***THIS POSITION IS ON-CALL***
Schedule: Weekend Shifts
General Statement of Duties:
This position performs duties that maintain order and efficiency of the nursing station, meet facility needs and comply with State, Federal, and local regulations.
Distinguishing Features of the Class:
This position provides clerical support and recordkeeping for the medical aspects of resident care at the nursing home. Under the general supervision of the Director of Nursing, the Ward Clerk is expected to work independently in the processing
and recording of forms, records, and vital statistics.
Examples of Duties:
Transcribes physician’s orders, notifies other facility departments regarding orders affecting them, and notifies pharmacy;
Reviews medical records to maintain quality assurance and notifies Unit Supervisor of any discrepancies found;
Maintains confidentiality of all resident information;
Performs as receptionist for unit, which includes answering phones and door, delivers messages to staff and residents, delivers mail/flowers to residents, greets and directs visitors to residents’ rooms;
Maintains a current listing of frequently used phone numbers of hospitals, clinics, specialists., and transportation companies for staff use;
Completes necessary chart paperwork and transportation for admissions/discharges/transfers; obtains photograph for medical record of all residents upon admission;
Coordinates clinic/hospital appointments for residents, which includes notification of family members, arrangements for appropriate paperwork to be sent, and transportation there and back;
Maintains oxygen supplies and medial supplies in the nursing unit, purchases supplies in the community as directed by the Director of Nurses;
Maintains records of all labs for residents; notifies nurses regarding labs required each week and transports lab specimens to the hospital as needed;
Updates and maintains resident information in nursing home computer program, which includes: MDS, diagnostic list, special needs listing, resident roster, census and conditions and admission information, prints out reports as needed;
Maintains and updates wanderers listing for facility;
Files dictations, labs, x-ray reports in chart;
Notifies pharmacy of any changes needed prior when to med sheets/treatment sheets/behavior sheets are due to come to the facility monthly; once arrived, processes these sheets to appropriate books for nursing staff’s use;
Participates in appropriate in-service training programs and fire safety/disaster preparedness drills; Follows established procedures in infection control and use of equipment and supplies;
Charts in nursing notes, records vital signs, weights as needed, records medical information in accordance with established documentation policies and procedures;
Updates and prints out resident information reports in nursing home computer;
Records resident identification data on designated med records and ID cards;
Copies medical forms and resident chart information as needed;
Notifies MD’s of visit requirements and when they need to see residents;
Coordinates yearly flu vaccines for residents;
Assists in replacement of staff scheduled on unit due to absenteeism;
Perform other duties as assigned.
Required Skills, Knowledge, and Abilities
Knowledge of medical terminology. Good spelling and good telephone etiquette. Must be able to work under minimal supervision and have good organizational skills. Be available to residents and families for information regarding facility chedules, policies, activities. Maintain good public relations and good rapport with other departments within the facility. Willing to implement new methods as the needs of the nursing home change. Knowledge of MDS assessment. Knowledge of computer clinical software applications for nursing homes. Subject to testing related to typing, spelling proofreading and medical terminology. Must be able to read, write, speak and understand English.
High School or equivalent. Additional ward clerk course at technical school preferred.
Any equivalent combination of experience and training which provides the required skills, knowledge, and abilities.
Must maintain valid driver’s license with the minimum state requirement for insurance as well as have a vehicle available for transportation.