provided in CPRS. 6) Establish an effective relationship with the patient and significant others to facilitate the development of the care plan. 7) Demonstrate knowledge of the impact of actual or potential illness on the patient's developmental, physical, social, emotional, age, spiritual, economic, vocational, and leisure status. 8) Coordinate and collaborate with patients, families, communities, and members of the interdisciplinary team in assessing needs, setting goals, planning interventions, providing care, and evaluating outcomes. 9) Participate with patients, families, and other health care providers in collaborative decision making that reflects the understanding that care should be culturally sensitive, ethical, legal, informed, compassionate and humane, and within the boundaries of available economic resources. 10) Retains current knowledge of multidisciplinary resources, programs, and services, referring patients for community resources as appropriate. Demonstrates ability to collaborate and coordinate with all levels of services and disciplines. 11) Maintains effective working relationships with professionals and support personnel within the medical center and the community. 12) Applies critical thinking and analytical skills to identify barriers for optimal patient care delivery and utilizes processes improvement strategies to correct or improve current state. 13) Utilizes creativity and innovation. Recommends and participates in interdisciplinary opportunities to improve patient care or clinical efficiency. 14) Life Sustaining Treatment Initiative: Identifying, coordinating and referring appropriate patients for Goals of Care conversations to PACT/Specialty clinics. Completes LST orders as needed. Coordinate with Social Workers within the various Service lines to ensure that LST orders are completed for all patients enrolling into hospice. 15) Attend and Participate in Sacramento Valley Community Veteran Partnership meetings. 16) Obtain data, generate reports, attend meetings to obtain and present information as it pertains to the Hospice and Palliative Care Team. 17) Educate patients/family, staff and community about Hospice and Palliative Care. 18) Works collaboratively and inter-professionally with learners of all levels and disciplines, including but not limited to, trainees, students, interns, residents, and fellows. The Nurse Practitioner must exhibit professional and effective communication skills with other HPC as well as non HPC professionals. The Nurse Practitioner, furthermore, provides integrated palliative care through application of advanced clinical knowledge and experience in delivering safe, effective quality care to palliative care patients. This individual use consultation and communication skills in working with clinical services to achieve patient goals of care. This individual is responsible for other duties as assigned in support of coverage for other Geriatrics and Extended Care Programs. Work Schedule: Mon-Friday 0800-1630
Internal Number: 574439800
About Veterans Affairs, Veterans Health Administration
Providing Health Care for Veterans: The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,255 health care facilities, including 170 medical centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.