Visiting Nurse Association
Job Description


EMPLOYMENT STATUS:    Hourly, biweekly.
REPORTS TO:                     Clinical Services Manager
SUPERVISES:                      No one
WORKS CLOSELY WITH:   Other Private Duty Staff, Quality Manager, Team Assistant, Patient family.

SUMMARY OF DUTIES: Provides comprehensive nursing service to individuals and families in the home and community health setting.

JOB REQUIREMENTS: Graduate of an accredited school of Nursing and one year home health experience desirable.  Licensure as a registered nurse in Iowa.  Car, driver's license and adequate insurance as outlined in the personnel policies.  A physical examination is required at the time of employment.  Annual TB testing is required.  All offers of employment are conditioned upon the result of a criminal background check conducted by the Iowa Division of Criminal Investigation, as required by law and a negative finding on the Office of Inspector General’s Excluded Provider List.

WORK ENVIRONMENT AND EQUIPMENT:  Work is performed in clients' homes with the employee driving from location to location during the work period.  The locations are throughout Johnson County and within a 50-mile radius of the agency.  This area includes Iowa City, small towns and rural areas.  The driving requirements include in-town and highway driving in good and inclement weather.

SKILLS AND KNOWLEDGE/COGNITIVE DEMANDS:  The employee will demonstrate skill and knowledge in providing professional nursing care for the treatment of acute and chronic illnesses.   The employee will demonstrate organizational skills required to complete cares within established time frames. The employee will demonstrate the ability to communicate effectively in the English language, both orally and in writing.  The employee will demonstrate the ability to maintain and update professional knowledge base and the ability to assimilate and utilize agency information regarding policy and procedure changes.  The employee will demonstrate competence in professional decision-making skills within the parameters of the Nurse Practice Act, including the ability to make appropriate assessments, problem-solve, prioritize, follow Plans of Care and evaluate their effectiveness.  The employee will demonstrate the ability to use technology and equipment effectively and appropriately, including client care equipment.   The employee will perform the duties of the job at clients' homes and /or community sites during employed hours.  
PHYSICAL DEMANDS:  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 cares, 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 lbs., reaching, pushing, walking, going up and down stairs, driving, etc., with or without the use of assistive/adaptive devices.

ESSENTIAL DUTIES:  To be performed satisfactorily with or without reasonable accommodation.  The following duties are normal for this position.  While this list is intended to be an accurate reflection of the job, it is not to be construed as exclusive or all-inclusive.  Other duties may be required and assigned by the employer.

Provides comprehensive nursing services to individuals and families in the home or community setting which include:
•    Assessment
•    Problem identification
•    Goal setting
•    Plan and implement appropriate nursing interventions for clients or multi-problem families requiring skilled care or intervention.
•    Evaluate effectiveness of plans interventions
•    Uses the nursing process and reports appropriately to the Nursing Supervisor.
•    Delivers care and instruction that is appropriate to the patient’s age, condition, psychological, educational and socio-economic conditions.

Maintains knowledge of community resources; utilizes appropriately and coordinates services to meet needs of individuals and families.

Promotes optimal independence of clients as feasible while meeting their needs.

Performs client visits according to Plan of Treatment or as client needs dictate.

Follows Universal Precautions.

Coordinates care with other agencies or vendors involved in the client’s case.    

Participates in Quality Assurance activities.
Attends individual client case conferences as scheduled.
Assists with preparation of the Plan of Treatment and summary letter every sixty days.
Reviews the client care plan to assure that the information is correct and up to date, nursing interventions are appropriate and updated according to client need on an ongoing basis.
Collects documentation weekly from the client’s home and forward it to the Nursing Supervisor.
Utilizes the Communication Notebook to convey any changes or revisions in orders, etc., to update other field staff.

Establishes effective communication with clients and families, respecting client rights, acting as a patient advocate and involving clients and families in decision making as possible. 

Follows agency policies concerning scheduling in regards to schedule requests directly made by the client.

Communicates and obtains verbal orders from acting physician as needed. 

Provides Nursing Supervisor with clinical updates, reporting changes in condition, doctor’s orders and treatments as appropriate.

Completes and generates all necessary documentation accurately within the timelines determined by the agency and other regulatory body requirements.
    Examples of documentation standards include but are not limited to:

•    Nursing Assessments and care are documented on appropriate forms and completed during shift/visit.
•    Communication book is read prior to beginning assigned shift.
•    Communication book is updated with appropriate information.
•    Visit notes and time sheets are turned in weekly by Monday noon.

Follows appropriate communication channels. 

Maintains, up-grades nursing knowledge through continuing education programs, review of literature, etc., applicable to home and community health.  Submits documentation of such activities for personnel record.

Maintains current CPR and knowledge of expected performance in emergency situations.

Meets requirements for mandatory in-services:
•    Workplace safety
•    Infection Control
•    Age- Appropriate Care
•    Right To Know
•    Compliance
•    Dependent Adult/Child Abuse Recognition

Attends staff development in-services as scheduled. 

Meets annual competency requirements.

Participates as necessary in orientation, instruction, and demonstration of agency services or skills to other staff or students.

Participates in agency group meetings, including in-services, performance improvement activities, and staffings.

Represents the agency in community activities and meetings as required.

Develops and maintains professional relationships with all staff by:
•    Addressing concerns in a confidential and straight forward manner
•    Respecting and maintaining privacy

Maintains current knowledge of agency policy and procedures through attendance at required meetings and by review of written materials provided by agency.  Special attention is given to policies on Confidentiality, Standards of Conduct and Documentation. Incorporates changes into daily job activities.

Complies with personnel record keeping requirements (e.g. auto insurance documentation, licensure) on a timely basis.

Maintains knowledge of and complies with the Nurse Practice Act.

Participates in Quality Improvement Process by completing incident reports as needed.

Participates in additional short-term projects, as they arise.

Contributes to agency growth and development.

Performs other duties as necessary, including required participation in VNA emergency/ disaster plans.