LVN (all shifts)

Job Title

Evergreen Care Center is family owned 49 bed skilled nursing facility in Fresno, CA. Staff is tight knit and welcomes new employees with open arms!

Position Description

Responsible for ensuring the delivery of efficient and effective nursing care while achieving positive clinical outcomes and resident/family satisfaction in accordance with accepted standards of practice, state and federal regulations and licensing requirements. Operates within the scope of practice defined by the state Nurse Practice Act. Responsible for resident care and direction of nursing care during assigned shift; includes staff assignments, mentoring and educating nursing personnel, working with physicians and other medical professionals.

Principal Responsibilities

• Conduct the daily nursing functions in accordance with Company, State, Federal and local rules, regulations, and guidelines.
• Admit, transfer and discharge residents with documentation regarding care and service provided.
• Participate in the orientation of new residents/family members to the facility.
• Participate in facility surveys (inspections) as scheduled.
• Ensures delivery of high-quality, positive clinical outcomes, and resident/family satisfaction during shift.
• Serves as a resource to all staff within the facility regarding the quality of services provided.
• Ability to administer medications and treatment timely and according to facility policy; Demonstrates ability to receive, transcribe, and carry out physician orders, if allowed by Nurse Practice Act.
• Effectively manages nursing personnel on shift to limit use of overtime and agency personnel.
• Assesses the work performance of nursing staff as it relates to unit standards of care and goals.
• Conducts unit huddles to promote communication programs and provides updates to DON.
• Participates in shift-to-shift communication between incoming and outgoing nursing staff.
• Coordinates shift assignments, resident assignments, rest and meal break for Certified Nurse's Aides.
• Collaborates with other departments to provide timely effective care consistent with individual's needs, choices, and preferences.
• Assumes nursing administrative responsibilities of the center for weekend and holiday coverage as requested.
• Stays and works beyond scheduled shift if needed to meet state staffing requirements and/or needs of residents.
• Ensures timely and accurate compliance of the MDS process and that it reflects the resident's plan of care.
• Ensures Point Click Care (PCC) is utilized according the company process.
• Ensures that physician orders are followed as prescribed.
• Effectively carries out medication management to ensure adequate supplies and that all medications are handled in accordance with company policy.
• Ensures that resident's attending physician and family or responsible party are promptly notified of any significant change in the resident's health condition.
• Ensures complete and prompt reporting of incidents, accidents, and adverse events to Administrator and Director of Nursing. Ensures that resident's accident/incident, adverse event and grievances/concerns are fully documented, investigated, reported and addressed in accordance with company policies and procedures and the Federal/State rules and regulations.
• Investigates resident/family complaints and takes appropriate actions to bring to resolution.
• Demonstrates knowledge and appropriate use of the Company Infection Control Manual.
• Evaluates the effectiveness of the care interventions, identifies problems and trends and develops alternative interventions.
• Other duties, responsibilities and activities may change or assigned at any time with or without notice.

Direct Care Responsibilities

• Charts progress notes in an informative, factual manner that reflects the care administered as well as the resident's response to care.
• Follows established procedure for charting and reporting all reports of incident/accidents (residents & employees).
• Identifies and reports changes in condition to supervisor, physician and family.
• Accurately identifies skin changes and follows the Company skin management protocols.
• Orders and reports diagnostic tests timely.
• Counts narcotics at the beginning and completion of each shift with the nurse leaving and coming on to the shift.
• Follows Pharmacy policy and procedures for ordering and delivering medications.
• Follows established procedures for restraint reduction.
• Assists with meal service; Identifies residents at risk for nutritional problems and implements preventative measures; Checks items and food that is brought in by family members to assure it complies with resident's orders, dietary needs, and safety; Monitors residents with significant weight loss and gain and reports this to the physician and dietary.
• Documents in progress notes any exceptions to resident's condition, including daily charting on ill residents, 24, 48, or 72-hour follow up charting on residents with infections, incidents or new admits.
• Completes documentation to reflect progress or lack of progress of residents participating in Quality of Life programs.
• Accurately completes and is familiar with the forms used throughout the resident's chart.
• Participates and conducts (as appropriate) investigations related to any alleged abuse.
• Ensures that the progress notes are reflective of the care plan and that the approaches on the care plan are being followed.

Special Nursing Care Responsibilities

Demonstrates knowledge and ability to work with: NG/tube: insertion, placement, irrigation; Colostomy care: irrigation; Foley catheter care: insertion, Irrigation; Catheter application; Straight catheterization;

• Demonstrates knowledge and ability to work with: Tube feeding: hanging and labeling, operation of pump, calculating intake and output, assuring dietary, recommended feeding allowances are maintained, monitoring the weights of residents, assessing for abdominal distention, feeding tube placement, residual.
• Demonstrates knowledge and ability to implement: Positioning techniques; Transfer techniques; ROM exercises.
• Demonstrates knowledge and ability to implement: Emergency procedures: properly administer s O2, suctions, performs CPR, and uses the ambu bag; glucometer checks.
• Demonstrates knowledge and ability to work with: IVs: conducts IV site care, applies and monitors a Heparin Lock, mixes, hangs and administers IV solutions to residents, can compute rate of IV fluid administration, operates the infusion pump.
• Demonstrates knowledge and ability to work with: Suctioning: tracheotomy, nasotracheal; Tracheotomy care; Gastrostomy care: irrigation, placement check; Sterile technique.
• Demonstrates knowledge and ability to implement: Collection of lab specimens; Isolation techniques.

Additional Responsibilities

• Attends and participates in scheduled training, educational classes, and meetings to maintain current certification as applicable; Attends and participates in in-service training as mandated by regulatory agencies and company policy.
• Adheres to work schedules in completing and performing assigned tasks; completes all assigned tasks in a timely manner as instructed by the direct supervisor.
• Meets acceptable center attendance requirements; notifies facility before late arrival to or absence from work according to established center policy.
• Cooperates with other facility personnel to ensure that services can be adequately maintained to meet the needs of residents; creates and maintains an atmosphere of warmth, personal interest, and positive emphasis, as well as a calm environment.
• Adheres to established employee policies.
• Adheres to established dress code.