Primary Purpose of this Position
The primary purpose of this position is to provide skilled nursing care to residents under the medical direction of the residents' attending physician and within the scope of nursing practice for the state.
Duties and Responsibilities
Administrative Functions

• Provide oversight of Certified Nursing Assistants (CNAs) and licensed nurses as directed by the Director of Nursing.
• Consult and coordinate with the interdisciplinary team (IDT) and healthcare professionals to assess, plan, implement and evaluate individualized resident care plans.
• Ensure initial baseline and periodic comprehensive assessments and care plans are completed within required timeframes.
• Participate in completing sections of the Minimum Data Set (MDS) assessment as requested.
• Facilitate physician rounds by preparing charts, flagging areas of concern and preparing physician orders for signature; document physician visits with residents.
• Initiate requests for consultations or referrals as requested.
• Report any suspicion of a crime that may have been committed to a resident in the facility.
• Perform administrative duties by completing medical forms, reports, evaluations, studies, charting, etc.

Committee Functions

• Participate in quality committees including quality assurance and performance improvement (QAPI), infection control, safety, risk management, etc.
• Serve on, participate in and attend various other committees of the facility (e.g., policy advisory) as required and as appointed by the Administrator.

Resident Care Functions

• Provide nursing services to residents in accordance with scope of practice, facility policies and professional standards of care.
• Monitor residents for developments of acute changes of condition including confusion, fever, difficulty breathing, increased pain, difficulty with urination, loss of appetite, constipation, diarrhea, vision or hearing loss, general malaise or decreased range of motion(ROM); conduct assessments and notify the provider as needed.

Duties and Responsibilities

• Monitor the chronic health conditions of residents; be familiar with reportable changes and potential causes for concern.
• Assist in the admission process; provide resident orientation as appropriate.
• Assist with a discharge planning process that focuses on the resident's discharge goals and preparation for successful transition to post-discharge care.
• Ensure that newly admitted residents have physician orders for immediate care.
• Participate in initial, comprehensive, quarterly, change of condition and other resident assessments using appropriate MDS forms.
• Contribute to the development of individualized, resident-centered care plans in coordination with the IDT.
• Provide nursing care that is compassionate and sensitive to residents with cognitive decline, memory loss or history of trauma.
• Provide nursing care that is appropriate and sensitive to the culture, language and background of the resident.
• Monitor resident weight and intake of food and fluids; notify the practitioner of significant weight loss or gain or changes in consumption.
• Maintain documentation of all nursing care and services provided to the residents; use nurse's notes, flow sheets and electronic medical records according to facility protocol.
• Collaborate with hospice services to provide end-of-life palliative care for dying residents.
• Promote the facility falls prevention practices to maximize resident safety.
• Provide first aid to residents as necessary and according to facility protocols.
• Adhere to the facility infection prevention and control practices.
• Administer medications according to practitioner orders and report adverse consequences, side effects or any medication errors.
• Transcribe telephone, verbal and telemedicine orders from providers as appropriate.
• Provide oversight of CNAs as directed.
• Assess for and address resident pain as necessary and appropriate and consistent with provider orders.
• Provide support and assistance with resident personal care and activities of daily living (ADLs) as needed.
• Help bed-bound or chair-bound residents reposition and turn as scheduled.
• Monitor the skin health of the resident; provide preventative skin care; administer wound treatments as ordered.
• Collect and submit specimens for laboratory analysis as ordered.

Duties and Responsibilities
Provide nursing care that is trauma-informed and sensitive to individual experiences and triggers.
Personnel Functions

• Cooperate with other personnel to achieve department objectives and maintain good employee, interdepartmental and public relations.
• Contribute to the orientation, training and development of new nursing team members as requested.

Staff Development Functions

• Attend continuing education and in-service training programs as required to provide person-centered and competent care.
• Participate as requested by the Medical Director or the Director of Nursing in the planning and conducting of in-service training classes concerning nursing skills and procedures used within the facility.

Safety and Sanitation Functions

• Ensure the resident environment remains as free of accident hazards as possible.
• Ensure each resident receives adequate supervision and assistive devices to prevent accidents.

Equipment and Supply Functions
Be familiar with and use as appropriate all items of personal protective equipment (PPE) offered by the facility including masks, gowns, gloves, back brace to be worn when lifting, etc.
Working Conditions

• Works in office areas as well as throughout the nursing services area (i.e., drug rooms, nurses' stations, resident rooms, etc.).
• Moves intermittently during working hours.)
• Is subject to frequent interruptions.
• Is involved with residents, personnel, visitors, government agencies/personnel, etc., under all conditions and circumstances.
• Is subject to hostile and emotionally upset residents, family members, personnel and visitors.
• Communicates with the medical staff, nursing personnel and other department directors.
• Works beyond normal working hours and on weekends and holidays when necessary. On call 24 hours per day, 7 days per week.
• Is subject to call back during emergency conditions (e.g., severe weather, evacuation, post-disaster, etc.).
• Is involved in community/civic health matters/projects as appropriate.
• Attends and participates in continuing education programs.
• Is subject to injury from falls, burns from equipment, odors, etc., throughout the workday as well as to reactions from dust, disinfectants, tobacco smoke and other air contaminants.
• Is subject to exposure to infectious waste, diseases, conditions, etc., including TB and the AIDS and Hepatitis B viruses.
• May be subject to the handling of and exposure to hazardous chemicals.
• Maintains a liaison with the residents, their families, support departments, etc., to adequately plan for the residents' needs.

Education
Must possess, as a minimum, a nursing degree from an accredited college or university or be a graduate of an approved Licensed Practical Nurse (LPN)/Registered Nurse (RN)program.
Experience
Must have, as a minimum, two (2) year(s)of experience as an LPN/RN.
Specific Requirements

• Must possess a current unencumbered active license to practice as an LPN/RN in the state.
• Must be able to read, write, speak and understand the English language.
• Must demonstrate the knowledge and skills necessary to provide care appropriate to the age-related needs of the residents served.
• Must be a supportive team member, contribute to and be an example of team work and team concept.
• Must possess the ability to make independent decisions when circumstances warrant such action.
• Must possess the ability to deal tactfully with personnel, residents, 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 and supervise other personnel.
• Must possess the ability to plan, organize, develop, implement and interpret the programs, goals, objectives, policies, 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 a resident's condition.
• Must not pose a direct threat to the health or safety of other individuals in the workplace.

Physical and Sensory Requirements (with or without the aid of mechanical devices)

• Must be able to move intermittently throughout the workday.
• Must be able to speak and write the English language in an understandable manner.
• Must be able to cope with the mental and emotional stress of the position.
• Must be able to see and hear or use prosthetics that will enable these senses to function adequately to ensure that the requirements of this position can be fully met.
• Must function independently and have flexibility, personal integrity and the ability to work effectively with residents, personnel and support agencies.
• Must meet the general health requirements set forth by the policies of this facility which include a medical and physical examination.
• Must be able to relate to and work with the ill, disabled, elderly, emotionally upset and, at times, hostile people within the facility.
• Must be able to push, pull, move and/or lift a minimum of 25 pounds to a minimum height of 5 feet and be able to push, pull, move and/or carry such weight a minimum distance of 50 feet.
• May be necessary to assist in the evacuation of residents during emergency situations.

Job Position Analysis Information
(1) Risk Exposure to Blood/Body Fluids Column:
A check mark entered into this column indicates the risk potential of your exposure to blood or body fluids. Established procedures identify the appropriate personal protective equipment (PPE) that you should use when performing this task.
(2) Essential Functions Column:
A check mark entered into this column indicates that you may be required to perform this task.
(3) Safety Factors Column:
RM = Repetitive Motion:
A "RM" in this column indicates that it will be necessary for you to perform some functions of this task repeatedly. When such tasks are not performed properly injury can result. Established procedures identify the precautions and/or equipment that should be used.
WL = Minimum Weight Lifting Requirement:
A "WL" in this column indicates that it will be necessary for you to perform functions of this task that require some lifting, moving, pushing or pulling. When such tasks are not performed properly injury can result. Established procedures identify the precautions and/or equipment that should be used when performing this task. Minimumweight lifting requirements that you must perform are located in the "Physical and Sensory Requirements" section of this job description.
SB = Prolonged Sitting, Standing and Bending:
A "SB" in this column indicates that some functions of this task require you to sit, stand or bend for an extended period of time. When such tasks are not performed properly injury can result. Established procedures identify the precautions and/or equipment that should be used when performing this task.