Job Description
Job Description
POSITION PURPOSE :
The RN manages and supervises resident care ensuring the highest quality of care is received in accordance with the BON standards, is guided by the Residents’ Bill of Rights and abides by the facility Quality Assurance and Performance Improvement (QAPI) program. Through the collection and analysis of data, the RN is accountable for performing a comprehensive assessment to establish the baseline health status of residents as well as to create a detailed Plan of Care that includes individual needs and preferences. RNs oversee practical nurses, CNAs and nursing personnel through assessment of their knowledge, skill and capabilities; clarifying expectations and addressing behavior to ensure the safety of residents and to attain the ultimate goal of achieving and maintaining the highest practicable physical, mental and psychosocial well-being of each resident.
ESSENTIAL FUNCTIONS OF POSITION :
RESIDENT HEALTH STATUS ASSESSMENT AND PLANS OF CARE
- Performs comprehensive assessment through the collection of data sourced from resident and family interviews, observation, review of medical records, etc., used to create an initial health status baseline.
- Drafts an integrated, resident-centered Plan of Care, based upon comprehensive health status assessment and input from the interdisciplinary care team.
- Facilitates Plan of Care through assigning responsibilities and clearly communicating residents’ needs.
- Maximizes quality of living through continual monitoring and evaluation of resident care and correlated recommendations, ensuring all goals and outcomes are thoroughly and accurately documented.
ENSURING ADEQUATE AND PROPER NURSING CARE
Ensures integration and effectiveness of resident’s Plan of Care while developing and implementing nurse interventions and evaluating correlated responses.Collaborates with and coordinates the interdisciplinary care team to manage implementation of care, delegating nursing activities as needed.Provides guidance on health promotion, disease prevention, care coordination and findings to the interdisciplinary care team, designing and implementing correlated resident teaching plans.Supervises ongoing resident care under the scope of the Residents’ Bill of Rights, immediately reporting any suspicions, reports or witnessed events of abuse, neglect, misappropriation of resident property.Maintains awareness of facility QAPI goals and abides by and promotes the QAPI program.Displays and promotes a strong culture of customer service, ensuring a resident-centered experienceProvides and ensures nursing activities are practiced in accordance with the BON standards while protecting residents’ dignity, privacy and autonomous decision-making whenever possibleProvides the highest quality care to all residents, without regard to race, gender, sexual orientation, religion, age or differences in cultureInteracts regularly with resident’s family or support network, reporting any changes in health, treatment, care, or living situationCompletes nursing activities indicative of RNs such as inserting PICC lines, preparing IVs, administering IV medications, accessing IV ports, drawing or administering blood, providing resident education, accepting verbal orders or determining nursing diagnoses.Recognizes limits of knowledge, skill and experience; facilitates situations beyond the RNs competency.COMPLIANCE – SAFETY, DOCUMENTATION, HIPAA
Ensure all call lights are promptly and courteously answered or immediately facilitates.Uses and guides other nursing staff on always using proper body mechanics.Uses, observes, and instructs nursing staff in safe lifting and care techniques including proper use of equipment.Maintains knowledge of, promotes and follows site safety policies, OSHA guidelines regarding bloodborne pathogens and Standard Precaution infection control policies to provide safe nursing care.Maintains a safe, clean environment in resident rooms and facility following procedure to bag infectious linens and equipment or proper disposal of them; proper handwashing, disinfection / cleaning schedules.Ensure physician orders are strictly followed, and that provisions are in place to assure compliance.Ensure resident records are complete through systematic collection of data, maintained and secure from unauthorized access, following all state and federal regulations, including HIPAA.Gather and documents data on admissions and discharges.Accurately complies with site pharmaceutical policies including sign out and administration of medications; reporting and documenting medication errors; obtaining and transcribing physician orders; proper procedure for label changes and expirations; following controlled substance policies and end of shift count; documenting PRNs.Documents all nursing orders that have been initiated.SUPERVISION AND MANAGEMENT
Manages, supervises, and evaluates nursing practices, articulates expectations and provides corrective guidance as needed.Prioritizes work assignments consistent with number and level of staff available and resident care acuity.Ensures proper staffing level, working as staff nurse if needed.Ensures duties re complete, following up with delegated tasks and reviews departing staff reports.Provides nursing reports to staff regarding daily resident care needs and significant changes in condition.Maintains knowledge of disaster procedures and implements if needed.Promptly reports and documents incidents and errors involving residents, staff, visitors, or self.Education / requirements :
Completion of a professional nursing education program approved by the Board of Nursing for the state in which the facility is located.Current License as a Registered Nurse for the state in which the facility is located.Current Certification in Cardiopulmonary Resuscitation (CPR) and emergency carePreferred : Experience in skilled nursing and / or assisted living community.Required Skills and Abilities
Leadership; achieves established goals through inspiration and loyalty of staff.Resilience : ability to welcome constructive feedback, course correct and not take it personallyPersonability; ability to get along with all personality types and inspire trust with residents, staff, family High emotional intelligence (EQ)Ability to actively listen, with the goal of understanding.Ability to clearly speak and proficiently read, write and understand English.PHYSICAL DEMANDS
The physical demands described below are representative of those that an employee in this position would encounter on the job. Reasonable accommodation may be provided, when possible, to enable individuals with disabilities to perform essential functions.
Rarely = not a regular part of this job
Occasionally = less than 1 / 3 of a shift
Frequently = 1 / 3 to 2 / 3 of a shift
Constantly = more than 2 / 3 of a shift
☒ = an essential part of the job regardless of frequency or duration
Physical Activity
☒ Lifting Weight / Exerting Force : Frequently throughout the day will lift or exert force up to 50 lbs; Occasionally lifts 100 lbs.
☒ Standing and Walking : Frequently needed throughout the day (ability to be mobile around the facility throughout the day)
☒ Sitting : Frequently sits throughout the day
☒ Using Hands : Constantly uses hands throughout the day
☒ Reaching : Frequently reaches throughout the day
☐ Climbing and / or Balancing : Rarely needs to climb or balance
☐ Stoop, Kneel, Crouch, Crawl : Occasionally needs to stoop, kneel, crouch or crawl
☒ Talking : Frequently needs ability to talk throughout the day
☒ Hearing constantly needs to hear and listen throughout the day
☒ Vision : This position requires the ability to use close, distance, peripheral-vision, depth perception and ability to adjust focus