LPN - Nurse - assisted living

FAHRNEY KEEDY

Boonsboro, Maryland - near Hagerstown

Licensed Practical Nurse / LPN - PRN

$30.00 plus generous applicable shift differentials

This is a PRN, as needed position in our Assisted Living/Memory Care.

Assisted Living/Memory Care

SUMMARY

The purpose of this position is to deliver daily quality nursing care to ALU residents. The Staff Nurse has the responsibility of monitoring the MT's and CNA's assigned to his/her floor to ensure the residents are receiving quality care and that they are following the policies and procedures of the FKHV and those mandated by the Federal, State, and Local Agencies.

ESSENTIAL DUTIES AND RESPONSIBILITIES

1. Conduct rounds at the beginning and end of each duty shift with on-coming/off-going shift.
2. Perform Admission Assessment on new resident admissions or re-admissions.
3. Make rounds with physicians when applicable.
4. Consult with the resident's physician in providing the resident's care, treatment, lab report results review and rehabilitation as necessary. Ensure necessary follow-up to consults is completed as directed.
5. Arrange for diagnostic and therapeutic services as ordered by the physician.
6. Assist the DRN/ALM in assessing residents, gathering data and establishing an accurate and appropriate care plan.
7. Make referrals to the Dietitian when the resident experiences a weight loss or there is an observed change in the resident's oral intake or when other nutritional concerns are noted.
8. Prepare referrals to the Rehabilitation Department when there is a change noted in the resident's physical functional status.
9. Review the resident's chart for specific treatments, medication orders, diets, etc. as necessary.

1. 10. Notify the attending physician when the resident has been in an accident or incident or when there is a change in the resident's condition. Provide the physician with an accurate assessment of the resident's condition.
2. 11. Notify the resident's family and/or responsible party when the resident has been in an accident or incident or when there is a change in the resident's condition.
3. 12. Administer professional services such as medication administration, catheterization, tube feeding, suction, applying and changing dressings/bandages, packs, colostomy and drainage bags, taking vital signs, transferring residents, feeding, toileting, etc. as required; document the provision of services accurately and on a timely basis.
4. 13. Obtain sputum, urine, stool and other specimens for lab tests as ordered.
5. 14. Monitor seriously ill residents as necessary.
6. 15. Ensure that the use of restraints (personal protective devices) is per established policies and guidelines.
7. 16. Institute and maintain preventative measures for skin breakdown.
8. 17. Complete resident skin assessments for signs of breakdown and take immediate action for treatment when indicated.
9. 18. Ensure that residents with decubitus ulcers receive appropriate treatment such as daily inspection of wounds, turning and positioning, nutritional support and maintaining a clean, dry bed.
10. 19. Participate in wound rounds when indicated.
11. 20. Review weights obtained by CNAs and verify accuracy; obtain reweigh and monitor when indicated.
12. 21. Cooperate with and coordinate social and activity programming in conjunction with Activities Department.
13. 22. Ensure that the CNA/MT’s are providing direct care to the residents and are providing such care in accordance with the resident's care plan and wishes.
14. 23. Meet with residents, and/or family members as necessary. Report problems to DRN/ALM.
15. 24. Inform the family member of the death of a resident; contact the funeral home when requested by the family; follows facility policy for postmortem care.
16. 25. Perform ADLs as required.

MEDICATION ADMINISTRATION FUNCTIONS

1. Prepare and administer medications as ordered by the physician within the specified time frames and according to established FKHV policy.
2. Document acceptance and/or refusal of medications per FKHV policy.
3. Administer medications orally, topically, by feeding tube, intramuscularly, subcutaneously, or rectally as specified per physician's order.
4. Administer all physician ordered nourishments.
5. Assess and observe resident for drug interactions and adverse reactions.
6. Assess need for PRN medications; assess and record effectiveness of administered dose.
7. Verify the identity of the residents before administering the medication.
8. Ensure that prescribed medication for one resident is not administered to another.
9. Ensure that an adequate supply of medications for assigned residents, floor stock medications, supplies, and equipment is on hand to meet the nursing needs of the residents. Report needs to the DRN/ALM.
10. Maintain medicine cart in a neat, clean and orderly manner.
11. Order prescribed medications, supplies and equipment as necessary and in accordance with FKHV and pharmacy policies.
12. Count narcotics accurately for the shift and document. Notify the DRN/ALM of any discrepancies.
13. Dispose of drugs and narcotics as required and in accordance with established procedures.

TREATMENT ADMINISTRATION FUNCTIONS

1. Perform sterile and clean dressing changes as ordered and per FKHV policy; label, date and initial dressings.
2. Assess wound appearance, stage, drainage, size, and document on skin grid per FKHV policy.
3. Administer tube feedings per physicians order (continuous or bolus) and flushes per physicians order and FKHV policy.
4. Insert/change urinary catheters (Foley and suprapubic) per physician’s orders and FKHV policy.
5. Irrigate Foley catheters per physician’s orders and FKHV policy.
6. Insert/change gastric tubes per physician’s orders and FKHV policy.
7. Administer oxygen and respiratory treatments.
8. Change oxygen tubing and other respiratory equipment per FKHV policy.
9. Perform Colostomy Care as ordered.
10. Administer douches and enemas as ordered.
11. Assess and document resident's response to treatments and procedures.

CHARTING AND DOCUMENTATION

1. Complete and file required forms upon resident's admission, transfer and discharge.
2. Ensure that attending physician's review, record and sign their progress notes and orders in accordance with FKHV policies.
3. Receive telephone orders from physicians and record accurately.
4. Transcribe physician's orders to resident's charts, MAR, TAR, ADL and Lab books accurately.
5. Chart nurses' notes in an informative and descriptive manner that reflects the care provided to the resident as well as the resident's response to care. Review previous nurse’s notes to assure continuity and follow up.
6. Date, time and sign all entries in the clinical record.
7. Write legibly in black ink.
8. Use only authorized abbreviations established by FKHV when recording information.
9. Chart all reports of accidents, incidents and change of condition.
10. Complete incident report for all accidents and injuries - witnessed or non-witnessed; initiate non-witnessed injury investigation when indicated.
11. Record new or changed diet orders and forward information to Dining Department.
12. Report all discrepancies noted concerning physician's orders, diet changes, charting errors to DRN/ALM. Complete Medication error reports as indicated.
13. Document medication and treatment administration and refusal and response to drugs per FKHV policy. Report refusal of medications to physician.

SAFETY AND SANITATION

1. Observe and follow established infection control policies and procedures; ensure that staff follows procedures and that par levels of personal protective devices is available.
2. Ensure that ALU areas are maintained in a clean and sanitary manner.
3. Ensure that resident’s rooms and common areas are maintained in a clean, safe, sanitary manner.
4. Participate in all fire safety and disaster preparedness drills in a safe and professional manner.
5. Follow established safety regulations for the use of equipment and supplies and ensure that staff follow established polices for their use.
6. Report broken or damaged equipment and supplies and complete work order slips as indicated.
7. Participate in Fall Risk Management program and ensure that CNAs and MTs are aware of residents at risk.
8. Institute appropriate infection control procedures when residents require specific precautions and/or isolation.

RESIDENT'S RIGHTS

1. Honor and maintain all Resident's Rights.
2. Maintain the confidentiality of all resident care information.
3. Monitor nursing care to ensure that all residents are treated fairly, and with kindness, dignity and respect.
4. Ensure that all nursing care is provided in privacy and knock before entering the resident's room.
5. Understand and honor the resident's rights to refuse treatment.
6. Report and assist in the investigation of all allegations of resident abuse and/or misappropriation of resident property. Notify DRN/ALM immediately when abuse is suspected.

PERSONAL AND PROFESSIONAL

1. Follow all rules and policies as outlined in the Associate Handbook.
2. Attend and participate in assigned committee FKHV meetings.
3. Attends and participate in all mandatory and scheduled in-services.
4. Attend continuing education programs to keep abreast of changes in assisted living and long term care.
5. Read memos, notices and communication books and keep abreast of changes occurring within FKHV.
6. Cooperate with other resident services and departments and maintains positive working relationships with all staff, residents, visitors and volunteers.

SUPERVISORY RESPONSIBILITIES

1. Participate in employee performance evaluations, providing information on performance of CNAs and MTs to DRN/ALM
2. Make daily rounds of the assigned residents; ensure that CNA/MTs perform their work assignment in accordance with acceptable nursing standards. Report problems to DRN/ALM.
3. Develop and maintain a good working rapport with intradepartmental personnel as well as interdepartmental personnel to ensure that nursing services and activities can be adequately maintained to meet the needs of the residents.

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION and/or EXPERIENCE

High school diploma or general education degree (GED) and completion of an approved nursing program. Must be knowledgeable of nursing and medical practices and procedures as well as laws, regulations, and guidelines that pertain to long term care.

COMPUTER SKILLS

Enter, adjust and retrieve data using a microcomputer or personal computer and keyboard.

LANGUAGE SKILLS

Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of residents, visitors, or associates of organization.

MATHEMATICAL SKILLS

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.

REASONING ABILITY

Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. Must posses the ability to make independent decisions when circumstances warrant such action.

CERTIFICATES, LICENSES, REGISTRATIONS

Must possess a current, unencumbered, active license to practice as a registered nurse or licensed practical nurse in Maryland.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to stand. The employee frequently is required to walk; sit; use hands to finger, handle, or feel; reach with hands and arms; stoop, kneel, crouch, or crawl; and talk or hear. The employee must frequently lift and/or move up to 50 pounds independently or move up to 100 pounds to a minimum height of 4 feet and be able to push, pull, move and/or carry such a weight a minimum distance of 100 feet with assistance from another or mechanical lift.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.

1. Works in office areas as well as throughout ALU. Is subject to frequent interruptions.
2. Is subject to hostile and emotionally upset residents, family members, and visitors.
3. Works beyond normal working hours and on weekends and holidays when necessary.
4. Is subject to call-back during emergency conditions (e.g. severe weather, evacuation, post disaster, etc.)
5. Is subject to the handling of and exposure to hazardous chemicals.
6. Is subject to exposure to infectious waste diseases, conditions, etc. including TB, and the HIV and Hepatitis B viruses.