Assesses physical, emotional, social, and spiritual needs and evaluates patients' adaptation to health changes. Develops a plan of care based on patients' disease, symptoms, and response to treatment. Educates patients, families, and caregivers on disease processes, treatment, side effects and symptom management. Coordinates with inter-disciplinary team to ensure continuity of care. Refers patients, families and caregivers as appropriate to other clinical resources/professionals such as social work, home health care, clinical nutrition, etc. Implements, evaluates and modifies plan of care. Integrates research and evidence based knowledge into clinical practice. In addition to primary responsibilities, skills, education and experience listed in the job description, the Transition RN will have the following key responsibilities:Able to provide Transition Planning services at the UW Medical Center and the Fred Hutch Clinic. Participate in assessment and evaluations of patient/family care throughout transitions. Participate in the nursing coordination for individual patient/families transitioning to various areas of care. Coordinate patient care plans with home infusion agencies, home care agencies and skilled facilities. Document assessments, interventions, plan in the Medical Record after each patient encounter. Collaborate with a multi-disciplinary team to ensure continuity of patient/family care throughout transition. Teach classes for patients and families both on a 1-on-1 basis and in a classroom setting. Function as liaison with insurance company case managers throughout treatment process including providing outpatient utilization review updates as needed. Communicates in a respectful and effective manner with other staff. Act as Clinic ambassador to Inpatient Units, infusion companies, and referring offices when appropriate. Facilitates as smooth a transition as realistically possibleSupport a patient and family centered philosophy. Listen to concerns of patient /families and/ caregivers in an objective manner. Review complicated discharges with Transition Supervisor to develop an overall plan and promote a consistent message. Informs Transition Supervisor of high-risk patient situations or operational issues. Discuss discharges briefly at beginning of each day with other Transition RN's and assume appropriate workloads. Follows report guidelines for transition. Serves as a resource regarding transition to all team members caring for patients. Flexible in incorporating patient care outside own assignment to assist with patient care needs within the Transition Team. Demonstrates appropriate problem solving when working with other departments. Follows and implements policies and standards of the Transition Program. Participates in continuing education programs. Keeps current in area of expertise through journals, books, and conferences. Participates in professional organizations. Qualifications Required:Graduated from an accredited school of nursing. Must have a current Washington State Registered Nurse (RN) license or current NLC multistate license (MSL); and must upgrade to an MSL with primary state of residence, WA, within 60 days of hire. This requirement may be waived under specific circumstances, subject to approval. Applicants that do not have previous oncology experience will be provided additional training and support. Current BLS AHA Health Provider Card (or equivalent course, such as by the American Red Cross) and renewal required every two years. Additional certification may be required dependent upon the department. Critical thinking: the ability to practice the cognitive skills of analyzing, applying standards, discriminating, information seeking, logical reasoning, predicting, and transforming knowledge. Ability to develop clinical judgment. Time Management skills: the ability to organize and manage time and tasks independently. Ability to communicate effectively by looking and listening for cues, asking open-ended questions, exploring cues, using pauses, screening responses, and clarifying responses. Ability to effectively listen by using reflecting, acknowledging, summarizing, empathizing, and paraphrasing skills. Ability to effectively provide information by checking what information the person knows already, giving small amounts of information at a time, using clear terms and avoiding jargon, avoiding detail unless it is requested, checking for understanding, and pausing and waiting for a response. Preferred:2 years of nursing experience, 3 years of experience in Bone Marrow Transplant, Immunotherapy or oncology strongly preferred. Excellent teaching skills. Basic computer skills (Outlook, EPIC, etc)Experience in following areas:Health Insurance Industry. Home health care. Discharge planning. Patient/family education. Ambulatory care. The hourly pay range for this position is from $47.64 to $88.19 and pay offered will be based on experience and qualifications. Registered Nurses are paid on a step-scale basis and are also eligible for shift differentials and other pay premiums such as advanced degree, preceptor and certification. Although Fred Hutch is not sponsoring most H-1 B visas at this time, candidates who already hold an H-1 B sponsored by another organization and are currently in the U.S. may be eligible for this position. This position may be eligible for relocation assistance. This position is 0.71 FTE, 28.4 hours/week. Fred Hutchinson Cancer Center offers employees a comprehensive benefits package designed to enhance health, well-being, and financial security. Benefits include medical/vision, dental, flexible spending accounts, life, disability, retirement, family life support, employee assistance program, onsite health clinic, tuition reimbursement, paid vacation (12-22 days per year), paid sick leave (12-25 days per year), paid holidays (13 days per year), paid parental leave (up to 4 weeks). Paid time off is prorated for part-time positions. Additional Information We are proud to be an Equal Employment Opportunity (EEO) and Vietnam Era Veterans Readjustment Assistance Act (VEVRAA) Employer. We do not discriminate on the basis of race, color, religion, creed, ancestry, national origin, sex, age, disability (physical or mental), marital or veteran status, genetic information, sexual orientation, gender identity, political ideology, or membership in any other legally protected class. We desire priority referrals of protected veterans. If due to a disability you need assistance/and or a reasonable accommodation during the application or recruiting process, please send a request to Human Resources at hrops@fredhutch.org or by calling 206-667-4700.