Director of Nursing

Job Description

Job Description

POSITION SUMMARY:

Under the supervision of the Administrator, the Director of Nursing has the authority, responsibility, and

accountability for the functions, activities, and training of the nursing services staff, in addition to the

supervision of the Therapy Department and its’ functions within the facility. In the absence of the

Administrator, the DON assumes responsibility for the facility. The DON is responsible for the overall

management of resident care 24 hours a day, seven (7) days per week. The DON is delegated the

responsibility for carrying out the assigned duties in accordance with current existing federal and state

regulations and established company policies and procedures.

ESSENTIAL JOB FUNCTIONS:

A. Role Responsibilities – Job Knowledge/Duties:

1. Demonstrates knowledge of age specific developmental factors specific to adult and geriatric

residents (i.e. physical, cognitive, and socialization factors) in planning delivery of care

2. Demonstrates knowledge, skills and techniques necessary to care for residents with the

following needs: therapeutic, neuro and dementia, dialysis, IV therapy, infectious disease and

wound care, if applicable

3. Attends all mandatory in-services by employee’s anniversary date

4. Acts appropriately under the direction of the Administrator and acts as an active member of

the interdisciplinary team

5. Demonstrates ability to adjust to changes in shift assignments to meet resident and family

needs

6. Ensures the residents receive skilled nursing and rehabilitation services, as needed

7. Successful completion of facility orientation on the care of a resident on a specialized

dementia unit, as appropriate

8. Communicates and observes the Corporate Compliance Program effectively and complies with

Code of Conduct when performing work functions

9. Other duties as assigned by the Administrator

B. Role Responsibilities – Administrative Duties:

1. Develops and periodically updates statements of philosophy and objectives that define the type

of nursing care, the facility proposes to provide. Ensures that these are understood and

implemented by nursing personnel

2. Supervises, evaluates, counsels, and disciplines inter-departmental personnel

3. Assists in the recruitment, interviewing, and selection and termination of nursing personnel

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4. Ensures that a sufficient number of qualified supervisory and supportive nursing personnel are

assigned for each unit/shift to meet the residents needs

5. Participates in all screening processes prior to admission. Assesses items needed by the facility

to meet resident needs

6. Participates in coordination of resident services through departmental and appropriate staff

committee meetings (i.e. Quarterly Quality Assurance and Assessment, Pharmacy Services,

Therapy Services, Infection Control and Resident Care policy and procedure meeting)

7. Plans staff development programs that will enhance staff knowledge of quality resident care

8. Conducts periodic review to ensure all documentation is informative and descriptive of

nursing care and of the resident’s response to that care

9. Participates in planning and budgeting for nursing services

10. Conducts periodic review to ensure that the nursing requirements of each resident admitted to

the facility are reviewed and that the physician is consulted in planning resident care

11. Maintains professional competence through continuing education

12. Conducts periodic review of appropriate staff to ensure nursing personnel have valid and

current licenses

13. Demonstrates knowledge of current Health Department Directives and ensures that directives

are implemented by staff

14. Conducts periodic review that the facility and personnel are in compliance with State Code

Requirements

15. Demonstrates availability to be on-call 24 hours a day for nursing emergencies

16. Makes rounds upon entering the building each day. Checks each nursing unit for staffing,

census, unstable residents, accidents and incidents, etc. Ensures grooming is 100% each day

and implements plans to correct grooming concerns, if necessary

17. Reviews all Accidents and Incidents (A/I) daily and develops an appropriate plan to prevent

future accidents and incidents. Conducts periodic reviews of documentation for inconsistencies

on each unit

18. Audits specific resident care issues on a daily basis such as skin, ambulation, etc. Devises a

Monthly Planning Calendar as a minimum guideline for auditing care issues. The calendar will

reflect weekend and night-shift audits as well as day shift audits

19. Makes frequent and focused rounds at least one time per week with supervisors and charge

nurse as appropriate

20. Approves the staffing schedule according to budgeted levels and checks daily for the number

of staff available for the week (especially weekends). Documents approved vacation/time off

for nursing department

21. Observes all pressure sores on a weekly basis, evaluating documentation and treatments

22. Meets with Nursing Assistants, Charge Nurses and all licensed staff on a routine basis to

review nursing and facility issues. Ensures plans are in place to correct employee concerns

23. Introduces self to new admissions within 48 hours. Checks for documentation initiation (i.e.

physician orders, initial assessments, nursing care plan, etc.)

C. Role Responsibilities – Nursing Systems:

1. Ensures that systems are established and consistent throughout the facility. These include but

are not limited to (as per standardized procedure):

a) Develops unit management system for group assignments and Nursing Assistant

responsibilities

b) Achieves goal of reducing restraints to a minimum, and ensuring restraints are released at

least every 2 hours, or per Care Plan. All restraint releases are to occur on the unit at the

same time or per Care Plan, and be observed by a licensed staff member

c) Conducts periodic review to ensure that all residents are to be out of bed by noon, or per

Care Plan, unless a specific physician order indicates bed rest

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d) Ensures turning and positioning schedules are followed every two hours (or per Care Plan).

Ensures turning and positioning system can be easily monitored (i.e. all face the door at the

same time)

e) Ensures that resident ambulation occurs as an observed system (i.e. before the meal period

in the dining room)

f) Oversees scheduling of nurses for employee meals or breaks

g) Conducts periodic reviews to ensure supplements are passed according to developed

schedule

h) Conducts periodic review to ensure that environment is clean, orderly, and organized.

Ensures cleaning schedules are in writing and audited daily. Reviews and implements

infection control and exposure control plans according to policies and procedures

i) Reviews Change of Condition/24-Hour Report daily and deletes residents from the report

as needed

j) Demonstrates ability to perform all physical and mental job functions of a certified nursing

assistant, licensed practical nurse, and registered nurse

D. Role Responsibilities – Nursing Documentation:

1. Ensures that nursing documentation meets the following standards:

a) Care Plans are to match monthly summaries; Nursing Assistant Care Sheets, Nursing

Assistant worksheets, treatment sheets and physician orders

b) Maintains and evaluates statistics for; pressure sores, resident Accidents and Incidents,

number N/G or G tubes, number of justified foley catheters, resident census, resident and

employee infections

c) Reviews all closed charts of expired residents and ensures appropriate documentation by

nursing during the last 48 hours and discharge orders by physicians are enclosed (to

contain how and where discharge, i.e. to funeral home via stretcher). Reviews discharge

summaries of all residents

d) Conducts periodic reviews of Care Plans to ensure they are interdisciplinary and updated

by the Charge Nurse daily as changes occur

e) Ensures all communication to nursing by other disciplines are flagged and the Charge

Nurse is responsible for implementing the changes on all forms

E. Role Responsibilities - Interpersonal Skills:

1. Is aware of, and adheres to, Resident’s Bill of Rights and Confidentiality of Resident

Information

2. Interacts with residents and family members, co-workers, clinical and ancillary staff in nonjudgmental, supportive and calm manner

3. Addresses family satisfaction issues immediately and assists in resolving the matter in a

professional manner

4. 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

5. Is aware of Resident Abuse Reporting Law and ensures staff understanding/compliance

6. Participates as assigned in the orientation of new staff and demonstrates a positive, helpful and

enthusiastic attitude

7. Creates and maintain an atmosphere of warmth, personal interest, and positive emphasis as

well as a calm environment throughout the facility

8. Maintains a productive working relationship with other department directors

F. Role Responsibilities - Safety:

1. Demonstrates ability to locate emergency equipment (i.e. emergency oxygen tank)

2. Understands and can demonstrate knowledge of role in Fire and Disaster drills

3. Demonstrates ability to identify and respond appropriately to potential behavioral outbursts

4. Uses facility equipment safely

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5. Recognizes, removes, and/or reports potential hazards

6. Ensures that nursing personnel follow established safety regulations in the use of equipment

and supplies at all times

G. Role Responsibilities – Infection Control:

1. Demonstrates proper hand washing techniques and ensures all nursing personnel follow

established hand-washing procedures

2. Disposes of waste properly and ensures that nursing personnel follow established policies

governing the use/disposal of personal protective equipment and disposal of infectious wastes

3. Understands and maintains nursing sanitation procedures, when necessary

4. Reports occupational exposures to blood, body fluids, infectious materials, and hazardous

chemicals in accordance with facility and governmental policies and procedures governing

accidents and incidents

5. Ensures all personnel performing tasks that involve potential exposure to blood, body fluids, or

hazardous chemicals participate in appropriate in-service training programs prior to

performing such tasks

H. Role Responsibilities – Resident Care/Dignity:

1. Addresses residents in a respectful manner

2. Maintains confidentiality and discusses confidential resident information in appropriate areas

only

3. Knocks on door prior to entering resident rooms and maintains resident privacy and dignity

when providing treatments or other resident care

4. Ensures nursing personnel comply with residents’ personal and property rights

EDUCATION/EXPERIENCE:

1. Maintains a current, valid Nursing License as a registered professional nurse in the state in

which the facility resides.

2. Possesses a minimum one (1) year of experience in nursing service administration. Additional

education or experience in such areas as rehabilitative or geriatric nursing is preferred

3. Possesses strong knowledge of state, federal and local regulations as they pertain to long term

care

4. Is employed full-time and serves only one facility in such capacity

5. Maintains rapport with outside medical professionals

6. Successfully completes facility conducted orientation, mandatory training and in-service

programs

7. Must meet health assessment requirements, including two stage Mantoux skin test

8. Must be capable of performing the essential functions of the job, with or without reasonable

accommodations

9. Must be able to communicate in English, both verbally and in writing, and possess sufficient

communication skills to perform the tasks required

PHYSICAL REQUIREMENTS & WORKING CONDITIONS:

“Occasionally” equals approximately 1% to 33% of the workday, “Frequently” equals approximately 34%

to 66% of the workday, and “Continuously” equals approximately 67% to 100% of the workday.

1. Job Requirements: Hours Per Day:

a) Sit 2 to 3 hours

b) Stand 3 to 4 hours

c) Walk 3 to 4 hours

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2. Movements: Frequency:

a) Bend/Stoop Occasionally

b) Squat/Crouch/Kneel Occasionally

c) Crawl Rarely

d) Reaching Occasionally

e) Balancing Occasionally

f) Pushing/Pulling Occasionally

g) Climbing Rarely

3. Weight Carried/Lifted: Frequency:

a) Up to 34 pounds Occasionally

b) 35 to 50 pounds Occasionally

c) 51 to 100 pounds Occasionally with assistance*

d) 100 + pounds Rarely with assistance*

4. Is subject to call-back during emergency conditions (e.g., severe weather, evacuation, postdisaster, etc.)

5. Is subject to injury from falls, burns from equipment, odors, etc., throughout the work day, as

well as to reactions from dust, disinfectants, tobacco smoke, and other air contaminants.

6. Is subject to exposure to infectious waste, diseases, conditions, etc., including TB and the

AIDS and Hepatitis B viruses

7. May be subject to the handling of and exposure to hazardous chemicals

8. May be necessary to assist in the evacuation of residents during emergency situation