Floor Nurse

Position Purpose:

The primary purpose of the job position of floor nurse is to provide direct nursing care to the elders, and to supervise the day-to-day nursing activities performed by Certified Nurse Aides and Certified Medication Aides. Such supervision must be in accordance with current federal, state, facility, and as may be required by the Director of Nursing Services to ensure that the highest degree of quality care is maintained at all times.

Delegation of Authority

Any and all Floor Nurses are delegated the administrative authority and accountability necessary for carrying out any and all assigned duties which are consistent with the scope of practice including in the Nurse Practice Act of the State of Kansas Board of Nursing.

Supervision:

The Floor Nurse is under the direct supervision of the facility’s Director of Nursing and/or the Adminstrator as delegated by the Director of Nursing.

Qualifications and Position Requirements:

The desired minimum requirements necessary to effectively perform position responsibilities include a Nursing Degree from an accredited college or university, or be a graduate of an approved LPN/RN program; excellent leadership skills or an acceptable equivalent combination of education and experience, and respect for the principles of resident rights, confidentiality, EEO and ADA
Must possess a current, unencumbered, active license to practice as an RN or LPN in this state
Must be able to read, write, speak, and understand the English language
Must possess the ability to make independent decisions when circumstances warrant such action
Must possess the ability to deal tactfully with personnel, elders, family members, visitors, government agencies/personnel, and the general public
Must be knowledgeable of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pertain to long-term care
Must possess leadership and supervisory ability and the willingness to work harmoniously with professional and non-professional personnel
Must possess the ability to plan, organize, develop, implement, and interpret the programs, goals, objectives, policies and procedures, etc., that are necessary for providing quality care
Must have patience, tact, a cheerful disposition and enthusiasm, as well as the willingness to handle difficult residents
Must be willing to seek out new methods and principles and be willing to incorporate them into existing nursing practices
Must be able to relate information concerning an elder’s condition
Must not pose a direct threat to the health or safety of other individuals in the workplace

Other Training, Skills and Experience Recommendations:

Computer skills, knowledge of medical terminology, dementia training
On-the-job training and on-going education will be provided

Essential Functions (with or without reasonable accommodations):

The duties and responsibilities included under the essential functions listing have been determined by management to be essential to the successful performance of this position. However, this listing may not be inclusive of all the duties and responsibilities that may be required. The omission or exclusion of duties and responsibilities from this description does not infer that the designated employee will not be required to perform additional job-specific duties if the work is similar, related or becomes an essential function of this position.

Direct the day-to-day functions of the nursing assistants in accordance with current rules, regulations, and guidelines that govern the long-term care facility
Ensure that all nursing personnel assigned to you comply with the written policies and procedures established by this facility
Periodically review the department’s policies, procedure manuals, job descriptions, etc. and make recommendations for revisions
Meet with your assigned nursing staff, as well as support personnel, in planning the shifts’ services, programs, and activities
Ensure that the nursing service personnel comply with the procedures set forth in the Nursing Service Procedures Manual
Make written and oral reports/recommendations concerning the activities of your shift as required
Cooperate with other elder services when coordinating nursing services to ensure that the elder’s total regimen of care is maintained
Ensure that all assigned nursing service personnel are in compliance with their respective job descriptions
Participate in the development, maintenance, and implementation of the facility’s quality assurance program for the nursing service department
Participate in surveys (inspections) made by authorized government agencies as may be requested
Periodically review the elder’s written discharge plan and participate in the updating of the resident’s written discharge plan as required
- Assist in planning the nursing services portion of the elder’s discharge plan as necessary
Interpret the department’s policies and procedures to personnel, elders, visitors, and government agencies as required
Admit, transfer, and discharge elders as required per policies and procedures
Complete accident/incident reports as necessary per policies and procedures and include thorough investigation of incident including root cause analysis of event
Perform administrative duties such as completing medical forms, reports, evaluations, studies, charting, etc., as necessary
Complete and file required recordkeeping forms/charts upon the elder’s admission, transfer, and/or discharge
Encourage attending physicians to review treatment plans, record and sign their orders, progress notes, etc., in accordance with established policies
Receive telephone orders from physicians and record on the Physicians’ Order Form
Transcribe physician’s orders to elder charts, cardex, medication cards, treatment/care plans, as required
Document nurses’ notes in an informative and descriptive manner that reflects the care provided to the elder, as well as the elder’s response to care
Record new/changed diet orders
- Forward information to the Dietary Department
Report all discrepancies noted concerning physician’s orders, diet change, charting error, etc., to the Director of Nursing
Ensure that appropriate documentation concerning unauthorized discharges is entered in the elder’s clinical record in accordance with established procedures
Perform routine charting duties as required and in accordance with established charting and documentation policies and procedures
Sign and date all entries made in the elder’s medical record
Perform “Five Rights” of Medical Administration
Ensure that an adequate supply of floor stock medications, supplies, and equipment is on hand to meet the nursing needs of the elders
- Report needs to the Nurse Supervisor
Order prescribed medications, supplies, and equipment as necessary, and in accordance with established policies
Ensure that narcotic records are accurate for your shift
- Notify the Director of Nursing of all drug and narcotic discrepancies noted in your shift
Review medication dispensing cards for completeness of information, accuracy in the transcription of the physician’s order, and adherence to stop order policies
- Notify the attending physician of automatic stop orders prior to the last dosage being administered
Dispose of drugs and narcotics as required, and in accordance with established procedures
Participate in employee performance evaluations, determining your shift’s staffing requirements, and making recommendations to the Director of Nursing concerning employee dismissals, transfers, etc.
Inform the Director of Nursing of staffing needs when assigned personnel fail to report to work
- Report absentee call-ins to the Director of Nursing
Review and evaluate your department’s work force and make recommendations to the Director of Nursing
Develop work assignments and/or assist in completing and performing such assignments
Provide leadership to nursing personnel assigned to your unit/shift
Make daily rounds of your unit/shift to ensure that nursing service personnel are performing their work assignments in accordance with acceptable nursing standards
- Report problem areas to the Director of Nursing
Meet with your shift’s nursing personnel, on a regularly scheduled basis, to assist in identifying and correcting problem areas, and/or to improve services
Ensure that department personnel, elders, and visitors follow the department’s established policies and procedures at all times
Develop and maintain a good working rapport with inter-departmental personnel, as well as other departments within the facility to ensure that nursing services and activities can be adequately maintained to meet the needs of the elders
Create and maintain an atmosphere of warmth, personal interest and positive emphasis, as well as a calm environment throughout the unit and shift
Turn in complaints and grievances to Social Services Director, Director of Nursing or Administrator
Ensure that disciplinary action is administered fairly and without regard to race, color, creed, national origin, age, sex, religion, handicap, or marital status
Receive/give the nursing report upon reporting in and ending shift duty hours
- Inform appropriate personnel of new admissions, their expected time of arrival, room assignment, etc
- Ensure that rooms are ready for new admissions
- Greet newly admitted elders upon admission
- Escort them to their rooms as necessary
- Participate in the orientation of new elders/family members to the facility
Make rounds with physicians as necessary
Requisition and arrange for diagnostic and therapeutic services, as ordered by the physician, and in accordance with our established procedures
Consult with the elder’s physician in providing the elder’s care, treatment, rehabilitation, etc., as necessary
Review the elder’s clinical record for specific treatments, medication orders, diets, etc., as necessary
Implement and maintain established nursing objectives and standards
Make periodic checks to ensure that prescribed treatments are being properly administered by certified nursing assistants and to evaluate the elder’s physical and emotional status
Ensure that direct nursing care be provided by a licensed nurse, a certified nursing assistant, and/or a nurse aide trainee qualified to perform the procedure
Cooperate with and coordinate social and activity programs with nursing service schedules
Notify the elder’s attending physician and next-of-kin when there is a change in the resident’s condition/death
Carry out restorative and rehabilitative programs, to include self-help and care
Inspect the nursing service treatment areas daily to ensure that they are maintained in a clean and safe manner
Administer professional services such as; catheterization, tube feedings, suction, applying and changing dressings/bandages, packs, colostomy, and drainage bags, glucometers, giving massages and range of motion exercises, care for the dead/dying, etc.
Obtain sputum, urine and other specimens for lab tests as ordered
Take and record vital signs, blood pressures, etc., as necessary
Monitor seriously ill elders as necessary
Ensure that personnel providing direct care to elders are providing such care in accordance with the elder’s care plan and wishes
Ensure that elders who are unable to call for help are checked frequently per the care plan
Meet with elders, and/or family members, as necessary
Report problem areas to the Director of Nursing
Assist in arranging transportation for discharged elders as necessary
- Ensure that discharged elders are escorted to the pick-up area
Call funeral homes when requested by the family
- Ensure that established post-mortem procedures are followed
Implement and maintain an effective orientation program that orients the new employee to your shift, its policies and procedures, and to his/her job position and duties
Assist in standardizing the methods in which work will be accomplished
Assist in training department personnel in identifying tasks that involve potential exposure to blood/body fluids
Attend and participate in outside training programs
Attend and participate in annual mandated CMS, OSHA and CDC in-service training programs for hazard communication, TB management, and blood-borne pathogens standard
Attend and participate in advance directive in-service training programs for the staff
Attend and participate in continuing education programs designed to keep you abreast of changes in your profession, as well as maintain your license on a current status
Monitor your assigned personnel to ensure that they are following established safety regulations in the use of equipment and supplies
Ensure that established departmental policies and procedures, including dress codes, are followed by your assigned nursing personnel
Assist the Director and/or Infection Control Coordinator in identifying, evaluating, and classifying routine and job-related functions to ensure that tasks in which there is potential exposure to blood/body fluids are properly identified and recorded
- Ensure that an adequate supply of personal protective equipment are on hand and are readily available to personnel who perform procedures that involve exposure to blood or body fluids
Ensure that your assigned work areas (i.e., nurse’s stations, medicine preparation rooms, etc.) are maintained in a clean and sanitary manner
Ensure that your neighborhood’s elder care rooms, treatment areas, etc., are maintained in a clean, safe, and sanitary manner
Ensure that your assigned personnel follow established hand-washing techniques in the administering of nursing care procedures
Ensure that your assigned personnel participate in and conduct all fire safety and disaster preparedness drills in a safe and professional manner
Participate in the development, implementation, and maintenance of the infection control program for monitoring communicable and/or infectious diseases among the elders and personnel
- Ensure that your assigned personnel follow established infection control procedures when isolation precautions become necessary
- Ensure that nursing personnel follow established procedures in the use and disposal of personal protective equipment
Participate in the development, implementation and maintenance of the procedures for reporting hazardous conditions or equipment
Ensure that all personnel wear and/or use safety equipment and supplies (e.g., back brace, gait belts, lifter, etc.) when lifting or moving elders
Recommend to the Director of Nursing the equipment and supply needs of your unit/shift
Ensure that an adequate stock level of medications, medical supplies, equipment, etc., is maintained on your unit/shift at all times to meet the needs of the elders
Participate in the development and implementation of the procedures for the safe operation of all nursing service equipment
Ensure that only trained and authorized personnel operate your unit/shift’s equipment
- Ensure that all personnel operate nursing service equipment in a safe manner
Monitor nursing procedures to ensure that nursing service supplies are used in an efficient manner to avoid waste
Review care plans daily to ensure that appropriate care is being rendered
- Inform the RAI Coordinator or Director of Nursing of any changes that need to be made on the care plan
- Ensure that documentation reflects that the care plan is being followed when administering nursing care or treatment
- Review elder care plans for appropriate elder goals, problems, approaches, and revisions based on nursing needs
- Ensure that your assigned certified nursing assistants (CNAs) are aware of the elder care plans
- Ensure that the CNAs refer to the elder’s care plan prior to administering daily care to the elder
- Assist the Resident Assessment/Care Plan Coordinator in planning, scheduling, and revising the MDS, including the implementation of CAAs
Maintain the confidentiality of all elder care information
Monitor nursing care to ensure that all elders are treated fairly, and with kindness, dignity, and respect
Ensure that all nursing care is provided in privacy and that nursing service personnel knock before entering the elder’s room
Ensure that all nursing service personnel are knowledgeable of the residents’ responsibilities and rights including the right to refuse treatment
Review complaints and grievances made by the elder and family or visitors and make a written report to the Director of Nursing indicating what action(s) were taken to resolve the complaint or grievance
Follow the facility’s established procedures related to abuse, neglect and exploitation
- Report and investigate all allegations of resident abuse, neglect and/or misappropriation of resident property immediately and report to Director of Nursing and Administrator immediately
Ensure that nursing staff personnel honor the elder’s refusal of treatment request
- Ensure that such requests are in accordance with the facility’s policies governing advance directives
Provide data to the Quality Assurance & Assessment committee as requested
Must attend Care Plan meetings as scheduled for elders

Physical Requirements and Emotional Requirements:

The employee must be able:

To move intermittently throughout the work day
Speak and write the English language in an understandable manner
Able to cope with mental and emotional stress of position
Able to see & hear or use prosthetics that will enable these senses to function adequately to ensure that the requirements of the position can be fully met
Function independently and have flexibility, personal integrity, and ability to work effectively with elders, family members, personnel and support agencies
Be in good general health and demonstrate emotional stability
Able to relate to and work with ill, disabled, emotionally upset and at times, hostile people within the facility
Able to assist in evacuation of elders during emergency situations
See, hear or use prosthetic devices to enable use of the senses adequately
Assist with the evacuation of elders if necessary
Sits, stand, bend, stoop lifts & moves for extended periods of time
Dexterity of hands and fingers to operate equipment
Subject to frequent interruptions
Ability to lift, move, push or pull a minimum of fifty (50) pounds
Involved with elders, personnel, visitors, government agencies/personnel under all conditions and circumstances
Subject to hostile and emotionally upset elders, family members, personnel and visitors
Communicates with medical staff, nursing personnel and other department supervisors
Works beyond normal working hours and in other positions temporarily when necessary

Work Environment:

The primary work environment is throughout the facility and at times the work is stressful
The employee may be exposed to blood, body fluids, infectious diseases and air contaminants
The employee may be subject to work call-back during times of facility emergency or disaster preparedness functions
Employee must be organized and detail-oriented
Employee may be requested to perform other duties or tasks that are not listed, but are within the competence and training of the individual.

Summary of Occupational Exposures:

Bloodborne Pathogens:

Tasks and procedures performed by employee involve risks classified by CDC as: Category III (Task/activity does not entail predictable or unpredictable exposure to blood.)

Specific Task Exposure:

General Elder Care: Blood, urine, feces, vomitus, wound exudates, semen/vaginal secretions other body fluids-cerebrospinal, synovial, pleural, peritoneal, pericardial
Handling soiled linens and clothing: Blood, urine, feces, vomitus, wound exudates, semen/vaginal secretions, other body fluids-cerebrospinal, synovial, pleural, peritoneal, pericardial
Cleaning elder rooms and common areas-Blood, urine, feces, vomitus, wound exudates, semen/vaginal secretions
Refer to Exposure Control Plan for additional information

Benefits:

Health and vision care

About Us:

Enterprise Estate Nursing Center is a community owned, non-profit nursing facility committed to providing personalized service with the highest standard of care since 1975. The resident rooms at Enterprise Estates offer a full range of service while our goal is to always serve our senior community with dignity and respect. Residents enjoy a safe, caring, homelike setting in a clean and inspiring environment.