Nurse Navigator Palliative BWH

Site: The Brigham and Women's Hospital, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Job SummaryFULL TIME 40 HOURS MAIN CAMPUS BWH BOSTON/ 40 Hours Variable Rotating Shift/ Staff Nurse/ Care Coordinator/ NavigatorThe PALLIATIVE CARE RN NAVIGATOR for the inpatient consult service serves as a central coordinator in managing referrals, patient flow, and care transitions for patients with serious or complex illness. This role is responsible for receiving inpatient palliative care consult referrals from a variety of sources, including inpatient providers, outpatient clinics, and the emergency department, and collaborating with referring clinicians to obtain additional clinical and psychosocial information necessary to appropriately triage and prioritize referrals. Prioritization is based on symptom burden, acuity of illness, goals-of-care needs, and patient/family support requirements to ensure patients with the most urgent palliative care needs receive timely intervention. The RN Navigator facilitates communication and coordination among interdisciplinary teams and specialty services to promote continuity, consistency, and alignment of care plans across the continuum. The role may also include participation in interdisciplinary huddles with Emergency Department, Palliative Care, Case Management, and other clinical teams to assess patient appropriateness for established care pathways and program protocols. The RN Navigator educates clinicians and staff on pathway criteria, supports appropriate patient entry into designated programs, and monitors patient progression through the continuum of care to ensure timely placement into the next appropriate level of care or disposition setting. In collaboration with these clinical teams the RN Navigator gathers pertinent clinical and social information to determine the most appropriate service line, level of care, and care setting within the health system, helping to optimize patient flow, resource utilization, and patient-centered outcomes.SummaryThe Registered Nurse is a professional nurse registered in Massachusetts who is responsible and accountable for planning and providing patient care for assigned patients in accordance with Nursing Standards of Care as set forth in the Nursing Department's Clinical Practice Manual. The registered nurse demonstrates initiative, knowledge and clinical skills in caring for the patient with complex needs. The Registered Nurse demonstrates the ability to effectively manage patients by assuming full responsibility for the assessment, plan, implementation and evaluation of patient care and is directly responsible to a designated nurse manager, or supervisor. Essential Functions-Organization of Patient Care• Accountable for assessing, planning, implementing and evaluating a plan of care for a specific patient assignment.• Sets priorities when organizing care for patients with varying acuity.• Maintain continuity through clear and concise (verbal and written) communication.• Demonstrates appropriate knowledge of growth and development of the adult and geriatric patient. In areas, such as the NICU and Obstetrics the principals of growth and development are applicable to the neonate. -Quality of Care• Documents patient care in a manner that is clear, complete, concise and in compliance with nursing documentation standards.• Develops a comprehensive plan of care based on data from an initial assessment of patient and family, information from other members of the health care team, intra-agency referral and previous medical records.• Develops a comprehensive educational plan for the patient and family, utilizing appropriate resources and documents according to the department’s documentation standards.• Develops a comprehensive discharge plan utilizing appropriate resources and referrals including community resources.• Evaluates the effectiveness of the plan of care, and documents progress in meeting stated goals. Revises plan of care as needed to achieve desired outcomes.• Participates actively in the unit-based and organizational quality management and/or quality improvement programs.• Provides a safe environment for patients, staff, family and visitors.• Administers medication safely according to established policies and procedures. • Performs nursing procedures safely and efficiently.• Uses equipment safely and efficiently.• Demonstrates awareness of potential/actual risks of infection and modes of transmission.• Utilizes universal precautions in nursing practice.-Coordination/Collaboration• Interacts with patients, families, and colleagues in a professional manner.• Collaborates with other discipline(s).• Develops, utilizes and evaluates unit-specific standards of care.• Upholds the A.N.A. code of ethics and acts as a role model to other staff members.• Participates in determining and implementing goals and objectives for the unit. • Participates in determining goals and objectives in the periodic review and evaluation. • Serves on unit-based and organizational committees and disseminates information to peers. -Education• Assumes responsibility for personal and professional growth through identification of own learning needs. • Shares knowledge and experience with colleagues.• Participates in unit-based and organizational educational programs.• Seeks and accepts guidance for additional learning needs.-Research• Utilizes nursing research findings in clinical practice.• Contributes to nursing and/or medical research endeavors by supporting investigators. -Budget• Utilizes time an