Purpose of Your Job Position
The primary purpose of your job position is to provide primary care to specific residents under the medical direction and supervision of the residents’ attending physicians or the Medical Director of the facility, with an emphasis on assessment, illness prevention and health care management. You will also assist in modifying the treatment regimen to meet the physical and psychosocial needs of the resident, in accordance with established medical practices and the requirements of this state and the policies and goals of this facility.
Delegation of Authority
As a Licensed Vocational Nurse, you are delegated the administrative authority, responsibility and accountability necessary for carrying out your assigned duties.
Every effort has been made to identify the essential functions of this position. However, it in no way states or implies that these are the only duties you will be required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or is an essential function of the position.
Duties and Responsibilities
Confer with the Medical Director and the attending physician regarding specific residents assigned to you.
Consult with the physician concerning resident evaluation and assist the Director of Nursing Services in planning and developing the nursing services to be performed for the resident.
Initiate requests for consultation or referral. Respond to requests from the resident, physician, or nursing staff.
Examine the resident and his/her records and charts to distinguish between normal and abnormal findings in order to recognize early stages of serious physical, emotional or mental problems.
Determine when to refer the resident to a physician for evaluation, supervision, or directions.
Perform administrative duties regarding assigned residents, such as completing medical forms, reports, evaluations, studies, charting, etc.
Implement and maintain established policies, procedures, objectives, quality assurance, safety and environmental and infection control. Interpret these to the physician, resident, family members, and public, as appropriate.
Make written and oral reports/recommendations to the attending physician, Medical Director, or the Administrator concerning the status and care of the assigned resident.
Participate in the planning and evaluation of the written policies and procedure that govern the day-to-day functions of the nursing service department.
Participate in facility surveys (inspections) made by authorized government agencies.
Assist the Quality Assessment and Assurance Committee in developing and implementing appropriate plans of action to correct identified deficiencies.
Medical Care Functions
Welcome residents and orient them to the environment.
Provide information and instruction to residents and their families in areas such as resident rights.
Provide assessment and diagnostic services to assigned residents.
Perform an assessment evaluation and a complete in-depth physical examination. Use assessment techniques including observation, inspection, auscultation, percussion, and palpation. Perform optic and ophthalmic examinations.
Record physical findings, and formulate plans and prognosis based on resident’s condition. Report these to the attending physician.
Order, interpret, and evaluate diagnostic tests to identify and assess resident’s clinical problems and health care needs. Report these to the attending physician.
Provide therapeutic services. Confer with the Care Planning Team in the development of the care plan.
Identify and manage specific minor illnesses such as colds, diarrhea, skin abrasions, simple sprains, and simple foot problems such as corns and calluses.
Provide, within established protocols and under the supervision of the physician, treatment for uncomplicated diabetes, hypertension, pneumonia, and such other conditions, as agreed upon on writing by the Nurse Practitioner and the physician.
Provide surveillance of medical regimens for chronically ill persons, adjust regimens within established protocols, and recognize when to refer the resident to his/her physician.
Give direct physical and psychological nursing care in emergencies, as well as in the presence of an illness or disability, in order to maintain life, provide comfort, reduce stress, and enhance the resident’s ability to cope.
Coordinate the admission or discharge of residents as necessary.
Work with other health agencies and family members in the physical and emotional transitions of admission, care, and discharge of the resident.
Assist in resident rehabilitation activities. Where required, perform range of motion, assist in ambulation, provide emotional support. Monitor the results of physical therapy activities.
Provide preventive health care services. Make recommendations to the resident concerning nutrition and the prevention of common illnesses, accidents, etc.
Provide information to resident and family members of prevention techniques and other ways to maintain or improve the general health and psychosocial status of the resident.
Safety and Equipment
Assist in monitoring the inventory of medications, medical supplies, and equipment to ensure that an adequate supply is on hand to meet the needs of residents.
Be familiar with, and use as appropriate, all items of personal protective equipment offered by the facility, including, but not limited to, masks, gowns, gloves, and face shields.
Ensure that adequate supplies of personal protective equipment are on hand and are readily available to personnel who perform procedures that involve exposure to blood or body fluids.
Assist the Infection Control Coordinator in identifying, evaluating, and classifying routine and job-related functions to ensure that tasks in which potential exposure to blood/body fluids are properly identified and recorded.
Ensure that all personnel performing tasks that involve potential exposure to blood/body fluids participate in appropriate in-service training programs prior to performing such tasks.
Participate in a program for monitoring communicable and/or infectious diseases, including TB, among the residents and personnel.
Ensure that nursing service personnel follow established infection control procedures when isolation precautions become necessary.
Report all hazardous conditions or equipment.
Ensure that all personnel wear and/or use safety equipment (e.g., back brace, mechanical lifts, etc.) when moving or lifting residents.
Ensure that the department’s policy and procedure manuals identify safety precautions and equipment to use when performing tasks that could result in bodily injuries.
Maintain the confidentiality of all resident care information.
Monitor the activities of and care provided to all residents to ensure that they are treated fairly, and with kindness, dignity, and respect.
Report any complaints or grievances made by residents regarding their medical care to the Director of Nursing Service. Maintain a written record of any resident’s complaints or grievances with a notation of actions taken.
Ensure that all nursing care is provided in privacy and that nursing service personnel knock before entering the resident’s room.
Ensure that all nursing service personnel are knowledgeable of the residents’ responsibilities and rights including the right to refuse treatment.
Report and investigate all allegations of resident abuse and/or misappropriation of resident property.
Ensure that nursing staff personnel honor the resident’s refusal of treatment request.
Ensure that such requests are in accordance with the facility’s policies governing advance directives.
Ensure that the facility’s policies and procedures governing advance directives are reviewed with the resident and/or representative.
Must possess a current, unencumbered, active license to practice as a Licensed Vocational Nurse in this state.
Must be able to read, write, speak, and understand the English language.
Must possess the ability to make independent decisions when circumstances warrant such action.
Must possess the ability to deal tactfully with personnel, residents, family member, visitors, government agencies/personnel, and the general public.
Must be knowledgeable of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pertain to long-term care.
Must possess leadership and supervisory ability and the willingness to work harmoniously with and supervise other personnel.
Must possess the ability to plan, organize, develop, implement, and interpret the programs, goals, objectives, policies, and procedures, etc., that are necessary for providing quality care.
Must have patience, tact, a cheerful disposition and enthusiasm, as well as willingness to handle difficult residents.
Must be willing to seek out new methods and principles and be willing to incorporate them into existing nursing practices.
Must be able to relate information concerning a resident’s condition.
Must not pose a direct threat to the health or safety of other individuals in the workplace.