The primary purpose of this position is to collaborate with the DON to plan, organize, develop, and direct the overall functions of resident care services in accordance with current federal, state, and local standards, guidelines, and regulations.
Essential Job Functions Duties and Responsibilities
Management Functions Assist to develop, maintain, update, communicate and enforce facility and state specific written policies and procedures that govern the daily functions of the nursing service department including the safety program. Maintain a current reference of written nursing material that will assist the nursing service department in meeting the day to day needs of the resident. Communicate nursing services schedules with other services to ensure the continuity of the resident's total regimen of care. Assist to develop, implement and maintain an ongoing Continuous Quality Improvement and Quality Assurance program for the nursing services department. Recommend to the Director of Nursing the equipment needs of the nursing department. Participate with the Director of Nursing to prepare and plan the nursing service department's budget and staffing plan.
Nursing Care Functions Conduct the daily nursing functions in accordance with current rules, regulations, and guidelines that govern the long term care facility. Ensure that all nursing personnel assigned to you comply with the written policies and procedures including the safety program. Admit, transfer, and discharge residents with documentation regarding care and service provided. Participate in the orientation of new residents/family members to the facility. Communicate with health care providers in a timely and appropriate manner. Utilize nursing personnel qualifications according to the resident's care plan, wishes, and health care provider orders. Complete daily clinical and environmental rounds to evaluate resident care being provided and report significant events. Meet and resolve issues with residents and/or family members. Report significant issues to the supervisor. Participate in facility surveys (inspections) as requested by management. Follow clinical programs including risk management, infection prevention, quality and staff development.
Communication/Documentation Functions Complete an initial assessment and develop service plan for assigned residents. Update, review, and transcribe the service plan that identifies the goals, problems, approaches, and revisions based on nursing needs and new health care provider orders. Communicate with health care provider to review treatment plans, complete orders, and progress notes in accordance with established policies. Review the resident's health record for specific treatments, medication orders, diets, labs etc., for implementation and follow up. Requisition and arrange for diagnostic and therapeutic services, as ordered by the health care provider, and in accordance with our established procedures. Communicate the department's policies and procedures to personnel, residents, and visitors. Communicate with written (24 hour report) and oral reports/recommendations concerning any changes in resident condition and other activities of your shift to nursing management. Fill out and complete Risk Watch for accident/incidents involving residents or staff and submit to Director of Nursing. Complete and file assessments and all other health record documentation as required to provide care services. Report all discrepancies noted concerning physician's orders, diet change, charting error, etc., to the DON. Complete clinically accurate documentation according to policy. Review the resident health documentation and progress notes from the interdisciplinary team to determine if the service plan is being followed. Inform nursing personnel of new admissions and the resident's care needs. Ensure that rooms are ready for new admissions. Greet newly admitted residents upon arrival. Notify the resident's attending health care practitioner and family when there is a change in the resident's condition. Meet with your assigned support personnel (Housekeeping, Dining Services, Caregivers, etc.) to plan the shift services, programs, and activities and monitor tasks are completed as directed. Coordinate services with other members of the interdisciplinary team (Housekeeping, Dining Services, Nursing, etc.) to ensure that the resident's total regimen of care is maintained. Assist in arranging transportation for residents and other third party services.
Medication Administration Functions Review medication administration record for completeness of information, accuracy in the transcription of the health care provider's order. Report concerns to your supervisor. Dispose of drugs and narcotics as required, and in accordance with established procedures.
Personnel Functions Assist in the recruitment and selection of nursing service personnel. Assist to develop work assignments, schedule duty hours, and assist and supervise nursing staff to ensure that all personnel are performing their work assignments in accordance with acceptable nursing standards. Assist in staff development. Formally and informally monitor performance of personnel and ensure adjustments/corrections are made by using coaching, counseling, and discipline methods. Work with the Director of Nursing and Executive Director to resolve staff performance issues including those that may lead to termination. Complete timely performance evaluations as directed. Review complaints and grievances, complete investigations, and work with the Director of Nursing for a plan of action and resolution. Participate in the planning, conducting and scheduling of timely in service and orientation training classes that meet state and federal requirements.
Required Knowledge, Skills and Abilities
Must possess the ability to make independent decisions, follow instructions, and accept constructive criticism. Must be able to deal tactfully with personnel, residents, family members, visitors, government agencies/personnel, and the general public. Must be able to work with ill, disabled, elderly, and emotionally upset people within the facility. Must be able to speak, write and understand English in a manner that is sufficient for effective communication with supervisors, employees, residents, and families.
Education and Experience Must have, as a minimum, 1 year of experience in nursing. Prefer two years' experience in a long-term care facility. Must have experience in supervision and principles, practice of teaching, etc. Must possess skills in leadership and communication. Must possess creativity, integrity, and initiative. Must be able to provide critical thinking skills to address clinical issues.
Must possess a current, unencumbered, active license to practice as a licensed nurse in this state.
Emerald Springs Senior Living