REGISTERED NURSE (Michigan Visiting Nurses)

This position is responsible for serving as a primary nurse and providing skilled nursing services to adult patients (generally 18 years of age and over) in their homes.  This position is responsible for assessing the nursing needs, including the physical, psychosocial, developmental, and environmental needs of patients and families.  The Visiting Nurse provides home health services which meet all state, federal, accreditation, and payer regulations.  The Visiting Nurse exercises independent judgment in day to day responsibilities, including the establishment of the plan of care and the provision of home health services.  The Visiting Nurse assigns and supervises Home Health Aides and Licensed Practical Nurses and collaborates with the patients primary and specialty physicians to develop, implement, and evaluate the individual plan of care.  The Visiting Nurse completes nursing procedures and treatments safely and in accordance with accepted professional standards of care.  The nurse is responsible for patient teaching, and counseling patients and families regarding self-care and evaluating the patients response to care.  The Visiting Nurse initiates appropriate referrals to other home health disciplines as necessary and as a multidisciplinary team member, collaborates to coordinate and evaluate care.  The nurse coordinates the daily visit schedule with the office staff and maintains acceptable standards of productivity.

Characteristic Duties and Responsibilities:

Admission/Assessment/Discharge

• Ensures patients are eligible for home care services and meet all required program guidelines.

• Exercises independent judgment in day to day responsibilities.

• Completes accurate comprehensive nursing assessments, including OASIS dataset when applicable, to identify physical, psychosocial, developmental, and environmental needs of the patient.

• Educates the patient and family regarding home care services and assists them in independence with care.      

Case Management

• Ensures that the care provided is safe, effective, patient-centered, timely and efficient.  This approach achieves optimum value and desirable outcomes for all ? the patients, their support systems, the providers and the payers.

• Facilitates the achievement of patient wellness and autonomy through advocacy, assessment, planning, communication, education, resource management and service facilitation.

• Secures and maintains complete physician orders within regulated time frames.

• Develops, updates, and maintains plan of care based on the initial and ongoing assessment of patient and family needs, meeting all regulatory time frames.

• Communicates and interacts with patients and families/caregivers in a positive, effective, and professional manner.

• Coordinates the plan of care with other nursing staff, physical therapists, occupational therapists, speech language pathologists, home health aides, dieticians, and medical social workers, and documents for inclusion in the medical record.

• Provides effective case management of assigned patients including the utilization of appropriate disciplines, achievement of quality metrics, cost-effective services and the appropriate use of medical supplies. 

Patient and Family Centered Care

• Actively engages the patient and family by exhibiting respect and dignity, sharing information in a timely and unbiased manner, and welcoming and encouraging participation to achieve shared decision making.

• Collaborates with other members of the team, including the patient and family, to achieve the ideal patient care experience.

Delivery of Care

• Performs and submits timely documentation of nursing assessments, procedures, and interventions in the home according to the plan of care.

• Ensures that patients meet insurance requirements for home health services.

• Adheres to all UMHS and agency infection control and safety policies.

• Delivers nursing care according to departmental and professional standards of care.

• Manages assigned patient caseload, and maintains departmental productivity standards.

• Teaches and/or supervises family members and other caregivers in the care of the patient, seeking to encourage the maximum amount of independence with the care.

• Accountable for utilizing all technology and equipment (i.e., cellular phones, point of care devices, computers, etc.) according to department expectations and policies.

• May also see patients under age 18 if specific pediatric competencies have been met and pediatric competency checklist has been completed.

Supervisory and General

• Supervises and assigns Licensed Practical Nurses and Home Health Aides.

• Directly supervises nursing students as assigned.

• Assists in the planning, organization, implementation, evaluation and supervision of student training and provision of care and services.

• Works up to two weekends out of every four weeks; holiday and evening rotations as assigned. 

• Communicates effectively and professionally with colleagues and provides support for smooth functioning of nursing teams.

• Updates required employee information as necessary.

Other Related Duties:

• Complies with all University of Michigan and departmental standards and expectations.
• Supports the departments commitment to continuous improvement activities and principles through positive and respectful contribution in all problem-solving and change processes at Home Care Services.
• Performs other duties as assigned.

Physical Demands:

The employee will be able to perform the assigned duties and responsibilities with or without reasonable accommodations.

The duties include performing skilled physical assessments and various skilled nursing activities, such as changing dressings, providing medication via IVs and injections, drawing blood, assisting with personal care, exercises/ambulation, auscultation of lung and bowel sounds, etc.  The duties also include the use of equipment for client care, such as oxygen equipment, suctioning, medication dispensers, laboratory screening meters, and IV pumps. This position requires knowledge of the use of laptop computers, and cell phones for documentation and communication.   These duties require fine motor coordination/dexterity, the ability to grasp, vision with or without corrective aids adequate for fine motor tasks, client assessment, and driving.  The job requires the physical demands of occasional lifting greater than 50 pounds, reaching, pushing, walking, going up and down stairs, driving, etc., with or without the use of assistive/adaptive devices.  Employee drives personal or University owned vehicle to various work site locations on a regular basis including in-town and highway driving in good and inclement weather.  

Work Environment:

The job requires the health care professional to work with the patient in the patients home. Must be able to travel from point A to point B throughout the workday in all kinds of weather as assigned.  Environmental factors of the patients home are not within the control of the Health System (i.e., whether or not there is a smoker in the home, pets, apartment complexes, home entrance, etc.).

OCCUPATIONAL HAZARD INFORMATION: Staff members may have routine exposure to all chemical inventory, inclusive of hazardous materials, housed at all work sites for Home Care Services, including but not limited to: the office, hospital, clinics, vehicles and warehouse. Chemical inventory reference materials are available to all staff in the form of hard copy and on-line Material Safety Data Sheets. Staff may carry out assignments in patient?s homes, hospitals, clinics and HCS offices. Staff may drive personal or University owned vehicle and walk on uneven surfaces to these various work site locations in all weather conditions on a regular basis.

• Current licensure to practice nursing in the State of Michigan
• Two (2) or more years of acute adult medical surgical and/or home care experience in the last 5 years
• Direct experience with all types of vascular access devices, wound care, and oxygen therapies
• In-depth experience in patient education (i.e. self-care, disease management state)
• Ability to travel from point A to point B throughout the workday as assigned

Expectations of the position:

• Ability to work independently in a multidisciplinary, fast-paced environment as demonstrated by interview, professional references and performance evaluations
• Ability to demonstrate excellent problem solving and triage skills
• Excellent communication and customer service skills
• Demonstrated proficiency with computer skills, Microsoft Word, e-mail, and smart phones

NOTE: Required qualifications must be met by the candidate in order to be interviewed and considered for the position.

RESUME REQUIRED (for both internal & external applicants): 
You must attach a complete and accurate resume to be fully considered for this position

  Home care experience as a Registered Nurse within the last two years
. Certification in home care related specialty; i.e. wound care, ostomy certified, cardiac rehabilitation, diabetes, COPD
. BSN
. Experience in teaching and developing patient education materials
. Experience with EPIC Home Health

Required qualifications must be met by the candidate in order to be interviewed and considered for the position. Posting may be filled after the initial 5-day posting period.
Applicants who have left the UMPNC bargaining unit must include on their resume dates of past employment including months and years of service along with effort. Positions less than 20 hours/week may be combined.

If you have questions regarding this posting or would like assistance with nursing opportunities please contact Nurse Recruitment at (734) 936-5183.

Appointment: 40 Hours 
Shift:: Day shift, with rotating weekends and evenings.

Location: Michigan Visiting Nurses

Note: All new employees will be expected to float to a designated unit(s) in times of low census.

This position is covered under the collective bargaining agreement between the U-M and the Michigan Nurses Association and the U-M Professional Nurse Council union, which contains and settles all matters with respect to wages, benefits, hours and other terms and conditions of employment.

Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third-party administrator to conduct background screenings.  Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.

In addition to the screenings indicated above under Michigan law, a criminal history check including fingerprinting is required as a condition of transfer or employment for this position.

Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally.  Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.

The University of Michigan is an equal employment opportunity employer.