A licensed professional nurse directly under the supervision of the Director of Nursing Services. The Charge Nurse is responsible for coordinating daily administrative duties of an assigned nursing unit including schedules, nursing assignments, delegation of resident care and supervision of nursing staff. Qualifications: • Graduate of an accredited school of nursing or an approved LVN program • Current nursing license, in good standing with the State licensing board • Experience in a long-term care setting, preferred • Strong qualities of leadership, communication, and organizational skills • Ability to provide patient care in accordance with applicable standards, policies, and procedures • Possess critical thinking skills to analyze, synthesize, and evaluate clinical data and observations in developing a nursing plan of care • Comprehensive knowledge of applicable nursing principles, practices, and standards of care • Possess the willingness to work with and supervise professional and nonprofessional personnel • Proficiency of the English language including the ability to speak, read, write, and comprehend the language with minimal to no difficulty • Valid CPR certification General Duties and Responsibilities: GENERAL In addition to the duties and responsibilities outlined in the LVN job description, the Charge Nurse will: • Assume responsibility and oversight of an assigned nursing unit including assignment and coordination of nursing care. • Provide supervision and support for nursing staff in accordance with their level of training and the resident’s acuity. • Monitor for compliance of facility approved procedures and policies as well as regulations set forth by state and federal agencies CLINICAL • Maintains overall shift operation in a safe, efficient, and effective matter. • Coordinates resident admissions, transfers, and discharges. • Makes daily resident rounds to interview physical and emotional status and to implement any required nursing interventions. • Routinely observes and guides direct patient care staff for appropriate technique and adherence to facility policies and procedures. • Participates in Interdisciplinary care plan meetings and contributes to the individualized person-centered plan of care for each resident. • Ensures that all safety and infection control practices are followed. • Responds to emergency situations. • Ensures that required documentation is complete and is in compliance with regulations and standards as well as policies and procedures • Assists with special projects or other duties as assigned by the Director of Nursing. COMMUNICATION • Communicates with patients and families promptly regarding treatment and care. • Communicates with the medical staff, nursing personnel, and other department supervisors and staff. SUPERVISION • Meets with unit personnel, on a regular basis, to assist in identifying and correcting problem areas, and/or the improvement of services. • Reviews and evaluates assigned personnel and makes written evaluations to the Director of Nursing and/or designee. • Coordinates Nursing service with other departments and nursing units. • Assures that all personnel follow established infection control practices and aseptic techniques when isolation procedures become necessary. • Follows required coaching and progressive disciplinary procedures. CONSUMER SERVICE • Presents professional image to consumers through dress, behavior and speech • Functions as a role model to staff. • Treats residents/family members with dignity and respect. • Responds to resident and family concern(s) and assists in resolving grievances. Records grievances per facility policy ADDITIONAL DUTIES • Actively participates in the facility's Quality Assurance (QA) program as requested or needed. Assists in correcting findings and deficiencies from the Department of Health Services, Consultants, and the Quality Assurance Team as directed by the Director of Nursing. · Ensures the protection of health information as required by the Health Insurance Portability and Accountability Act (HIPAA). • Participates in the facility’s Infection Control Program for monitoring communicable and/or infectious disease among residents and staff • Participates in procedures for reporting hazardous conditions or equipment. • Orients new staff members upon request • Attends various facility meetings (care conferences, stand-up meetings, staff meetings, Medicare meetings, discharge plan meetings, etc.) as required • Attends in-services and educational classes to maintain nursing skills competency, and current knowledge for standard of care and effective practices • Performs other position-related duties as assigned.
Sub-Acute Clinical Care Coordinator RN (Registered Nurse) POSITION SUMMARY: The Sub-Acute Clinical Care Coordinator RN (Registered Nurse) is responsible for the day-to-day nursing activities on the Sub Acute Unit, and for the quality of resident care delivered in that unit. As the Clinical Care Coordinator of the Sub Acute Unit, the RN is responsible for the overall management of the sub-acute unit. Clinical Care Coordinator reports to the Director of Nursing and/or the Facility Administrator. This position involves 30% direct patient care and 70% administrative non-direct patient care. Sub-Acute Clinical Care Coordinator RN (Registered Nurse) Qualifications/Experience: The CCC must meet the following: • Current, unrestricted California RN license • One year experience as RN in a sub-acute unit • Minimum of one year experience within the past two years working in a general acute care facility or an acquired equivalent competency appropriate to the type of sub-acute patient for which the facility provides care Direct patient care; Includes but not limited to: • Initial and ongoing rounds of unit to identify/ensure that resident needs are met: o Identification and assessment of change of condition of residents o Notification of Physician and family initiating the new plan of care o Management and Implementation of interventions • Initial resident assessment of new admissions that includes bedside review of: o Body/skin, head-to-toe assessment o Need-for-restraint assessment o Fall risk assessment o Pain assessment o Glascow Coma Scale o Oral/Dental Assessment o Dehydration Assessment o Bowel/Bladder Assessment o Psychotropic Medication Assessment o Self-Administration of Medications o Mood Assessment • Daily and ongoing bedside assessments that include: o Airway assessment and respiratory interventions o Hydration and I and O evaluation o Wound care assessment and interventions o IV therapy interventions o Nutrition assessment and weight interventions o Physical and Mobility assessment and interventions o Appropriate identification of daily activity capacity o Bowel evaluation and interventions o Evaluation of overall resident appearance including hygiene o Pain assessment with associated interventions o Fall Risk assessment and interventions • Provision of direct care that includes: o Suctioning o Identify change of condition o Follow up on skin integrity changes o IV management o Tracheostomy care/tracheostomy tube change o Emergency situation interventions o Proper positioning of residents o Observation of delivery of Respiratory care o Assessment and treatment for anxiety and distress o Tracheostomy site for signs of infection/inflammation o Dressing condition o Proper infection control with use of sterile techniques and hand washing o Condition of mouth and oral cavity and skin hygiene o Condition of emergency use equipment o Identification, evaluation and implementation of weaning process: including but not limited to; ventilator, G-tube, tracheostomy tube, pain medication, restraints and foley catheters o Care plan development, documentation and implementation based on assessment o Lab test evaluations, review and physician follow up o Direct resident care rounds with physicians Administrative non direct patient care: • The day-to-day nursing activities of the unit, which include residents’ daily care needs, emergencies, admissions, staffing and other issues as they arise. • Clinical education of nursing staff. • Oversees cost control of Sub Acute nursing supplies. • Completes monthly budgeting and staffing logs for government reports. • Utilization review, including Medicare management, documentation requirements. • Completes monthly nurse schedules and daily staffing projection. • Assists with orientation, counseling, and inservice education of subordinate staff. • Develops and integrates policies and procedures as needed. • Completes work performance evaluations of subordinate staff. • Review polices and procedures annually with Administrator and DON. • Coordinates and schedules interdisciplinary meetings. • Reviews infection control issues with infection control nurse, and coordinates integration of policies. • Completes TAR’s and PASSAR’s as needed. • Communicates with families as needed. • Coordinates facilities QA program monthly for Sub Acute unit. • Completes required documentation for chart reviews and audits. These audits are to include the following: o Incident investigations o Lab reports o Telephone order review o Admission chart review o Weight review o Skin review o Change of condition review o Psychotropic summaries • Assists with and screens patients for possible admission. Reviews, corrects, and follows up for consultant reports and audits. • Reviews CMS quality indicators monthly. • Performs other duties as assigned by the DON or Administrator. *Other duties may be assigned.
A Certified Nursing Assistant (CNA) is responsible for providing routine nursing care in accordance with established policies and procedures and as may be directed by the Charge Nurse, RN Supervisor, Director of Nurses or Administrator, to assure that the highest degree of quality resident care can be maintained at all times. Certified Nursing Assistant (CNA) QUALIFICATIONS • Currently enrolled in a school for nursing assistants or have a license as a certified nursing assistant. • A minimum of 6 months experience as a certified nursing assistant or clinical experience while enrolled in a nursing assistant certification class. • Must possess a sincere desire to serve the ill, aged and infirm. • Ability to read, write and speak the English language. • Possess the ability to deal tactfully with personnel, residents, family members, visitors, and the general public. • Willingness to work harmoniously with other personnel. • Must have patience, tact, cheerful disposition and enthusiasm, as well as be willing to handle residents based on whatever maturity level they are currently functioning. • Must be in good general health and demonstrate emotional stability. • Must be able to relate to and work with ill, disabled, elderly, emotionally upset, and, at times, hostile people within the facility. Certified Nursing Assistant (CNA) GENERAL DUTIES AND RESPONSIBILITIES: GENERAL • Perform all duties as assigned and in accordance with facility’s established policies and procedures, nursing care procedures and safety rules and regulations. • Make resident rounds at the beginning of each shift and every two hours thereafter to administer quality nursing care. • Verify the identification of a resident before administering nursing care or serving food, to assure that appropriate care is being provided to the correct resident. Report missing ID bands to admission coordinator immediately. • Make beds, clean bedside and overbed tables. • Serve drinking water as required. Assure that water pitchers are cleaned, filled with fresh drinking water and within the resident’s reach. Pass water pitcher as per established policy and procedure. • Dress residents neatly and in their own clothing. Assist residents in dressing as necessary. • Assist in preparing residents for meals (taking to/from dining room, serving trays, placing bibs, assisting in feeding or cutting food, removal of trays, supervision in dining room, etc.). • Serve nourishment in accordance with established facility procedures. • Feed residents who cannot feed themselves. • Assure that resident’s food is accessible and self-help devices are available as needed. • Prepare residents for therapy, activities, physician visits, religious services, etc., to include transporting residents to/from such activities. • Keep incontinent residents clean and dry as possible at all times. Change bed linens, diapers and clothing as often as necessary. • Do not permit residents to smoke in bed. • Assure that the nurse’s call system is attached to the bed and within easy reach at all times when residents are bedfast. • Answer residents’ call lights promptly. • Check for food in residents’ room. Ensure that food is kept in a sealed container. • Report all complaints to the Charge Nurse. • Report any resident abuse immediately (ie., harsh/abusive language, unnecessary roughness, etc.) • Report any medication found in the resident’s room. Take to the Charge Nurse immediately. • Report all hazardous conditions and faulty equipment to the Charge Nurse immediately. • Report any bruise, skin tears, incidents or accidents to the Charge Nurse immediately. • Attend in-service educational programs, on the job training programs and meetings as directed. • Other related duties as may become necessary or as directed by the Charge Nurse, RN Supervisor, Director of Nurses, or Administrator. CLINICAL • Wash hands before and after caring for each resident. • Place residents in correct and comfortable position. Head of bed elevated at 30 for all residents on enteral feeding. • Assist residents with dental and mouth care. Clean dentures after each meal. Keep dentures clean and soaked with Efferdent after dinner. • Record resident’s food and nourishment intake as directed. • Perform after meal care as required – cleaning resident’s hands, face, clothing, dentures, etc. • Assist residents to/from bathroom. Offer bedfast residents bedpans and urinals. Clean and store such equipment after each use (document Intake and Output as directed). • Check and document bowel movements and character of stools every shift. • Bathe residents as assigned and in accordance with established facility procedures (encourage showers and other self-help measures/activities). • Comb and brush resident’s hair daily. Shampoo hair on shower days. • Clip and trim fingernails. • Shave male residents daily or as needed. • Keep hair under arms and face on female residents clean-shaven as necessary or instructed. Trim hair in nose and ears as needed. • Observe and report the presence of reddened areas on bony prominences. • Keep drainage bag off the floor when resident is in bed or in wheelchair. • Apply Vaseline or A & D ointment to dry skin in accordance with established policies. • Move and turn bedfast residents at least every two hours and record such information on CNA notes. • Observe disoriented and comatose residents and notify Charge Nurse immediately. • Apply postural support properly. Check with Charge Nurse for type of restraint to be used. • Apply hand roll or splint to residents with contractures as outlined within the facility’s established policies and procedures. • Follow infection control procedures in accordance with established facility policy when isolation techniques are necessary. • Chart required information every shift. • Complete Intake and Output documentation on all residents with orders before the end of each shift. • Other related duties as may become necessary or as directed by the Charge Nurse, RN Supervisor, Director of Nurses, or Administrator. CONSUMER SERVICE • Presents professional image to consumers through dress, behavior and speech. • Adheres to Company Standards for resolving consumer concerns. • Ensures that all consumer/resident rights are protected.
