Per Diem Charge Nurse RN/LPN - Holiday Retirement Home

Basic Qualifications

Education/Training: Graduate of an approved school of nursing; current Rhode Island license to practice as a registered nurse or a licensed practical nurse.

Skill(s): Proficient reading, writing, grammar, and mathematics skills; proficient interpersonal relations and communicative skills; knowledge of drug interactions, side effects, and incompatibilities; decision-making skill; proficient assessment skills; minimal typing skills; auditory and visual skills; ability to sit, stand, lift, bend, reach, and push and pull items weighing 50 pounds or less; must be willing to comply with RIDOH medical guidelines; including COVID-19 vaccination(s).

General Responsibilities

Responsible for performing a variety of duties to provide quality nursing care to residents and to coordinate total nursing care for residents; implementing specific procedures and programs; participating with the Director of Nursing, ADNS the Nursing Supervisor in establishing specific goals, determining work procedures and expediting work flow; insuring compliance with all operating policies and procedures and Rhode Island Department of Health regulations and Federal regulations; communicating with and supervising appropriate personnel; providing daily reports and other periodic reports; perform all the duties of a certified nursing assistant when required.

Standard Requirements

1. Supports the Mission, Values and Vision of The Holiday Retirement Home.
2. Is knowledgeable of resident rights and ensures an atmosphere which allows for the privacy, dignity and well-being of all residents in a safe, secure environment.
3. Supports, cooperates with, and implements specific procedures and programs for:
   1. Safety, including universal precautions and safe work practices, established fire/safety/disaster plans, risk management, and security, report and/or correct unsafe working conditions, equipment repair and maintenance needs.
   2. Confidentiality of all data, including resident, employee and operations data.
   3. Quality Assurance and compliance with all regulatory requirements.
   4. Compliance with current law and policy to provide a work environment free from sexual harassment and all illegal and discriminatory behavior.
4. Supports and participates in common teamwork:
   1. Cooperates and works together with all co-workers; plan and complete job duties with minimal supervisory direction, including appropriate judgement.
   2. Uses tactful, appropriate communications in sensitive and emotional situations.
   3. Follows up as appropriate with supervisor, co-workers or residents regarding reported complaints, problems and concerns.
   4. Promotes positive public relations with residents, family members and guests. Completes requirements for in-service training, acceptable attendance, uniform and dress codes including personal hygiene, and other work duties as assigned.

Essential Duties – Charge Nurse

1. Perform various duties to provide quality nursing care to residents to maintain or attain the highest practical level of functioning and to coordinate total nursing care for the residents as illustrated by the following:
   1. Assess residents and analyze obtained information to develop appropriate interventions to prevent decline; record signs of change in condition; notify appropriate staff per facility protocol to evaluate weight loss, decline in ambulation, development of skin breakdown, etc.; observe conditions which indicate possible need for restorative nursing programs and then notify appropriate staff per facility protocol of the need for evaluation; inform the physician of changes in assessment when appropriate.
   2. Administer medications and treatments to residents; monitor administration of intravenous fluids; place orders for medication from the pharmacy.
   3. Assess residents upon admission to develop interim care plan and further assess in depth to contribute to the complete care plan. Update care plans as warranted and required.  Attend and participate at Plan of Care meetings as scheduled.
   4. Respond to emergencies; assess the condition of the resident; decide on the type of medical attention; call appropriate ambulance service if needed; notify family when resident is transferred or admitted to the hospital; notify the physician when a change in condition occurs.
   5. Confer with residents and families; make referrals to other departments when appropriate.
   6. Maintain resident clinical files; keep charts updated; document appropriately (see Task List).
   7. Complete employee and resident incident report forms; complete follow-up investigation forms.
   8. Make rounds to see each resident daily and as needed.
   9. Ensure that residents are aware of the services that are available to them; encourage residents to participate in activities program and provide staff support to enable residents to get to and from and participate in activities.
   10. Maintain accountability for controlled substances; inventory medications at the beginning and end of the shift with another licensed nurse; notify supervisor of discrepancies.
   11. Support the facility’s medical supply system; follow procedures for resident charge items.
   12. Correlate accurate and complete documentation and its impact on reimbursement and federal regulations.
   13. Communicate status of residents to incoming personnel according to established procedures; communicate with physicians; transcribe, clarify, and implement physicians’ orders.
2. Supervise the certified nursing assistants and the CMT’s and determine work procedures, prepare work schedules, expedite workflow, evaluate, counsel and discipline.
3. Insures that certified nursing assistants and CMT’s and all supervised personnel adhere to standard job requirements.

Task List – Charge Nurse

1. Documentation requirements include, but are not limited to, the following:
   1. Changes in medical and physical condition;
   2. Response to antibiotic therapy;
   3. Report of weight loss or gain and response to change;
   4. Report of peg tube patency as directed;
   5. Complete accurate, and timely physicians; information;
   6. Changes in specialized diets; and
   7. Report of pressure ulcer condition and response to treatment weekly.
2. Shift report to the certified nursing assistants must include, but are not limited to, the following:
   1. Changes in resident condition;
   2. Report of new admissions;
   3. Residents scheduled for appointments and rehabilitation;
   4. Assigned baths and restorative instructions;
   5. Splint applications;
   6. Changes in specialized diets;
   7. Individualized patient instructions; and
   8. Special attention needs to be given to the CNA’s who are new to their assignments.
3. Charge nurses are responsible for the knowledge of patient information through the maintenance of accurate lists. This knowledge includes, but is not limited to:
   1. Resident skin condition;
   2. Diet and supplements;
   3. Special equipment needs;
   4. Contingency and protection used;
   5. Weight gain or loss;
   6. Side rail use and reason for use;
   7. Assistance required by resident; and
   8. Residents at high risk for skin breakdown requiring more frequent positioning.
4. Assessment of the residents for skin breakdown done by following the admission, Braden Scale analysis and by personal physical assessment done of the resident by the charge nurse per policy.

Other Duties – Charge Nurse

Perform tasks which are supportive in nature to the essential functions of the job, but which may be altered or redesigned depending upon individual circumstances.

Job Location

As assigned.

Equipment/machines used in the performance of this job

The incumbent must maintain skills necessary to safely and efficiently operate the following equipment and machines used in the performance of this job:

1. Telephone
2. Fax machine
3. Photocopier
4. Various medical equipment
5. PC/computer keyboard
6. Mechanical lifts