Overview
At Houston Methodist, the Discharge Nurse position is a licensed Registered Nurse (RN), who, as an experienced clinician functions at the Competent to Proficient stage of Benner's model of clinical practice. The Discharge Nurse position is accountable for ensuring patients are discharged in an effective and efficient manner including resolving any complex needs. This position assumes the lead role with discharging patients, collaborates with the Physician, Case Manager and all interprofessional health care team members involved with discharging the patient. The Discharge Nurse position demonstrates compassion and clinical competence when providing care, using technology, administering medications, performing procedures as appropriate, managing emergencies, and acting as a patient and family advocate in order to monitor and maintain patient rights. This position will assume bedside RN responsibilities as needed. This Discharge Nurse position is responsible for providing discharge instructions/plans and reviewing medications with patients/families that are being discharged from the hospital.This position also is responsible for the improvement of the discharge process.
Houston Methodist Standard
PATIENT AGE GROUP(S) AND POPULATION(S) SERVEDRefer to departmental "Scope of Service" and "Provision of Care" plans, as applicable, for description of primary age groups and populations served by this job for the respective HM entity.
HOUSTON METHODIST EXPERIENCE EXPECTATIONS
- Provide personalized care and service by consistently demonstrating our I CARE values:
- INTEGRITY: We are honest and ethical in all we say and do.
- COMPASSION: We embrace the whole person including emotional, ethical, physical, and spiritual needs.
- ACCOUNTABILITY: We hold ourselves accountable for all our actions.
- RESPECT: We treat every individual as a person of worth, dignity, and value.
- EXCELLENCE: We strive to be the best at what we do and a model for others to emulate.
- Practices the Caring and Serving Model
- Delivers personalized service using HM Service Standards
- Provides for exceptional patient/customer experiences by following our Standards of Practice of always using Positive Language (AIDET, Managing Up, Key Words)
- Intentionally collaborates with other healthcare professionals involved in patients/customers or employees' experiential journeys to ensure strong communication, ease of access to information, and a seamless experience.
- Involves patients (customers) in shift/handoff reports by enabling their participation in their plan of care as applicable to the given job
- Displays cultural humility, diversity, equity and inclusion principles
- Actively supports the organization's vision, fulfills the mission and abides by the I CARE values
Responsibilities
PEOPLE ESSENTIAL FUNCTIONS
- Fosters staff engagement by demonstrating active listening, requesting and acknowledging feedback, making equitable decisions, providing rationale when appropriate, and supporting organizational goals. Anticipates the needs of the staff members and proactively offers assistance. Role models to team members effective communication skills, assisting in their development of such skills. Collaborates with all members of the patient care team by actively communicating and reporting pertinent patient care information and data in a comprehensive manner.
- Implements staff education specific to patient populations and unit processes; coaches and mentors other staff and students. Ensures knowledge transfer of discharge process. Uses peer-to-peer accountability to contribute towards department score for turnover/retention/employee satisfaction on unit-based scorecard.
SERVICE ESSENTIAL FUNCTIONS
- Provides the unit RN with the 24-hour discharge checklist and monitors the progress, assertively managing the progress throughout the day. Reviews chart for notes that require consultation and approval for discharge and pending test/procedures. Reviews Discharge Orders. Coaches physicians on discharge process and timely documentation.
- Completes unit rounds by rounding on all patients with the probability of discharge, educating the patient/family regarding the discharge process and discharge medications/prescriptions. Screens for communication barriers and seeks to educate caregivers when appropriate. Uses teach back method to ensure understanding of information. Establishes mutual educational goals with patient and family, providing appropriate resources, incorporating planning for care after discharge. Provide education regarding their medical condition and self care post-discharge. Confirms transportation with patient/family members. Ensures all homecare is arranged if applicable.
- Incorporates after visit summaries and appropriate scripting to ensure patient comprehension Contributes to meeting department target for patient satisfaction on unit-based scorecard through peer-to-peer accountability.
QUALITY/SAFETY ESSENTIAL FUNCTIONS
- Anticipates/prevents and recognize/resolves early declines in patient condition and emergent situations. Proactively recognizes, determines a plan of action, and responds to situations as appropriate this includes, but is not limited to, potential barriers to self care after discharge such as ability to pay for medications, get to doctors appointments, and complete ADL's. Collaborates with multiple departments to make sure the discharge plan is actionable by the patient and caregivers.
- Prepares patients, caregivers, and staff for identified discharges for the next 24-48 hours. Facilitates communication across the care team to assure important information is reported in a comprehensive, unbiased manner.
- Collaborates with consultants regarding patients cleared for discharge.
- Completes discharges in timely manner with accurate documentation and anticipates/plans for potential problems. Reports errors in discharge plans promptly and consistently seeks to improve systems and processes and identify trends.
- Leads and identifies opportunities for practice changes and performance improvement. Actively participates in meeting quality and safety targets and hospital initiatives on the unit and hospital scorecard, reporting near misses and identifying solutions by collaborating with the interprofessional health care team. Role models situational awareness, using teachable moments to improve safety. Assists with audits as needed.
FINANCE ESSENTIAL FUNCTIONS
- Actively participates in the stewardship and efficient utilization of resources, optimizing efficiency, minimizing incidental overtime, and other areas according to department specifications and needs including providing input to unit capital and operational budgets. Models independent time management effectively and prioritization of daily tasks.
- Identifies population and/or service-specific trends impacting Length of Stay (LOS) and addresses/resolves problems impeding treatment progress. Proactively takes action to achieve continuous improvement and expedites care/facilitates discharge. Contributes to meeting department financial target on scorecard.
- Attends Care Coordination Rounds and notes discharges for the next 24-48 hours, and facilitates patients timely progression. Ensures that follow-up has been implemented on any concerns or issues identified by the team. Facilitates removal of barriers and collaborates with departments to ensure prioritization of discharging patients.
GROWTH/INNOVATION ESSENTIAL FUNCTIONS
- Investigates and incorporates evidence-based practices which are presented to shared governance and leadership. Supports change initiatives and adapts to unexpected changes. Leads change in practices occurring with discharge. Teaches unit staff about the discharge process.
- Fosters identification and implementation of innovative solutions to improve patient care or unit operations such as reduction of hospital readmissions or other department-specific measures by leading and/or participating in unit projects and shared governance activities. Assists with guiding departmental strategy for improvements in quality and efficiency in discharge process.
This job description is not intended to be all-inclusive; the employee will also perform other reasonably related business/job duties as assigned. Houston Methodist reserves the right to revise job duties and responsibilities as the need arises.
Qualifications
EDUCATION
- Bachelor of Science degree from an accredited School of Nursing
WORK EXPERIENCE
- Eighteen months nursing experience
License/Certification
LICENSES AND CERTIFICATIONS - REQUIRED
- RN - Registered Nurse - Texas State Licensure and/or Compact State Licensure within 60 days OR
- RN-Temp - Registered Nurse - Temporary State Licensure within 60 days AND
- BLS - Basic Life Support (AHA)
KSA/ Supplemental Data
KNOWLEDGE, SKILLS, AND ABILITIES
- Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations.
- Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security.
- Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles.
- Acts as effective change agent.
- Uses therapeutic communication to establish a relationship with patients, families and interprofessional team to collaborate on the plan of care.
- Strong assessment, organizational and problem solving skill as evidenced by capacity to prioritize multiple tasks and role components
- Ability to function independently and exercise judgment in interactions with physicians, interprofessional care team and patients and their families
- Demonstrates proficient time management skills
- Uses critical thinking skills and clinical judgment to work autonomously as defined by the Nurse Practice Act.
- Competencies, skills, training as listed in Policy NU-903, ¿Competence of Nursing Staff¿ and HR 07 ¿Competency Assessment
- Maintains level of professional contributions as defined in Clinical Career Path program guide.
- Working knowledge of Microsoft products including PowerPoint, Word, Excel and Outlook
SUPPLEMENTAL REQUIREMENTS
WORK ATTIRE
- Uniform No
- Scrubs Yes
- Business professional No
- Other (department approved) No
ON-CALL**Note that employees may be required to be on-call during emergencies (ie. DIsaster, Severe Weather Events, etc) regardless of selection below.
TRAVEL****Travel specifications may vary by department**
- May require travel within the Houston Metropolitan area No
- May require travel outside Houston Metropolitan area No
Company Profile
Houston Methodist Clear Lake Hospital brings the expertise and compassionate care of Houston Methodist Hospital in The Texas Medical Center – a national Honor Roll hospital – to Bay Area communities. The hospital provides a broad spectrum of adult medical and surgical care, is an accredited chest pain center, and is also acute stroke-ready designated through DNV. Houston Methodist Clear Lake offers many inpatient and outpatient services including 3-D mammography and other state-of-the-art imaging, labor and delivery with a level II neonatal ICU, Cancer Center of Excellence, advanced laparoscopic surgery, comprehensive orthopedics and sports medicine, neurology, urology and otolaryngology. Also, Houston Methodist Clear Lake Hospital is honored to be the only hospital in the bay area to have a Grade A rating from Leapfrog Hospital Safety Grading.
