Assistant Director of Nursing - Lawrence Street Healthcare

Benefits: 

• Health Insurance
• Dental, Vision & Disability coverages also available
• Full Tuition payments for license improvements 
• 401K Retirement Plan with Employer Contributions 
• Paid Holidays
• Shift Differentials
• Company Paid Life Insurance
• Professional, Friendly & Social Team Members

Wage scale determined by years of experience. Benefits & bonuses 

General Purpose:
Organizes, directs, and oversees the work of the nursing team, nursing programs, compliance with facility policies and applicable state and federal regulations, and customizes procedures to ensure the highest degree of quality care is offered as delegated by the Director of Nursing.

Qualifications:

       Must have and maintain throughout employment an unencumbered Registered Nurse (RN) or Licensed Practical Nurse/Licensed Vocational Nurse licensure issued by the State Board of Nursing.

       Must have valid CPR certification and maintain active CPR certification throughout employment.

       Demonstrated leadership and supervisory skills in the areas of nursing administration, nursing practice, rehabilitation, and employee relations management.

       Knowledgeable of nursing and medical practices and procedures, as well as state and federal regulations specific to nursing home operation and licensure.

       Must have knowledge of abuse, neglect, exploitation, misappropriation, mistreatment, and injury of unknown origin regulations and reporting requirements.

       Make independent decisions when circumstances warrant such actions.

       Must possess leadership and supervisory ability and the willingness to work harmoniously with residents, families, vendors, visitors, government agencies, facility staff, hospital personnel, hospice representatives, and the general public.

       Must have excellent follow-through.

       Must possess the ability to plan, organize, develop, implement and interpret programs, goals, objectives, policies and procedures, etc., that are necessary for providing quality individualized care.

       Ability to manage through delegation, goal setting, and building respect from all nursing staff through use of positive leadership principles.

       Ability to prepare and present educational material and or reports to various audiences.

       Ability to formulate reports, disseminate information, interpret data, and coordinate with multiple departments.

       Must be able to lift 60-70lbs frequently.

       Must be able to stand and/or walk throughout the scheduled shift.

       Must have knowledge of computer systems, systems applications, and other office equipment.

       Must adhere to the facility dress code.

       Must agree to participate in on-call duties (24/7) and work nights, weekends, and holidays as needed.

       Must have excellent analytical, written and verbal communication skills.

       Must have working knowledge of the facility’s fire, safety, and disaster procedures.

       Must be able to meet all local health regulations, and pass pre/post-employment physical exams if required. This requirement also includes drug screening, criminal background investigation, and reference inquiry.

       Must have the ability to promote positive interpersonal relationships through the use of tactful, direct and sensitive interaction. Must be able to communicate verbally in a positive and professional manner.

       Must be able to relate positively and favorably to residents, families, co-workers, and to work cooperatively with others.

       Must attend in-service/education programs as required to learn new procedures and develop skills to meet regulatory compliance.

       Must agree not to disclose resident protected health information and report suspected or known violations of such to the Administrator.

Duties and Responsibilities:

1. Operate and supervise within the prescribed scope of practice for a Registered Nurse (RN) in the state.
2. Participate in the development, reviews, and revisions of the philosophy, objectives, and standards of practice for the nursing department.
3. Make administrative decisions in the absence of the Director of Nursing.
4. Review, maintain, and update the nursing department job descriptions and policies and procedures as assigned.
5. Review and follow the nursing department’s budgetary guidelines for operation.
6. Ensure staffing schedules are created fairly, updated routinely, posted for the staff, time off requests are handled according to policy, and the daily staffing PPD’s are maintained per policy and regulation.
7. Meet with nursing staff as well as support personnel, in planning facility services, progress, and activities as needed.
8. Participate in establishing a competitive wage, salary, and benefit plan for nursing department staff.
9. Participate in pre-screening resident referrals for appropriateness of admission, collaborate with necessary departments to ensure proper room assignment and other specialized needs/conditions as indicated.
10. Participate in marketing events and initiatives as requested.
11. Ensure the admission, transfer, and discharge processes are followed. 
12. Cooperate in the development and implementation process for an interdisciplinary approach to health care services focused on the individual resident needs.
13. Ensure RD/Nutrition recommendations are completed timely.
14. Ensure Pharmacy recommendations are completed timely.
15. Ensure monthly and weekly weights are recorded in the clinical record per facility policy.
16. Quality Assurance and Risk Management Meetings-may attend, prepare reports, update data, present information, document as needed, and participate in sub-committees as assigned (example: infection control, psych, safety, pharmacy, utilization review, falls, etc.).
17. Perform administrative duties as assigned (such as: complete various medical forms, reports, evaluations, studies, training, tracking and trending, audits, daily/weekly/monthly reviews, etc.). Some of these items may include (but not limited to):

       Infection Control-tracking and trending antibiotic use, verifying accuracy of antibiotic prescribed, monitoring adherence to the Antibiotic Stewardship Program, monitoring compliance and appropriateness of isolation, confirming completion of clinical documentation and accuracy of order transcription.

       Skin Conditions/Wounds- tracking and trending of wounds, monitoring compliance and appropriateness of treatments prescribed, verifying physician/resident notification, confirming completion of clinical documentation and accuracy of order transcription. Participate in wound rounds as directed.

       Psychotropic Medication Usage- tracking and trending of psychotropic medications, appropriate diagnosis and indication for use, gradual dose reduction attempts, confirming completion of clinical documentation and accuracy of order transcription. Participate in psych meetings as directed.

       Restraint- tracking and trending of restraint usage, appropriate diagnosis and indication for use, reduction attempts, confirming completion of clinical documentation and accuracy of order transcription. 

       Return to Hospital (RTH)-track, trend, and analyze all RTH data for presentation at routine QA meetings.

       Audits (examples)-med room audit, med pass observations, crash cart checks, med cart inspections, new admission chart audits, documentation audits, and any staff competencies completed.

       Performance Evaluations-Evaluating staff, completing forms, and delivering the performance evaluation to the staff members.

       Staffing-Verify staffing every day and assist with call-offs, replacing shifts, calculating PPD’s, creating assignments, staff cancellations, staff floating, etc.

       Daily inspection of the medication room(s) and refrigerators, nourishment room(s), soiled utility room(s), clean utility room(s), medication carts, treatment carts, nursing station(s), resident rooms-verify cleanliness and orderliness, proper item storage, etc.

       Labs/X-Rays-verify tests were performed as ordered, results were obtained, notification of results to the physician, documentation in the clinical record, etc.

       Resident Appointments-verify appropriate scheduling, transport is arranged, resident/family notified, documentation completed, etc.

       Logs-maintaining and updated logs such as: return to hospital log, contracture log, enteral log, psychotropic log, indwelling catheter log, infection control log, coumadin log, and fall log.

       Quarterly Evaluations-verify completion (if indicated) such as: fall, AIMS, Braden or skin, side rail, bowel and bladder, elopement, smoking, and self-administration of medications.

1. Assist and remind physicians and their extenders to complete required documentation, review treatment plans, care plans, sign documents, etc. Accompany on rounds as needed.
2. Contact physicians, nurse practitioners, and physician assistants as needed to report resident change of condition, convey lab/x-ray reports, emergencies, resident/family concerns, incidents/accidents, etc. and document new/changed orders and communication outcomes per facility policy.
3. Inform residents, resident representatives, and/or family members of resident change of condition, emergencies, incidents/accidents, new/changed etc. and document new/changed orders and communication outcomes per facility policy.
4. Review individualized plans of care (problems, goals, and interventions/approaches) for the residents to include: overall health, diagnoses, fall risk/positioning devices, restorative nursing programs, elopement risk, behaviors, skin conditions, discharge plans, therapy services, restraints, psychotropic medication usage, etc. Attend resident care plan meetings as requested.
5. Review and monitor timely completion of employee performance evaluations per facility policy.
6. Assess and monitor nursing supplies for necessity, availability, ease of access, etc.
7. Coordinate and implement a Restorative Nursing Program to assist residents in attaining their highest level of functioning. Ensure adequate staff training to include: documentation, communication with nursing and therapy, care plans, services offered, etc.
8. Oversee and participate in as needed, the timely and accurate completion of Resident Assessment Instruments (RAI’s) (MDS’), care plans, and care plan meetings per regulation and facility policy.
9. Plan and encourage participation of in-service and continuing education for all levels of the nursing team.
10. Administer medications and treatments as prescribed by the physician, nurse practitioner, or physician’s assistant. Document administration timely.
11. Order/Reorder prescribed medications, supplies, and equipment per facility policy.
12. Dispose of medications and narcotics in accordance with facility policy and state and/or federal regulations.
13. Administer specialized skilled services per physician or extender orders to include (but not limited to):

       Urinary catheterization, catheter removal, intermittent catheterization, catheter irrigation, urine specimen collection, etc.

       Tracheostomy care, suctioning, sputum specimen collection, monitoring, ostomy care, etc.

       G-tube/J-tube/PEG tube care, feedings, flushes, medication administration, ostomy care, etc.

       Wound/Skin care, preventative measures, advanced dressings, wound irrigation, wound packing, wound vacs, suture/staple removal, etc.

       Colostomy/Urostomy care, bag/wafer changes, skin care, irrigation, etc.

       IV therapy-peripheral catheter insertion and site change, central line care/maintenance/flushing/dressing changes, administration of medications and/or fluids, etc.

1. Coordinate with other departments as needed to ensure resident care is delivered per the individualized plan of care.
2. Meet with residents and/or families often-If a resident or family member expresses any concerns, direct the information to the appropriate person for prompt resolution of the issue. If able to address the concern, do so promptly and follow-up with the resident and/or family to ensure satisfaction.
3. Assist residents with standard ADL’s (Activities of Daily Living) to include: bathing, toileting/bed pan, transfers, bed mobility, turning and repositioning, peri-care, grooming, dressing, changing bed linens, applying/utilizing specialized equipment, etc. per the individualized plan of care.
4. Ensure residents remain clean, have clean dentures in place, hearing aids in or stored appropriately, clean eyeglasses on, prosthetic limbs/devices in place, dressed appropriately, clothes are in good repair, and dressed appropriately to temperature/season. 
5. Ensure use of positioning devices, restraints, splints, braces, immobilizers, cushions, etc. are utilized per the individualized plan of care.
6. Assist residents to prepare for meals and snacks ensuring proper attire, position, and location. Ensure the proper assistive devices/equipment are available and offered. Document food and fluid consumption per facility policy.
7. Complete facility incident/accident reports as necessary and initiate investigations as requested. Incident reports (including falls, skin tears, medication errors, etc.) should be reviewed daily for accuracy and completeness and family and physician notification.
8. Conduct facility investigations in a professional manner with a keen attention to detail. Investigations shall include: interviewing staff, interviewing residents, interviewing visitors, gathering statements (witnesses, staff, physicians, residents, etc.), reviewing video surveillance, gathering relevant data, preparing timelines, determining root cause, recreating events, drawing diagrams, creating charts, and detailed reporting of results with outcomes.
9. Makes frequent unit/facility rounds during normal hours, and nights, weekends, and holidays as needed.
10. Participate in the on-call rotation for the nursing department.
11. Observe the quality of care and services provided, ensuring compliance with the facility policies and taking corrective action including, but not limited to employee counselling, performance reviews, staff competency evaluations with return-demonstration, and disciplinary action.
12. Understand and adhere to established facility policies. Interpret the department's policies and procedures to personnel, residents, visitors, and government agencies as required.
13. Assist in recruiting, hiring, and orientation of new staff. Follow-up with new staff during and after floor-orientation to verify they are adequately prepared to work independently while adhering to facility policy and applicable regulations.
14. Attend meetings as assigned.
15. Use proper body mechanics when lifting.
16. Maintain security of the premises and direct unauthorized persons to leave as indicated.
17. Adhere to safety policies pertaining to infection control and isolation, personal protective equipment (PPE), gait belts, mechanical lifts, and fire/emergency procedures.
18. Customer Service-Promote and maintain positive relationships with co-workers, residents, visitors, volunteers, vendors, and regulatory representatives.  
19. Resident Rights-Understand and promote resident rights. Have positive interactions with residents, families and caregivers. Maintain a professional appearance. Ensure confidentiality of all resident information, compliance with HIPAA regulations and policies, Encourage resident autonomy decision-making.
20. Documentation-Complete documentation in the individual clinical record per policy. Complete any other documentation as assigned.
21. Other-Complete all other duties as assigned.

Physical and Sensory Requirements: Walking, sitting, standing, reaching, stooping, bending, lifting, grasping, pushing and pulling, and fine-hand coordination. Ability to hear and respond to overhead pages. Ability to communicate with residents, families, personnel, vendors, and consultants. Ability to apply training and in-service education provided. Must present a neat, clean, professional appearance and demonstrate a positive approach with employees and residents.

Every effort has been made to make your job description as complete as possible. However, it in no way states or implies that these are the only duties you will be required to perform. The above statements reflect the general duties considered necessary to perform the principle functions of the job as identified and shall not be considered as a detailed description of all the work requirements that may be inherent in the position. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or is a logical assignment to the position.

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