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An RN shall be responsible for the clinical nursing supervision of unlicensed Direct Care Staff in the performance of nursing tasks and activities.  It shall be the responsibility of the agency to ensure that all staff is adequately trained regarding the elements of clinical nursing supervision, and the difference between clinical nursing supervision and administrative supervision.  Adequate nursing supervision is the provision of guidance by an RN for the accomplishment of a nursing task or activity including: 
Ensuring initial training of the task or activity occurs; 
Periodic inspection of the actual act of accomplishing the task or activity; 
Evaluation of the outcome for the consumer; and  
Availability for consultation and intervention as needed. 
It is the responsibility of the RN to exercise his/her judgment as to the type and frequency 
of supervision that is required.  In determining the type and frequency of supervision 
required, the RN must consider: 
The complexity of the task: 
The skill and experience of the staff involved; and 
The health conditions/status of the consumer receiving the services. 

Frequency of visits: 
The frequency of visits by the RN providing clinical nursing supervision to IRA’s designated as an FSR center shall be at the discretion of that RN, but in no case shall visits occur less frequently than once a week when in operation.  Such visits shall occur when individuals receiving respite are present in the facility. 

Professional nursing availability: 
There shall be am RN available to unlicensed direct care staff during all hours that they are on duty at the FSR center.  The RN must be either on site or immediately available by telephone defined as responding within thirty (30) minutes.  The RN assigned to the FSR, or during hours that this RN is not available, the RN on-call will be immediately notified of changes in medical orders for a consumer and/or of changes in a consumer’s health status.  Plan of nursing services. 

The RN is responsible for ensuring that there is an appropriate individualized plan for nursing services for any consumer who requires nursing care at the IRA’s designated as a FSR center, including those who require medication administration for diagnosed medical conditions.  Such plans will be reviewed and updated each time the individual is admitted for respite services, or if there is a significant change in the consumer’s condition during the respite session. 

For scheduled respite, at least one week prior to an initial admission, the person 
requesting the respite shall provide the following information: 
Most recent annual physical with a list or current diagnosed medical conditions, 
including any known allergies and information related to special precautions such 
as limitations on activities, weather precautions, etc. 
Any recent illnesses including known exposures to communicable diseases. 
List of all current physician’s/health care providers. 
Prescriptions/orders for all medication, including over-the-counter and as needed 
(PRN) medication that the consumer is receiving, including any information 
related to medication allergies.  Prescriptions and/or orders may be written by any 
person authorized to prescribe (e.g.; physicians, dentists, registered physician’s 
assistants, nurse practitioner’s, 
Orders for any treatments that the consumer may require during the respite 
session. 
Immunization records, including date and result of last PPD. 
Information related to the individual’s diet, food likes and dis-likes, food 
allergies, special dining equipment and/or precautions, history of difficulty 
swallowing or choking. 
Information on the person’s sleeping habits, toileting needs, personal hygiene, 
communication adaptive equipment needs, safety needs, any special supervision 
concerns in the home or in the community, travel safety needs. 
Name of person who can give informed consent for medical or dental treatment, 
and contact person’s name (s) and phone number (s).  The contact person must be 
a person who is ready, willing and able to care for the individual should the 
individual becomes ill to the extent that they can not continue the respite 
experience. 

The RN shall review the information and develop a plan of nursing services.  The RN review the plan of nursing services with the direct care staff that will be providing care prior to the arrival of the consumer at the respite center.  The RN shall document that direct care staff have been educated about the chronic conditions and related health care needs of each consumer. The RN shall ensure that there is a medication information sheet for each medication that is administered.  This sheet shall include all of the information required by 14 NYCRR Section 633.17 (a) (17) (iii). 

Prior to subsequent scheduled respite sessions, the respite center shall ensure that there are currently valid prescriptions/orders for all medications the consumer will or may receive during the respite stay, and for all other treatments required by the consumer.  The RN will review the required information with the person requesting the respite and update the information as needed.   The RN shall review the plan of nursing service and update as needed.  The RN shall review the plan of nursing service with each direct care staff that will be providing care, and ensure that any additional training or direction required is provided. 

For emergency respite, the RN or the RN on call will respond in person to the respite center as soon as possible to assess the person and to provide direction to the staff.  Every effort is to be made to obtain the above information within 24 hours of admission. For individuals who are receiving respite that does not include an overnight stay, RN shall develop a plan of nursing service to address the care required during the respite episode and shall ensure that staff are trained to provide any necessary care. 

Nursing procedures:  It shall be the responsibility of the RN to exercise professional judgment in determining which nursing procedures unlicensed direct care staff will be allowed to perform, and which unlicensed staff will be allowed to perform them.

Training: It is the responsibility of the RN to ensure that initial and on-going training for unlicensed direct care staff has been provided in all nursing tasks and/or functions that they will perform. An RN must conduct this training. The RN must periodically review the performance of unlicensed staff to ensure that it is consistent with standards of care and training. In the event that staff must be trained in medication administration, tube feeding and /or diabetic care the training shall be taught utilizing a standard curriculum approved by OMRDD.

Clinical evaluations: The RN shall conduct annual clinical performance evaluations for unlicensed direct care staff for procedures that include but are not limited to medication administration. The evaluation shall become part of the employee’s annual performance evaluation. Staffing ratios: The following items need to be considered when an agency/facility establishes nurse/consumer ratios for RN’s assigned to provide nursing supervision in FSR Centers: 1. The health conditions/status of the consumer (s); 2. The number and complexity of delegated nursing tasks; 3. The availability of LPN’s to perform necessary nursing tasks; 4. The competency of the staff; 5. The number of staff (both unlicensed staff and LPN’s) who are to receive training and supervision; 6. The number of other programs assigned to the RN and their proximity to each other; 7. The turnover rate of both staff and consumer(s) and 8. Number of hours of operation per week.

Qualifications:

• Bachelors degree LIC in NYS; with one year related experience and/or training
• Valid NY Drivers License with a clean driving record
• 28 years old with Clear Criminal Background Check
• Medical exam prior to start date

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to stand, walk, and use hands to finger, handle, or feel. The employee is frequently required to reach with hands and arms. The employee is occasionally required to sit. The employee must occasionally life and/or move up to 10 pounds.

Employers Rights:

This job description does not list all of the duties of the job. Employees may be asked to perform other duties. Performance evaluations, in part, will be based upon performance of the task listed in this job description.

The employer has the right to revise this job description at any time. The job description is not a contract for employment. That is, employment with Eihab Human Services can be terminated with or without cause, and with or without notice at any time, at the option of the employee or that of Eihab Human Services.