Charge Nurse, RN 6p-6a WEW

Staff Nurse (RN)

The Staff Nurse (RN) is responsible for operating within scope of practice to coordinate care delivery interventions for approximately 25 residents in assigned area in accordance with current professional practice standards, physician's orders, community policies and procedures, and local, state and federal regulations.

Essential Functions Statement(s)

• Assesses residents and manages their treatments
• Distributes and administers prescribed medications and treatments, when required, according to approved nursing protocols, including IVs if certified
• Participates in assessing, planning, implementing and evaluating resident care delivery with actual outcome, also assesses, plans, implements and evaluates services and education to be delivered to the family or significant other in coping with and participating in the management of the resident's care
• Assists in completing the initial and ongoing nursing assessments needed to plan care and interventions
• Makes resident rounds to ensure care delivery meets quality standards and restorative protocols
• Utilizes appropriate infection control techniques to prevent spread of infection
• Observes vital signs and hydration status to detect deviations from normal limits, utilizing resident care equipment and ancillary supplies
• Assists in receiving, transcribing and implementing physician's orders
• Requests and arranges for diagnostic and therapeutic services as ordered by resident's physician, from departments within the institution or from outside the facility
• Orders prescribed medications, requisitions supplies, equipment from appropriate resources, when requested
• Records resident's responses to treatments/medications, response or lack of progress toward care plan or restorative goal
• Assists in documenting and observing changes in condition and unusual incidents and reports findings to supervisor, physician and responsible party, as required
• Oversees the proper execution of the following: NG/tube insertion, placement and irrigation; Colostomy care (including irrigation); Foley catheter care (including insertion and irrigation); Texas catheter application; Straight catheterization; Tube feeding, including hanging and labeling; operating the pump; calculating intake and output
• Ensures dietary recommended feeding allowances are maintained and monitors the weights of residents, assessing for abdominal distention and residual tube placement
• Administers proper assessment skills and techniques as appropriate, including the following: Gastrointestinal, genitourinary, pulmonary, cardiac, circulatory, neurological, musculoskeletal and integumentary assessments
• Administers proper positioning techniques including transfer techniques and ROM exercises
• Administers emergency procedures, as necessary; properly administers oxygen, suctions, performs CPR and uses the ambu bag
• Demonstrates expertise in the care of the patient with a central line
• Complies with the State regulations specific to RNs in the insertion, administration and care of IVs through the following: Conducts IV site care, applies and monitors a Heparin Lock, mixes, hangs and administers IV solutions to patients, computes rate of IV fluid administration, operates the infusion pump
• Demonstrates expertise in the care of the patient with hyper alimentation
• Demonstrates knowledge of and monitors for potential complications related to central lines, and PICC lines
• Performs suctioning, as necessary including tracheotomy, nasotracheal and Tracheotomy care
• Applies proper sterile and isolation techniques as necessary
• Collects lab specimens as required
• Performs glucometer checks
• Demonstrates expertise in the care of the patient with a central line; Flushes, infusions, monitoring, tubing and bag changes, mixing of medications
• Flushes, infusion, monitoring, piggybacking of lipids, site care, obtaining orders, checking contents of bag and label compared to order
• Consults with Dining Services regarding resident's special dietary needs and follows through on recommendations
• Monitors residents with significant weight loss/gain and identifies residents at risk for nutritional problems and implements preventative measures, reporting to the physician and dietary
• Checks food brought by family members, ensuring it complies with residents' orders, dietary needs and safety
• Completes medical forms, reports, evaluations, studies, charting, etc., as necessary
• Documents the following according to policies and procedures: medications, treatments, prn's; daily 24-hour report; residents' intake and output; monthly medication renewal process; any exceptions to residents' condition; daily charting on ill residents; 24-, 48-, or 72-hour follow-up charting on residents with infections; incidents or new admits; new/changed diet orders
• Reports any discrepancies noted concerning physician's orders, diet changes, charting errors, etc., to supervisor and/or the Dining Services department
• Completes forms used throughout the residents chart accurately
• Interprets policies and procedures to personnel, residents, visitors and government agencies as required
• Assists in completion of the care plans (acute and long term)
• Participates in care conferences as deemed necessary
• Evaluates effectiveness of care interventions, identifies problems/trends and develops alternative interventions
• Understands resident's rights and conducts (as appropriate) investigations related to any alleged abuse
• Ensures progress notes are reflective of care plan and ensures they are properly followed
• Ensures assigned nursing assistants are aware of the resident care plans, and ensures nursing assistant refers to the care plan prior to administering care
• Oversees the admission process through the following: Orients patient to room, facility, policies; Obtains necessary physician orders; Completes nursing admission assessments; Orders necessary medication, supplies and diagnostic test
• Oversees the discharge process through the following: Completes post discharge plan; Educates resident on post discharge needs; Completes discharge paperwork; Informs nursing personnel of planned discharges for their shift; Arrange for discharge transportation
• Oversees the successful transfer of a patient
• Ensures all documentation is accurately completed for any admission, discharge and transfer
• Coordinates and evaluates the supportive interventions provided by nursing to other departments or services to achieve a holistic approach to resident care
• Coordinates and evaluates the efforts of other departments/services in providing education and support to family members in coping with and participating in the management of the residents' care needs
• Assists physicians, when necessary, during rounds and examinations
• Participates in the assessment, planning and implementation of nursing staff in providing resident care
• Participates in planning and implementing the coordination and involvement of nursing staff with other departments/services to teach family the management of the resident's care
• Assists with sending requisitions to initiate physician orders
• Assists in planning, developing, directing, and teaching programs of in-service and continuing education for all nursing service and other personnel and directs other departments in the same, as necessary
• Takes positive action to ensure equal opportunity in the conduct of all business activities without regard to race, religion, color, age, sex, marital status, national origin, disability, or veteran status
• Maintains confidentiality of necessary information; Handles unusual occurrences calmly and logically to maintain continuity of business and duties
• Follows all appropriate safety and security guidelines, procedures and protocol for residents in the Special Care Unit
• Maintains appropriate, effective communication with residents, and with residents' family or other significant relationships
• Provides all care, treatment and services with appropriate special care protocols
• Participates in relevant educational and training activities as appropriate
• Performs all other duties as assigned or directed

Competency Statement(s)

• Accountability - Ability to accept responsibility and account for his/her actions.
• Accuracy - Ability to perform work accurately and thoroughly.
• Communication, Oral - Ability to communicate effectively with others using the spoken word.
• Communication, Written - Ability to communicate in writing clearly and concisely.
• Customer Oriented - Ability to take care of the customers' needs while following company procedures.
• Honesty / Integrity - Ability to be truthful and be seen as credible in the workplace.
• Interpersonal - Ability to get along well with a variety of personalities and individuals.
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