Registered Nurse Home Care - Relocation Offered!

Analyzes and documents patient's and family's response to interventions. Evaluates measurable progress toward goals and revises plan of care. Identifies and modifies underlying factors that impede progress toward goals. Makes recommendations for update in plan of care, using knowledge of interventions and resources.


Collaborates with the patient's physician and staff in planning and evaluating patient care. Provides timely, pertinent written and verbal information to physicians and insurance case managers. Establishes visit schedule and informs patient/family and team supervisor. Uses wide variety of community and agency resources as needed to meet patient needs. Independently manages activities of caseload mix for patients. Independently organizes patient assignments for completion of tasks within acceptable time frames. Seeks assistance from Clin III, or supervisor regarding complex patient problems. Maintains necessary clinical records, collects data and prepares reports on activities. Submits completed admission records within 48 hours. Submits daily records within 24 hours. Recertification completed prior to recent date. Maintains caseload mix and productivity for acuity level of patients.


Contributes to the achievement of established goals and objectives and adheres to department policies, procedures, quality standards, and safety standards. Completes annual Code of Conduct, Compliance and other mandatory training. Complies with governmental and accreditation regulations.


Independently develops and documents individualized plan of care and includes patient and family in development and revision of plan and goal setting. Care plan includes specific care interventions with expected measurable patient outcomes. Establishes and documents teaching plan for patients/families.


Independently identifies comprehensive learning needs of designated patients. Independently develops teaching plans that specify time frames. Bases teaching and counseling plan on patient's level of knowledge, diagnosis, prescribed treatment and available resources. Utilizes demonstration, verbal and written instruction in order to carry out care plan. Independently evaluates effectiveness of teaching plan in meeting patient/family goals. Revises as needed


Independently implements and documents plan of care for patients with routine to complex problems to facilitate continuity of care. Documented interventions are related to plan of care. Interventions reflect standard of care for patient condition/diagnosis. Interventions include utilizing agency and community resources. Performs nursing procedures consistent with home care protocols. Interventions reflect knowledge of standard home care supplies and equipment used in patient care.


Is responsive to and communicates respectfully with patients/families, peers and other health team members. Initiates and participates in regularly scheduled case conferences; includes all disciplines. Includes patient and family in mutual goal setting and care plan revision.


Maintains effective working relationships with other departments and participates in multidisciplinary quality and service improvement teams. Participates in meetings and on committees and represents the department and agency in community outreach efforts. Enhances growth and development and enriches personal knowledge and skill through participation in educational programs and affiliations.


Performs history and assessment related to episode of patient illness. Identifies primary patient problems from assessment. Identifies discharge planning needs. Interprets abnormal clinical data to anticipate problems associated with changing patient status.


Performs other duties as assigned.


Demonstrates basic leadership skills as a Case Manager and with other responsibilities as required.




About MedStar Health MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation and research. Our 30,000 associates and 5,400 affiliated physicians work in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest visiting nurse association in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar is dedicated not only to teaching the next generation of doctors, but also to the continuing education and professional development of our whole team. MedStar Health offers diverse opportunities for career advancement and personal fulfillment.