LPN, Charge Nurse, RN Nurse

Overview

General purpose:
The primary purpose of the position is to provide direct nursing care to residents and to supervise day-to-day nursing activities performed by nursing assistants, in accordance with current federal, state, and local standards, guidelines, and regulations governing the facility, as required by the Director of Nursing Services or Nurse Supervisor to ensure the highest quality of care at all times.

• Administrative Functions
  • Direct the day-to-day functions of the nursing assistants in accordance with current rules, regulations, and guidelines that govern the long-term care facility.
  • Ensure all nursing personnel assigned comply with the facility’s written policies and procedures.
  • Periodically review the department’s policies, procedure manuals, and job descriptions; make recommendations for revisions.
  • Meet with assigned nursing staff and support personnel to plan shifts’ services, programs, and activities.
  • Maintain the Nursing Service Procedures Manual to reflect day-to-day nursing procedures; ensure compliance with its procedures.
  • Prepare written and oral reports/recommendations concerning shift activities as required.
  • Coordinate nursing services with other resident services to maintain the resident’s total care regimen.
  • Ensure personnel are in compliance with their job descriptions; participate in quality assurance for the nursing service department.
  • Assist in facility surveys and update discharge plans as required; assist in planning nursing services for the resident’s discharge plan.
  • Explain department policies and procedures to personnel, residents, visitors, and government agencies as required.
  • Admit, transfer, and discharge residents as required; complete accident/incident reports; manage resident charge slips and census reporting; perform administrative duties as needed.
  • Protect resident privacy and information; promptly report suspected violations. Report unauthorized access attempts to the facility’s information system.
• Charting and Documentation
  • Complete required records on admission, transfer, and discharge.
  • Encourage physicians to review and sign orders and progress notes; transcribe orders as required; document care accurately.
  • Chart nurses’ notes reflecting provided care and resident responses; file accident/incident reports and transfer forms; document dietary changes and lab-related records.
  • Ensure entries in the resident’s medical record are signed and dated.
• Drug Administration Functions
  • Prepare and administer medications as ordered; verify resident identity.
  • Maintain adequate stock of medications and supplies; order medications as needed; maintain narcotic records; report discrepancies.
  • Review medication cards for accuracy; notify physicians of stop orders; dispose of drugs per procedure.
• Personnel Functions
  • Participate in evaluating staff, determine staffing needs, and communicate with the Nurse Supervisor; manage attendance and scheduling.
  • Provide leadership to nursing personnel; conduct daily rounds to ensure standards; ensure CNAs are trained and supervised; promote policy adherence.
  • Develop good interdepartmental relationships; foster a positive unit environment.
  • Address complaints and grievances; enforce fair discipline; report occupational exposures and fraud; ensure security of computer workstations.
• Nursing Care Functions
  • Coordinate admissions, orientation, rounds with physicians, and coordination of diagnostic and therapeutic services.
  • Consult with physicians; review treatment plans, medications, and diets; implement nursing objectives and standard care.
  • Supervise administration of treatments and ensure care plan adherence by staff and residents.
  • Coordinate social and activity programs; notify physicians and family of changes; implement restorative and rehabilitative programs.
  • Inspect treatment areas daily for cleanliness and safety; perform professional services as required; utilize restraints per policy; collect specimens and record vital signs; monitor seriously ill residents; manage dietary concerns and post-discharge arrangements; provide post-mortem procedures as needed.
• Staff Development
  • Develop, plan, conduct, and schedule in-service training;…