POSITION:
As a member of the interdisciplinary team, the Charge Nurse assumes responsibility and accountability for nursing services delivered to all residents of a designated unit for the duration of the shift. The Charge Nurse provides direct care, administers treatments and medications, organizes and distributes daily assignments to direct care staff consistent with staff competency and each individual resident’s comprehensive resident observation and plan of care. This position also supervises direct care staff, including participating in the hire and termination process, doing annual performance reviews and raises and performing disciplinary actions. This position makes decisions about resident care needs during shift within scope of clinical competence, consistent with facility policies and procedures.
REPORTING:
This position reports to the Director of Nursing.
FLSA STATUS: Non-Exempt
ESSENTIAL JOB FUNCTIONS:
- Make daily rounds on assigned unit at least at beginning and at end of shift to observe, assess or interview residents, to verify information for or from ongoing shift, to monitor regulatory compliance and to determine staff assignments or completion of assignments
- Develop and distribute resident care assignments to direct care staff. Assignments match resident needs with skills of direct care staff, and maintain consistency to the extent practicable. Adjust assignments according to availability of qualified staff. Change assignments if necessary during shift to meet resident needs
- Provide orientation to unit and unit routines to new staff members or staff from temporary agencies
- Perform performance evaluation reviews for staff, including determination of wage increases if applicable
- Correct staff performance and administer discipline, if required
- Train and develop staff by conducting skills observations of nurse aides identifying learning needs and taking advantage of opportunities to teach on the unit.
- Keys information into computer systems, including EMR
- Describe care plan goals and approaches to direct care staff so that care plan is consistently implemented on all shifts by all caregivers. Seek input from nurse aides about resident condition, functional abilities, preferences and alternative approaches to care. Monitor delivery of care and services throughout shift to ensure needs are met, tasks are completed and that work of direct care staff is of acceptable quality and quantity
- Administer medications, treatments and provide direct care to residents on unit according to physician orders and in compliance with facility policies and procedures
- Perform physical observation of new admissions and current residents as indicated by change in condition or as required by regulation. Complete assigned sections of resident observation instruments used in facility
- Based on observation of the resident’s condition, develop or revise the plan of care with interventions and time measurable objectives to assist each resident to attain or maintain highest practicable physical, mental and psycho social well being. Develop or revise the plan of care with participation of the interdisciplinary team members and resident to the extent feasible. Consult with and refer relevant resident care issues to attention of interdisciplinary care team members
- Coordinate care and delivery of services with all disciplines, outside agencies and community providers as required
- Respect rights of residents regarding freedom of choice, consent for care and services, refusals of treatment and implementation of advance directives if any. Promptly consult with nursing supervisor and Social Worker if unsure of proper course of action that respects resident’s rights, comply with facility policies and procedures that is consistent with county, state and federal laws and regulations, as applicable, including abuse reporting
- Complete required documentation of care and services delivered during shift including subjective findings, objective symptoms, interventions and resident responses to interventions. Complete required documentation of special circumstances including accident/incident reports in compliance with facility policy and procedures and regulations
- Present to the on-coming shift or receives from the off-going shift charge nurse a report making special note of significant changes in condition, admissions, transfers, discharges, initiation or use of physical or chemical restraints, incidents, unexplained injuries, medication errors, loss of resident property or expression of resident and/or family complaint or concern
- Inform the resident in advance about care and treatment and any changes to the plan of care
- Immediately inform the resident, consult with the resident’s physician and notify the designated family member and/or the resident’s legal representative when there is an accident involving an injury which has potential for requiring physician intervention; a significant change in the resident’s physical, mental or psycho social status; a need to alter treatment significantly or a decision to transfer or discharge the resident from the facility. Promptly notify the resident, designated family member and/or resident’s legal representative when there is a change in room or roommate
- Report relevant information to the Supervisor including, interdisciplinary team functioning and communication, regulatory compliance issues, quality improvement issues, resident risk factors, sudden changes in resident behavior, expressed dissatisfaction by resident or family, refusals of treatment, unexplained injuries, staff conduct
- Monitor staff for compliance with OSHA mandates on workplace safety including hazard communication and blood staff member for post-exposure follow-up
- Report all injuries to self or others to supervisor immediately
- Take job actions with staff members under appropriate circumstances. Apply facility policies about progressive discipline correctly. Remove staff member from unit if necessary to avoid endangerment to health and safety of residents or other staff members. Report all job actions taken to supervisor promptly
- Attend in-service education programs as assigned. Apply information to job tasks
- Assist supervisor with preparation for long term care survey. Attend survey training, interacts with state surveyors as instructed by supervisor
REQUIREMENTS:
- Follow all HIPAA guidelines
- Demonstrate knowledge of, and respect for, the rights, dignity and individuality of each resident in all interactions
- Appreciate the importance of maintaining confidentiality of resident and facility information
- Demonstrate honesty and integrity at all times in the care and use of resident and facility property
- Knowledge of geriatric nursing principles and professional standards of nursing practice and ability to apply to resident specific circumstances. Able to identify, implement and evaluate appropriate objectives and interventions for residents
- Demonstrate competency in clinical skills needed for facility resident population
- Demonstrate competency in observation of long term resident’s physical, behavioral and functional status
- Working knowledge of laws and regulations that influence provision of care and services in nursing facilities
- Sufficient organizational and interpersonal skills to assign, motivate staff, elicit work output, improve quality and interact effectively with residents, families, interdisciplinary team members, facility staff, administration, government officials, consultants, visitors and others
- Able to understand and to follow written and verbal directions. Able to express self adequately in written and/or oral communication (including documentation in clinical records) with direct care staff, interdisciplinary team members, administration, and government officials
- Knowledge of emergency and disaster procedures of facility. Able to locate nearest exit, to understand and respond to written or oral instruction in case of emergency
- Sufficient mobility, and strength to move freely through the building, to assure resident safety at all times and to assist, transfer or otherwise move residents of facility out of danger in case of emergency
- Demonstrate respect for co-workers and responds to needs of residents by complying with facility policies on attendance and punctuality and dress code. Able to arrive and to begin work on time and to report for duty as scheduled including weekends and holidays
- Working knowledge and ability to comply with facility policies and procedures for workplace safety including infection control procedures, application of standard precautions for blood borne pathogens, use of personal protective equipment and handling of hazardous materials
- Must be able to key information into computer systems
- Demonstrate ability to prioritize tasks/responsibilities and complete duties/projects within allotted time
- Able to respond to change productively and to handle additional tasks/projects as assigned
- Able to carry out the essential functions of this job (with or without reasonable accommodation) without posing specific, current risk of substantial harm to health and safety of self and others
Other duties as assigned by the Director of Nursing
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PHYSICAL CAPACITIES: (With or Without the Aid of Mechanical Devices)
- Must be able to move intermittently throughout the workday.
- 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 meet the general health requirements set forth by the policies of this facility which includes an annual TB screening and physical examination.
- Frequent bending, twisting and reaching.
- Must be able to lift and carry up to 25 pounds.
- Requires infrequent lifting of weight up to 100 pounds with assistance.
- Frequent pushing and pulling of medical carts/
- Infrequent transporting of residents.
- Must be able to cope with the mental and emotional stress of the position.
ENVIRONMENTAL CONDITIONS:
Inside work, normal temperatures, some noise, occasional fumes/odors, chemical exposure and potential exposure to bloodborne pathogens.
This job cannot be performed without exposure to the stresses associated with an intimate, 24 hour skilled care environment that delivers care and services primarily to disabled and cognitively impaired residents in an aging population. Examples of these stresses include, but are not limited to: emergency health or safety response, weekend and holiday duty, unusual or impaired behavior by residents, family reactions to having a loved one in a nursing home, death and dying, oversight of state surveyors, ombudsmen and federal officials, presence of consultants and attorneys, and variable involvement of medical staff.
QUALIFICATIONS/REQUIREMENTS:
Education:
Graduate of accredited school of nursing
License:
Current, active license as Registered Nurse or Licensed Vocational Nurse
Work Experience:
- Experience in long term geriatric nursing care and experience and/or training in supervision preferred
Language Skills:
- Must be able to read, analyze, and interpret common scientific and technical information, and to be easily understood through verbal communication in the English language.
Mathematical Skills:
- Must be able to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Ability to perform these operations using units of weight measurement, and volume.
Communication Skills:
- Must have exceptional communication and customer service skills, and be empathetic.
- Ability to effectively communicate with patients, families, responsible parties, staff and outside resources and agencies.
