BASIC FUNCTION: The Registered Nurse is responsible for the coordination and supervision of all nursing activities in his/her assigned section/unit during a designated shift. In the absence of the Director of Nursing and Administrator, a Registered Nurse on some shifts is responsible for facility operations. EDUCATION, QUALIFICATIONS, CREDENTIALS: Has an active Indiana license as a Registered Nurse or Licensed Practice Nurse, and graduated from an accredited school of nursing. Has strong organizational and time management skills. One-year professional nursing experience providing direct care to residents in long-term care, acute care, restorative care, or a geriatric setting. Prior experience as a Charge Nurse or similar supervisory experience is preferred. RESPONSIBLE TO: Director of Nursing (DON), Director of Clinical Services, Administrator ESSENTIAL FUNCTIONSThe employee must be able to perform each essential function effectively to be successful in this position.Supervisory FunctionsEvaluates the compassionate delivery of quality nursing care and supervision through daily rounds to monitor staff coverage and response, absence of odors, general cleanliness, preventive skin care, respect for resident rights, and the apparent maintenance of optimal resident functions.On the basis of staff qualification, facility size and layout, characteristics of patient load, and specific needs of residents, delegates direct care and other duties through work assignments developed and distributed to CNAs for completion during each shift. Attempts to balance resident needs and staff skills when making assignments and maintains consistency to the extent practicable.Directly supervises CNAs and QMAs on the unit assigned and evaluates their time management to continually improve nursing service.Ensures sufficient staff is on duty and when necessary, schedules employees to work and replaces call-ins for the following shift. Authorizes lunch breaks, rest breaks and/or requests to leave assigned shift prior to completion for personnel assigned to his/her unit, and approves overtime if Nurse Manager or DON is not present.Helps training weekend nursing staff in their duties and responsibilities. Authorizes the administering of PRN medications and treatments by a QMA when necessary.Monitors staff performance providing coaching, praise, or redirection as needed and participates in their evaluation, recognition, and discipline according to facility policies.Has the authority to suspend an employee when appropriate and in the best interests of the safety and welfare of the residents or staff, and participate in related investigations, with knowledge (involvement) of the DON.Makes daily rounds of all areas supervised to visit residents and evaluate immediate status or condition, receive comments and suggestions from nursing personnel, and implement nursing interventions. Monitors and helps train staff in safe work practices and OSHA compliance mandates (handwashing, Universal Precautions, blood-borne exposures, hazardous wastes, etc.), and corrects deficiencies. In case of exposure, coordinates immediate first-aid and follows post-exposure policies for treatment and documentation.Explains care plan goals and approaches to direct care staff to promote implementation, and seeks input from them about resident condition, functional abilities, preferences, and alternative approaches to care.Keeps the DON informed of personnel or supervisory matters and makes recommendations for hiring, discipline, or terminations.Clinical FunctionsPerforms physical assessment of new admissions and of current residents as indicated by change in condition or as required by regulations. Completes assigned and required daily and weekly documentation including any ancillary assessment in conjunction with the MDS process.Provides direct patient care, administers medications and specialized treatment and diet to residents on unit as prescribed by physician orders and in compliance with facility policies and procedures. Receives and gives a comprehensive report on all residents.Works with the Interdisciplinary Team in the development and implementation of plans of care to help each resident maintain highest practicable physical, mental, and psychosocial well-being. Refers relevant care issues to this team.Modifies approaches to accommodate resident needs and preferences, manage their risk factors for functional decline, and improve their functional abilities.Reviews diet orders and other needs periodically with dietary services and other appropriate persons. Monitors restorative measures provided (range of motion, self-help skills, positioning, and transfers). Monitors skin care, measures/charts all wounds, and performs proper wound care as ordered. Keeps the Director of Nursing informed of the status of residents and other related matters through verbal communication, written reports, or team meetings. Calls physicians promptly when required by regulations and nursing care policies and charts these contacts appropriately. Calls the Medical Director if neither attending physician or alternate can be reached. Makes rounds with physicians and implements any changes in orders after visits. Orders and re-orders and checks in medication from the Pharmacy.Schedules lab tests, x-rays, and other diagnostic appointments as ordered.Administers injections as ordered and follows work practices to prevent needlesticks and procedures for proper disposal of hazardous waste. Reviews lab test results and notifies physician of same.Performs TB testing of employees and residents in accordance with TB policies and accepted practices, if by documentation, certified to do so.Immediately informs the resident, calls physicians, and notifies the designated family member and/or legal representative when there is an accident involving an injury with potential for physician intervention, a significant change in the resident's status, a need to alter treatment significantly, or a decision to transfer to a hospital, change a resident's room location or roommate, or discharge the resident from the facility. Communicates and coordinates care and delivery of services with all disciplines. Constantly observes environment for cleanliness, safety and overall appearance and makes assignments to personnel or recommendations to nursing management for addressing findings and concerns. Participates in the orientation of nursing staff, and attends all mandatory inservice training meetings. Participates on committees or teams as requested. Maintains sound customer service principles to respond to resident concerns and resolve complaints. Administrative FunctionsParticipates in the screening of prospective residents if requested. Collaborates with other departments, medical professionals, consultants, and organizations, including government agencies and advocacy groups, to support the coordination of resident care and related administrative functions, and to represent the interest of the facility. Utilizes allocated resources in an efficient and economic manner in conjunction with quality care.Collaborates with the DON to develop the Plan of Correction responses and the related QA activities.Promotes teamwork, mutual respect, and effective communication among co-workers. Oversees or is responsible for the CNA and QMA certification programs, competency testing, and all related records.Helps the Director of Nursing prepare reports of outcome trends according to Key Clinical Quality Indicators, and implements systems needed to achieve and/or surpass acceptable thresholds.Helps Director of Nursing develop or revise nursing policies and procedures that reflect current clinical practices, professional standards, and operations policies.The preceding list of essential functions is not exhaustive and may be supplemented. Note: If serving as Staffing Coordinator, Staff Development Coordinator, Infection Control Coordinator, MDS Coordinator, Quality Assurance Coordinator, or Weekend Manager, see the appropriate job description(s).
KNOWLEDGE, SKILLS, AND ABILITIESKnowledge of current state and federal laws and regulations that apply to the practice of nursing in a long-term care setting. Ability to coordinate numerous activities at any given time and make sound judgments and judicious decisions quickly, often under pressure. Ability to define problems, collect data, establish facts and draw valid conclusions. Ability to effectively present information and respond to questions from groups of managers, clients, staff, and the general public. Ability to add and subtract two-digit numbers and to multiply and divide with 10s and 100s, and perform these operations using units of American money and weight measurement, volume, and distance. Ability to read, analyze, and interpret professional journals, technical procedures, or governmental regulations; and write reports, compile statistics, define problems, establish facts, and draw conclusions. SPECIAL REQUIREMENTSMust maintain good attendance. Must be available to work overtime. Must be able to function effectively in stressful situations and emergencies. Has ability to hear the conversational voice and has sufficiently good near and far vision to supervise residents and staff and perform record-keeping duties. WORKING CONDITIONSWorks in a climate-controlled and well-lighted environment with a smoke-free policy. Works at nursing stations(s) and throughout the building daily. Is continuously subject to interruptions, noise, and odors daily. Is exposed to infections daily but is trained in handwashing practices, Universal Precautions, and the use of personal protective equipment to reduce risk. Assists with resident lifts and transfers when needed, but receives lifting training and has access to lifting equipment to reduce the risk of injury. PHYSICAL DEMANDSThe physical demands below are typical of those that must be met by the employee to successfully perform the essential functions of the position. Reasonable accommodations may be available for individuals with disabilities. Lifting/Carrying 1-10 lbs.Continuously - (61-100%)Lifting/Carrying 11-25 lbs.Continuously - (61-100%)Lifting/Carrying 26-50 lbs.Continuously - (61-100%)Pushing/Pulling 20-50 lbs.Continuously - (61-100%)Pushing/Pulling Over 50 lbs.Continuously - (61-100%)Climbing/BalancingFrequently - (31-60%) Stooping/BendingFrequently - (31-60%)Standing/SittingContinuously - (61-100%)WalkingContinuously - (61-100%)ReachingFrequently - (31-60%)