Assistant Director of Nursing

Job Overview Summary:

The Assistant Director of Nursing acts as the back-up leader of the nursing department for the DON. They ensure the highest quality of care is provided to residents by ensuring that systems of care are followed, coaching and mentoring the Unit Managers, and performing restorative and infection control nursing functions.

Functions:

Quality of Care Duties

• Patient/Clinical Care: Ensuring the delivery of high quality, standardized care to patients.
• Manage implementation of corporate systems for delivering care in order to improve and standardize care
• Oversee and coordinate implementation of programs (e.g., falls, restorative, At-Risk) in order to deliver quality care
• Ensure clinical integrity and appropriate clinical management is delivered by orienting nursing staff to care plans, and ensuring care plans are assessed, reviewed and revised as necessary
• Ensure proper documentation is maintained relating to residents’ treatment, medications and conditions
• Consult with Unit Managers on their rounds to ensure residents receive proper care and quality assurance is obtained
• Identify and encourage the sharing of best practices between units in order to improve clinical outcomes
• Mentor the Unit Managers on how to perform their jobs, including ensuring the nursing staff know how to develop and deliver the plan of care
• Meet regularly with the DON to receive coaching on the ADON role in order to be the back-up to the DON
• Ensure standardized and consistent care of practice is delivered within the facility
• Ensure residents’ rights and customer satisfaction by treating residents with dignity and respect
• Quality Improvement/Survey Preparation: Improving the quality of care delivered to patients and staying in compliance.
• Assist in the implementation of quality improvement plans and plans of action to correct deficiencies
• Assist in the preparation for federal, state and JAHCO surveys by ensuring programs are implemented and documentation is complete and accurate
• Investigate causes of incidents, analyze patient trends, and report findings to DON in order to prevent deficiencies
• Attend quarterly meeting and provide reports, graphs, safety and infection control information
• Assist DON during survey by answering questions and providing information

Restorative Program Coordinator:

• Ensuring that restorative plans are implemented, and nursing staff perform their jobs in accordance to restorative plans.
• Ensure that therapy plans are documented and carried out in order to improve patient functioning (e.g., ambulation, eating)
• Ensure that the transition from therapy is smooth, and that therapy goals are written
• Ensure that all residents have at least two restorative programs of 15 minutes each for minimum of 6 days/week to be eligible for reimbursement
• Participate in monthly review of restorative plans, and sign off on documented plans at the end of the month
• Ensure that restorative tracking forms are signed, and that Unit Managers meet with restorative aides to stay abreast of restorative activities
• Attend daily PPS meeting and bring all restorative minutes for skilled residents
• Infection Control Coordinator: Ensuring that an effective control program exists, and that nursing staff perform their jobs in accordance with the program.
• Coordinate and direct the Infection Control Program by maintaining infection control precautions, isolation procedures, aseptic techniques, and removal of infected material
• Ensure that residents with known infections and diseases are placed in isolation in order to prevent the spreading of infections
• Analyze infection control trends and arrange in-services to address identified trends
• Ensure that nursing services personnel follow established infection control precautions and procedures, and that nursing service work areas are safe and clean
• Educate nursing staff about infection control policies and procedures
• Ensure infection control logs are complete, run monthly meetings and produce minutes in order to control infections
• Ensure proper documentation of infection control issues for DON

Managerial Duties

• Manager: Effectively guiding the performance of the ADON’s direct reports by managing and motivating Unit Managers.
• Articulate the vision for the building in order to provide the Unit Managers with motivating goals
• Work with the DON to create a positive working environment to increase morale, decrease turnover and promote longevity of nursing staff
• Coach, recognize and reward staff in order to create a nursing staff team
• Motivate and encourage staff during challenging times in order to create a sense of stability and proactivity
• Work with Unit Managers to teach them how to encourage positive behavior and outcomes
• Delegate and help the Unit Managers problem solve in order to encourage problem solving at the lowest levels (i.e. only escalate problems that cannot be resolved by the ADON to the DON)
• Ensure that Unit Managers are articulating consistent expectations and managing to those expectations
• Problem solve with Unit Managers so the conflicts over roles and responsibilities among staff are resolved

Staff Development/Learning Promoter:

• Developing capabilities in the nursing staff by assessing and addressing learning needs.
• Identify group educational needs of staff and coordinate resources to fulfill those needs (e.g., work with Director of Education, reach out pharmacy, wound nurse)
• Address individual learning needs, and serve as the educational point person
• Schedule in-services and log all nursing department in-services in books
• Assist with tracking Harborside University
• Track CNA hours quarterly to ensure they are maintaining compliance with state regulations
• Work with DON to create mentor program
• Ensure that all nursing services personnel have valid and current licenses and are performing duties in accordance with acceptable nursing standards

Management Team Duties:

• Developing relationships and setting common goals with the nursing staff.
• Prepare for and run the weekly nursing management meeting
• Meet with DON to present united DON-ADON front to the Unit Managers
• Act for and speak for the DON in his/her absence (i.e. act as DON backup)
• Meet with other members of the nursing management team in order to coordinate nursing department efforts

Budgetary Duties

• Financial Duties: Understanding how revenue and costs contribute to the finances of the nursing department.
• Work with the DON to learn DON financial duties (e.g. how to maximize the length of stay, minimize unplanned discharges, and control costs)
• Ensure the completion of Medicaid reimbursement forms (MMQ) and additional responsibilities as assigned depending on the state reimbursement system
• Inventory and Equipment: Ensuring that supply requests are identified, and staff know how to operate equipment.
• Interact with central or medical supply to convey supply requests
• Ensure that trained and authorized personnel operate nursing services equipment in a safe manner (e.g., glucometer machine, Hoyer lifts, pulse oximeter)
• Admissions: Understanding the admissions process and communicating admission decisions to the nursing staff.
• Communicate new admits to staff in order to establish expectations with nursing staff
• Learn the admission process from the DON (e.g. how to evaluate admits, establish relationship with the Nurse Liaison and ensure clinical capability to meet care
• Staffing: Ensuring that staffing policies and programs are implemented.
• Work with the scheduler to ensure information about tardiness and absences are gathered and delivered to the DON
• Participate in implementing programs developed by the Corporate Compensation Committee in order to creatively staff the building (e.g., employee recognition, trading days, creative staffing)

Other duties

• Human Resource Duties: Ensuring that the appropriate nursing staff are available and prepared to do their jobs.
• Recruit, interview, and select nursing services personnel
• Perform reference checks, annual license/certification checks and ensure that new employees have first step PPD at least two days prior to orientation
• Coordinate general orientation with other departments for all new hires
• Oversee employee health (e.g., TB testing and Hepatitis) to ensure records are complete and in order
• Document and coordinate personnel actions with the Human Resources Director and Administrator
• Discipline and terminate Unit Managers
• Assist in monitoring of labor hours and staffing levels
• Scheduling: Overseeing the schedule for the nursing department.
• In the absence of a nurse scheduler position in the facility, the ADON may be responsible for the following as assigned by the DON: develop strategies for replacing staff and dealing with call offs, post vacant shifts by the time clock, etc.
• Training/Professional Development (Self): Ensuring that the ADON identifies and addresses his/her own learning needs.
• Work with DON to receive training on how to act as the DON in his/her absence
• Establish relationships with other ADONs to problem solve/share best practices
• Attend outside management and clinical seminars as approved by the DON, Administrator and Regional VP
• Meet CEU licensing requirements (e.g. physical assessment course, Harborside University)
• Attend workshops offered by Harborside (e.g. Vital Learnings)

Qualifications:

• Must be a registered nurse in good standing and currently licensed by the state
• Must show ability to read and write in a legible and understandable manner
• Must speak and understand English
• Previous experience in a hospital, long-term care facility, or other healthcare related facility
• Previous experience as an ADON or Unit Manager
• Must be knowledgeable of general, rehabilitative and restorative nursing and medical practices and procedures and laws, regulations and guidelines governing long-term care
• Must have advanced training in infection control procedures

Knowledge and Skills:

• Check assignment and sign in on nurse sign-in sheet to include room #'s of assignment.
• Obtain report from off-going nurse.
• Complete and sign narcotic count with off-going nurse.
• Give CNAs assignments to include pertinent information and report, as well as review cleaning assignment and scheduled break times.
• Make walking rounds on assignment every two hours.
• Supervise CNAs and provide constructive direction as well as assistance when needed.
• Give medications as per orders. Be sure to check MARS/TARS prior to the end of shift for missing initials.
• Utilize 24-hour report to its fullest potential. (This also helps to keep you focused on who, what, when and where you need to document and notify).
• Notify MD, family and supervisors of change in condition of residents PRN and document fully in nurse’s note.
• Complete all treatments and document.
• Complete all admission, discharge and transfer paperwork.
• Answer call lights and assist with ADLs as needed.
• If resident falls, fill out an incident report. An investigative report is required for all falls and the Fall Care Plan must be updated at the time of the fall.
• Chart on assigned residents.
• Chart on new admissions every shift for 72 hours
• Clean and stock medication and treatment carts at the end of each shift. Provide shift-to-shift report to oncoming nurse.
• Chart changes of condition on 24-hour report.
• Complete and sign narcotic count with oncoming nurse.

Required Responsibilities:

Successful demonstration of work standards, quality work product, productivity, and job knowledge are standard expectations for all company employees.

Core Competencies:

• Caring/Compassion
• Accountability
• Dependability
• Adaptability/Flexibility
• Effective Communication
• Confidentiality
• Team Player
• Dedication