The R.N. provides direct nursing care to the residents in the assigned work area in compliance with current applicable federal, state, local and facility standards, guidelines and regulations and as may be directed by the Shift Supervisor or Director of Nursing to assure that the highest degree of quality health care of our residents is maintained at all times.
- Directs and renders care to the residents in an assigned unit within the scope of the Nurse Practice Act for Registered Nursing.
- Assists with resident assignments, admits, transfers, and discharges ensuring all care is appropriate, reflects nursing protocol and is provided on an individualized basis according to each resident’s personal, psychosocial and medical needs.
- Maintains accurate and timely reporting and recording of information regarding condition of residents and communicates a change in condition to physicians, supervisor, DON and responsible party.
- Plans, organizes and conducts the administration of medications and or treatments in compliance with state and federal regulation
- Reviews medication orders and medication sheets for completeness and accuracy of information, accuracy in the transcription of physician orders, and adherence to stop order policies.
- Ensures narcotic / controlled medication records are accurate for your shift. Notifies Director of Nursing of all drug and narcotic discrepancies noted on your shift.
- Maintains timely, accurate, and complete reporting and recording of information regarding each resident (daily charting, weekly summaries, noting of physicians orders, medication and treatment charting, consent forms, etc.).
- Monitors dietary intake of residents by supervising the meal service as assigned. Checks all trays for accuracy of special diets before trays are served to residents. Encourages positive interaction between staff and residents.
- Participates in plan of care for each resident. Assists in completion of MDS form section GG.
- Oversees the service/operations on a particular assigned group on any given shift including the orientating/training of new nursing staff and monitoring for compliance with facility policies, procedures and nursing systems to maintain and promote resident dignity and rights.
- Provides direct resident care as directed and when needed. (i.e., assist with lifting, transferring, turning residents).
- Follows facility protocol for reporting allegations of resident abuse and/or misappropriation of resident property to the Director of Nursing or Assistant Director of Nursing.
NON ESSENTIAL DUTIES
- Improves professional knowledge through professional reading, and in-service education.
- Promotes a positive calm environment on assigned unit and respond to emergencies in a calm, confident and professional manner.
- Performs all duties in a safe manner and insures that staff follow infection control procedures and universal precautions in accordance with facility procedures.
- Operates computer and programs necessary to perform job including other business office machines.
- Maintains the highest level of confidentiality at all times.
- Maintains business/professional boundaries with all staff, management and outside vendors.
- Attends and participates in department meetings and other required trainings.
- Complies with safety standards and ensures the safety, health and welfare of staff, residents, and guests at all times.
- Provides encouragement, guidance and resources to staff and residents when needed.
- Adheres to company and departmental policies and procedures.
- Performs and assists with other related duties and special projects as needed and assigned.
- Graduation from an accredited School of Nursing.
- Current CA – R.N. (Registered Nurse) license required.
- Valid CPR and First Aide certification.
- Practical knowledge of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pertain to long term care.
- Ability to demonstrate good theory base as well as good clinical skills and participates in delivering direct patient care as needed.
- Must possess supervisory ability to plan, organize and schedule work tasks and duties for assigned staff.
- Good communication skills.
- Must be able to easily interpret program, goals, objectives, policies and procedures necessary to providing quality care to assigned staff.
- Performs well with minimal supervision and organizes work load so that assigned duties and patient care can be completed within the guidelines and according to facility policies and procedures as well as state and federal regulations.
- Basic computer knowledge and skills. Experience in Point Click Care preferred.
- Ability to read, write and communicate to residents, staff, families, vendors, and all business relationships in English language.
- Ability to pass a criminal background clearance check, physical, and TB test.
- Must be able to communicate with all levels of staff in an effective, neutral and professional manner.
- Ability to function as a member of the team in a multi-task environment.
- Must be flexible and able to handle multiple priorities, with the ability to adjust to high pressure and changing conditions.