The Clinical Registered Nurse, Home Based Primary Care (HBPC) is located within Geriatrics and Extended Care Service, at the North Florida/South Georgia Veterans Health System in Ocala CBOC in Florida. The Clinical Nurse (HBPC) position is located at the Ocala CBOC. The address, 1515 Silver Springs Blvd. Ocala, FL 34470 The Registered Nurse, Home Based Primary Care (HBPC) role may support the provision of care by others to the HBPC population, Medical Foster Home and Veteran Directed Care populations. Duties include, but are not limited to: Functions as a registered nurse in the Veteran's home environment Developing and coordinating the patient's plan of care to include ongoing assessment and re-assessment, care planning, care coordination, monitoring, and evaluating clinical outcomes. Evaluates Veteran's health, as well as family, and psychosocial history to identify health care needs and initiates or revises plan of care based on polices of HBPC Performs physical examinations, using nursing techniques of inspection, palpitation, percussion, and auscultation Uses appropriate instruments and orders and performs relevant diagnostic tests Provides health teaching to Veterans and their families related to present health problems, prevention of illness, accidents, and health maintenance for them to assume more responsibility for their overall health care and to optimize clinical outcomes and support quality of life decisions Interacting, coordinating and advocating for the patient/caregiver with other relevant parties across a continuum of care, beyond a single episode of care, ensuring seamless transitions. Providing intensive care management which may include educating veteran on medication and treatments; initiates referrals, consultations, community follow ups and equipment and supply orders as appropriate. Linking Veterans with community resources. Coordinating resources for comprehensive care to avoid duplication of services and streamline staff interaction and services with the Veteran. Participating in the development of the individual plan of care at interdisciplinary care meetings for assigned panel of patients. Work along with the APRN and other disciplines as part of the HBPC PACT team to provide care to a panel of his/her patients. This position will require a great deal of driving and very significant case management duties. The role may support the provision of care by others to the HBPC population, Homemaker/Home Health Aide population, Home Hospice and Intermittent Skilled Services patient population and Contract Nursing Home population. The incumbent may also help with patient care needs in other areas of HomeCare/HBPC as needed, or other duties as assigned by the Associate Chief of Staff for Geriatrics and Extended Care &/or the Chief, Home & Community Based Care. Work Schedule: Monday - Friday, 7:30 am. - 4:00 pm. or 8:00 am. - 4:30 pm. Telework: Not Available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized PCS Appraised Value Offer (AVO): Not Authorized Financial Disclosure Report: Not required
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.