RN Field Clinician - Evening/Clinical Operations

***THIS POSITION IS ELIGIBLE FOR A $7,500 SIGN ON BONUS!!!***
(Must have two years of home health experience to qualify. Terms and Conditions apply.)

**Standard Schedule for the Evening RN: 1:00 p.m.–9:00 p.m.; scheduled days, weekends and holidays based on operational needs

The VNA is seeking an RN Field Clinician Evening/Clinical Operations to provide skilled professional nursing care and late-day clinical operations support for Home Health patients and the Home Health team during afternoon and evening hours. The position extends field capacity beyond traditional daytime operations through scheduled visits, same-day overflow, time-sensitive patient needs, late-day admissions and resumptions of care when qualified and assigned, changes in condition, urgent clinical field response, staffing contingencies, and continuity of care.
Patient care and urgent clinical needs are the first priority. When field demand permits, the RN supports designated Homecare Homebase (HCHB) clinical workflows to reduce avoidable workflow aging, support timely documentation and order follow-up, and prepare unresolved items for appropriate PCM or next-day review. The RN may complete workflow items only when the action is within RN scope, assigned authority, established protocol, and supported by sufficient clinical information. The Patient Care Manager retains accountability for supervisory decisions, complex clinical management, and functions requiring PCM approval. From the conclusion of normal business hours through 9:00 p.m., the RN also serves as the designated field-response clinician for clinically appropriate after-hours patient needs following telephone triage. This position is not the designated telephone triage/on-call role unless separately assigned.
Incorporates and demonstrates the VNA Core Values of Integrity, Collaboration, Accountability, Respect, and Excellence in all aspects of the role.

Responsibilities:
1. Provides skilled nursing visits in accordance with the plan of care, practitioner orders, organizational policies, professional standards, and applicable regulatory requirements.
2. Provides flexible afternoon/evening capacity for scheduled visits, same-day overflow, time-sensitive care, staffing gaps, and care that cannot reasonably or safely be deferred to the next day.
3. Serves as the primary field responder through 9:00 p.m. for clinically appropriate after-hours needs following RN telephone triage and established dispatch/escalation processes.
4. Performs comprehensive and focused assessments; recognizes clinical deterioration, medication concerns, safety risks, caregiver concerns, and changes in condition requiring intervention or escalation.
5. Initiates appropriate nursing interventions within scope and promptly communicates significant findings to the practitioner, PCM, on-call RN, or appropriate clinical leader.
6. Supports avoidable hospitalization/ED reduction through timely assessment, intervention, practitioner communication, patient/caregiver education, and appropriate escalation.
7. Recognizes emergencies requiring EMS/911 and initiates emergency response procedures when indicated.
8. Performs wound care, medication management, disease-management interventions, specimen collection, catheter care, infusion services, and other skilled procedures for which competency is validated and orders are present.
9. Performs medication reconciliation as applicable and identifies discrepancies, adverse effects, adherence concerns, high-risk medications, and education needs.
10. Provides individualized patient/caregiver education using teach-back regarding disease management, medications, symptom recognition, safety, emergency planning, and the plan of care.
11. Completes SOC, ROC, recertification, or other comprehensive assessments when assigned and only after successful validation of applicable Home Health and OASIS competencies.
12. Reviews relevant patient information, orders, recent documentation, medications, risks, and care-team communications before providing care.
13. Coordinates with the RN Case Manager, PCM, therapy, HHA, Workforce Coordination/Scheduling, practitioner, on-call RN, and other interdisciplinary team members.
14. When patient-care demand permits, works assigned HCHB workflow queues/worklists in accordance with established role permissions, protocols, and priorities.
15. Reviews designated HCHB workflow items for completeness, aging, missing information, outstanding documentation, routine order/document coordination needs, and other items appropriate for RN follow-up.
16. Completes routine HCHB workflow actions when the required action is within RN scope and assigned authority and the clinical record contains sufficient information to support appropriate completion.
17. Follows up with clinicians regarding routine missing or incomplete documentation and routes items requiring correction by the original clinician back to that clinician; does not rewrite, alter, or author documentation on another clinician's behalf.
18. Prepares and routes workflow items requiring PCM review by identifying the issue, relevant clinical information, actions already taken, and the specific decision or follow-up needed.
19. Does not independently perform or close functions requiring PCM supervisory approval, complex care-management judgment, performance-management action, or other authority specifically assigned to the PCM.
20. Escalates changes in condition or urgent clinical issues identified during workflow review rather than allowing the item to remain in a routine queue.
21. Supports routine follow-up of outstanding clinical documentation and orders in accordance with established organizational workflows; unresolved or aged items are escalated according to defined thresholds.
22. Maintains patient care as the priority and immediately shifts from workflow-support activities when scheduled, urgent, overflow, or after-hours field needs arise.
23. Provides a clear end-of-shift handoff to the overnight on-call and/or next-day team for patients and workflow items requiring follow-up, including changes in condition, new orders, unresolved concerns, aging items, and next actions.
24. Promptly reports inability to reach a patient, refusal/declined care, inability to safely complete a visit, missed visits, incidents, and other exceptions through established workflows.
25. Completes accurate, clinically meaningful, timely documentation at or as close to the point of care as practicable and within organizational standards.
26. Ensures documentation supports skilled need and reflects assessment, interventions, education, patient response, progress, communication, and next steps.
27. Maintains appropriate productivity and geographic efficiency while preserving flexibility for urgent, complex, SOC/ROC, and after-hours field response.
28. Works with Workforce Coordination/Scheduling to optimize routing and reprioritize routine work when urgent after-hours field response is required.
29. Maintains readiness throughout the shift for changing priorities and additional clinically appropriate assignments.
30. Participates in clinical education, competency validation, interdisciplinary communication, QAPI/quality activities, and team meetings as assigned.
31. Maintains required licensure, certifications, competencies, health requirements, driver's license, automobile insurance, and other employment requirements.
32. Follows infection prevention, standard precautions, medication safety, emergency preparedness, field safety, patient identification, HIPAA/privacy, and organizational compliance requirements.
33. Immediately reports significant safety events, suspected abuse/neglect, serious medication concerns, environmental hazards, or other reportable conditions.
34. Performs other duties consistent with RN scope of practice and Home Health operational needs.

Qualifications:

Graduate of an accredited school of professional nursing required.
Current, unrestricted Registered Nurse license in the State of Florida required.
Current CPR/BLS certification required.
Minimum one year of professional nursing experience preferred; Home Health experience strongly preferred.
RNs new to Home Health may be considered and must complete the organization's new-to-Home-Health clinical education and competency pathway before independent practice.
OASIS competency required before independently completing OASIS assessments; specific competency validation required before independent SOC/ROC/recertification.
Valid driver's license, acceptable driving record, reliable transportation, and required automobile insurance.
Ability and willingness to travel throughout the assigned service area during afternoon and evening hours.