Knowledge of geriatric, restorative and general chronic care nursing principles and professional standards of nursing practice and the ability to apply to resident specific circumstances. Able to identify, implement and evaluate appropriate objectives and interventions for residents.
Demonstrates competency in clinical skills needed for facility resident population.
Working knowledge of laws and regulations that influence the provision of care and services in nursing facilities.
Working knowledge and ability to interpret and demonstrate facility policies, procedures to direct care staff.
Sufficient organizational and interpersonal skills to assign, motivate staff, elicit work output, improve quality and interact effectively with residents, families, interdisciplinary team members, administration and government officials.
Carries out all duties in accord with the facility mission and philosophy.
Demonstrates knowledge of and respect for the rights, dignity, and individuality of each resident in all interactions.
Appreciates the importance of maintaining the confidentiality of resident and facility information.
Demonstrates honesty and integrity at all times in the care and use of resident and facility property.
Able to understand and to follow written and verbal directions. Able to express self adequately, accurately in written and/or oral communication (including documentation in clinical records) with direct care staff, interdisciplinary team members, administration, and government officials.
Knowledge of emergency and disaster procedures of the facility. Able to locate the nearest exit, to understand and respond to written or oral instruction in case of an emergency.
Sufficient mobility and strength to move freely through the building, to assure resident safety at all times and to assist, transfer or otherwise move residents of the facility out of danger in case of emergency.
Working knowledge and ability to comply with facility policies and procedures for workplace safety including infection control procedures, application of universal precautions for bloodborne pathogens, use of personal protective equipment and handling of hazardous materials.
Demonstrates the ability to prioritize tasks/responsibilities and complete duties/projects within allotted time.
Able to respond to change productively and to handle additional tasks/projects as assigned. Able to carry out the essential functions of this job (with or without reasonable accommodation) without posing specific, current risk of substantial harm to health and safety of others.
ESSENTIAL JOB FUNCTIONS:
NOTE: The essential functions of this job may be revised or updated as facility needs dictate.
Makes daily rounds on the assigned unit at least at the beginning and at end of shift to observe, examine or interview residents, to verify information from the ongoing shift, to monitor regulatory compliance and to determine staff assignments.
Develops and distributes resident care assignments to direct care staff. Assignments match resident needs with skills of direct care staff and maintain consistency to the extent practicable. Adjusts assignments according to the availability of qualified staff. Changes assignments if necessary during shift to meet resident needs.
Provides orientation to unit and unit routines to new staff members or staff from temporary agencies.
Describes care plan goals and approaches to direct care staff so that care plan is consistently implemented on all shifts by all caregivers. Seeks input from nurses’ aides about the residents’ condition, functional abilities, preferences and alternative approaches to care. Monitors delivery of care and services throughout the shift to ensure needs are met, tasks are completed and that work of direct care to residents on unit according to physician orders and in compliance with facility policies and procedures.
Performs physical assessment of new admissions and current residents as indicated by a change in condition or as required by regulation.
Coordinates care and delivery of services to assist each resident to attain or maintain the highest practicable physical, mental and psychosocial well-being. Consults with and refers relevant resident care issues to the attention of interdisciplinary care team members.
Give pertinent information to the care plan team to accommodate resident needs and preferences, to manage risk factors for functional decline and to improve functional abilities.
Respect rights of residents regarding freedom of choice, consent for care and services, refusals of treatment and implementation of advance directives, if any. Promptly consults with DON and Social Worker if unsure of the proper course of action that respects resident’s rights, comply with facility policies and procedures and that is consistent with state and federal laws and regulations.
Trains and develops staff by conducting skills observations of nurses’ aides identifying learning needs and taking advantage of opportunities to teach on the unit. Reports information to DON as part of staff performance evaluations.
Completes required documentation of care and services delivered during shift including subjective findings, objective symptoms, interventions and resident responses to interventions. Completes required documentation of special circumstances including accident/incident reports in compliance with state and federal laws and regulations.
Completes written 24-hour facility report. Gives and listens to taped shift report making special note of significant changes in condition, admissions, transfers, discharges, initiation or use of physical or chemical restraints, unnecessary use of any drug, incidents, unexplained injuries, medication errors, loss of resident property or evidence of resident or family dissatisfaction.
Informs the resident in advance about care and treatment and any changes to the plan of care.
Immediately informs the resident, consults with the residents’ physician and notifies the designated family member and/or the resident’s legal representative when there is an accident involving an injury which has potential for requiring physician intervention; a significant change in the resident’s physical, mental, or psychosocial status; a need to alter treatment significantly or a decision to transfer or discharge the resident from the facility. Promptly notify the resident, designated family member and/or resident’s legal representative when there is a change in room or roommate.
Reports relevant information to the DON including, interdisciplinary team functioning and communication, regulatory compliance issues, resident risk factors, sudden changes in resident behavior, expressed dissatisfaction by resident or family, refusals of treatment, unexplained injuries, staff behavior (positive and negative), staffing needs, equipment and supply needs, opportunities to revise policies procedures, improve quality.
Monitors staff for compliance with OSHA mandates on work place safety including hazard communication and blood borne pathogens. In cases of work place exposure, provides immediate first aide and refers an employee to appropriate facility staff member for post-exposure follow up.
Reports all injuries to self or others to supervisor immediately.
Takes job actions with staff members under appropriate circumstances. Applies facility policies about progressive discipline correctly. Removes staff member from the unit if necessary to avoid endangerment to health or safety of residents or other staff members. Reports all job actions taken to DON promptly.
Attends in-service education programs as assigned. Applies information to job tasks.
Assists DON with preparation for long-term care survey. Attends survey training, interacts with state surveyors as instructed by supervisor.
LPN’s will take and transcribe physician’s telephone or verbal orders after proper instruction and in-service from DON and SDC.
PHYSICAL, PSYCHOLOGICAL AND ERGONOMIC REQUIREMENTS:
Successful performance of essential functions can best be achieved through consistent application of current knowledge, use of good judgment, teamwork, common sense, ability to establish and carry out priorities, effective use of interpersonal skills and ongoing communication with residents, staff, families, interdisciplinary team members, and government officials, including state surveyors and ombudsman.
This job cannot be performed without exposure to the stresses associated with the intimate, 24-hour residential care environment that delivers care and services primarily to disabled and cognitively impaired residents. Examples of these stresses include, but are not limited to: shift rotation, weekend and holiday duty, unusual or impaired behavior by residents, family reactions to having a loved one in the nursing home, death and dying, oversight of state surveyors, ombudsman and federal officials, presence of consultants and attorneys, and variable involvement of medical staff.
Essential functions are carried out in a variety of positions including standing and sitting. To meet the resident’s needs, virtually all positions require the ability to move freely through the building. Stooping, bending, lifting and carrying as well as other physical demands may be required as described in the Essential Physical Demands of this position.
ESSENTIAL PHYSICAL DEMANDS OF THE POSITION.
MOBILITY: Ability to move freely in all directions.
LIFTING: Able to lift up to 75 pounds.
STOOPING/BENDING: Up to 200 times a day for brief times to give treatments to residents.
PUSHING: Up to 50 pounds to push med cart or residents in wheelchairs.
STANDING/SITTING: Ability to walk or stand 75% of the time, sitting 25% of the time.
REACHING: Ability to reach for supplies and give treatment to residents.
HEARING: Ability to hear verbal communication.
SPEAKING: Ability to speak for others to understand.
VISION: Adequate vision to read and to recognize residents.
COLOR VISION: Ability to see red biohazard labels and color code system of medication cassettes.
ESSENTIAL ENVIRONMENTAL DEMANDS OF THE POSITION
INSIDE/OUTSIDE: Inside 100% of the time.
COLD/HEAT: Controlled temperature.
NOISE/VIBRATIONS: Voices, telephones, and call lights.
FUMES/ODORS/CHEMICAL EXPOSURE: Odors of body substances.
The Occupational Safety and Health Administration (OSHA) has determined that certain employees in nursing homes are at significant risk of exposure to bloodborne pathogens such as Hepatitis B and Human Immunodeficiency Virus (HIV).