The primary purpose of your job position is to provide direct nursing care to the residents, and to supervise the day-to-day nursing activities performed by certified nursing assistants. Such supervision must be in accordance with current federal, state and local standards, guidelines, and regulations that govern our facility, and as may be directed by Nursing Administration, or Nurse Manager, or a Nurse Supervisor, to ensure that the highest degree of quality care is maintained at all times.

As the LPN you are delegated the administrative authority, responsibility, and accountability necessary for carrying out your assigned duties.

Director of Nursing Services

Assistant Director of Nursing Services

Nurse Manager

Nurse Supervisor

Every effort has been made to identify the essential functions of this position. However, it in no way states or implies that these are the only duties you will be required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or is an essential function of the position.

a. Support and implement the facility’s mission statement.

b. Direct the day-to-day functions of the nursing staff in accordance with current rules, regulations, and guidelines that govern the long-term care facility.

c. Ensure that all nursing personnel assigned to you comply with the written policies and procedures established by this facility.

d. Meet with your assigned nursing staff, as well as support personnel, in planning the unit’s services, programs, and activities.

e. Ensure that the Nursing Service Procedures Manual is current and reflects the day-to-day nursing procedures performed in this facility.

f. Ensure that all nursing service personnel comply with the procedures set forth in the Nursing Service Procedures Manual.

g. Make written and oral reports/recommendations concerning the activities of your unit as required.

h. Cooperate with other resident services when coordinating nursing services to ensure that the resident’s total regimen of care is maintained.

i. Ensure that all nursing service personnel are in compliance with their respective job descriptions.

j. Participate in the development, maintenance, and implementation of the facility’s quality assurance program for the nursing service department.

k. Participate in facility surveys (inspections) made by authorized government agencies as may be requested.

l. Participate in the updating of the resident’s written discharge plan as required.

m. Assist in planning the nursing services portion of the resident’s discharge plan as necessary.

n. Interpret the department’s policies and procedures to personnel, residents, visitors, and government agencies as required.

o. Admit, transfer, and discharge residents as required.

p. Complete accident/incident reports as necessary.

q. Perform administrative duties such as completing medical forms, reports, evaluations, studies, charting, etc., as necessary.

r. Forward copies of x-ray and lab requisitions to the Business Office.

a. Work with the Interdisciplinary Care Plan Team in developing a comprehensive assessment and care plan for assigned residents.

b. Serve on, participate in, and attend various other committees of the facility as required, and as appointed by the Administrator.

c. Provide written and/or oral status reports of residents that you are treating.

d. valuate and implement recommendations from established committees as they may pertain to the medical activities of the facility and the care of residents.

a. Complete and file required record keeping forms/charts upon the resident’s admission, transfer, and/or discharge.

b. Encourage attending physicians to review treatment plans, record and sign their orders, progress notes, etc.,in accordance with established policies.

c. Receive telephone orders from physicians and record on the Physicians’ Order Form.

d. Transcribe physician’s orders to resident charts, medication administration records, treatment administration records, and/or care plans, as required.

e. Document progress notes in an informative and descriptive manner that reflects the resident’s condition, the care provided to the resident, as well as the resident’s response to the care.

f. Chart all reports of accidents/incidents involving residents.

g. Record new/revised physician orders and forward information to the appropriate departments.

h. Report all discrepancies noted concerning physician’s orders, diet change, charting error, etc., to Nurse Manager or Supervisor.

i. Fill out and complete transfer forms in accordance with established procedures.

j. Ensure that appropriate documentation concerning unauthorized discharges is entered in the resident’s medical record in accordance with established procedures.

k. Perform routine charting duties are performed as required and in accordance with established charting and documentation policies and procedures.

l. Sign and date all entries made in the resident’s medical record.

m. Maintain the clinical record in an organized, systematic manner in accordance with guidelines established by the medical records department.

a. Prepare and administer medications as ordered by the physician.

b. Verify the identity of the resident before administering the medications/treatment.

c. Ensure that prescribed medication for one resident is not administered to another.

d. Ensure that an adequate supply of floor stock medications, supplies, and equipment is on hand to meet the nursing needs of the residents. Report needs to the Nurse Manager or Supervisor.

e. Order prescribed medications, supplies, and equipment necessary, and in accordance with established policies.

f. Ensure that narcotic records are accurate for your shift.

g. Notify the Nurse Manager or Supervisor of all drug and narcotic discrepancies noted on your shift.

h. Review medication administration records for completeness of information, accuracy in the transcription of the physician’s order, and adherence to stop order.

i. Dispose of drugs and narcotics as required, and in accordance with established procedures.

a. Inform the Nurse Manager or Supervisor of staffing needs when assigned personnel fail to report to work.

b. Report absentee call-ins to Nurse Manager or Supervisor

c. Develop work assignments and/or assist in completing and performing such assignments.

d. Provide leadership to nursing personnel assigned to your unit/shift.

e. Make daily rounds of your unit to ensure that nursing service personnel are performing their work assignments in accordance with acceptable nursing standards. Report problem areas to the Nurse Manager or Supervisor.

f. Meet with your unit’s nursing personnel, on a regularly scheduled basis, to assist in identifying and correcting problem areas, and/or to improve services.

g. Ensure that department personnel, residents, and visitors follow the department’s established policies and procedures at all times.

h. 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 residents.

i. Create and maintain an atmosphere of warmth, personal interest and positive emphasis, as well as a calm environment throughout the unit.

j. Forward complaints and grievances made or filed by your assigned personnel to the Nurse Manager or Supervisor.

k. Make appropriate reports to the Nurse Manager or Supervisor as required or as may be necessary. Follow facility’s established procedures.

l. Ensure that departmental disciplinary action is administered fairly and without regard to race, color, creed, national origin, age, sex, religion, handicap, or marital status.

m. Receive/give the nursing report upon reporting in and ending shift duty hours.

n. Report occupational exposures to blood, body fluids, infectious materials, and hazardous chemicals in accordance with the facility’s policies and procedures governing accidents and incidents.

a. Inform nursing personnel of new admissions, their expected time of arrival, room assignment, etc.

b. Ensure that rooms are ready for new admissions.

c. Greet newly admitted residents upon admission. Escort them to their rooms as necessary.

d. Participate in the orientation of new residents/family members to the facility.

e. Make rounds with physicians as necessary.

f. Requisition and arrange for diagnostic and therapeutic services, as ordered by the physician, and in accordance with our established procedures.

g. Consult with the resident’s physician in providing the resident’s care, treatment, rehabilitation, etc., as necessary.

h. Review the resident’s chart for specific treatments, medication orders, diets, etc., as necessary.

i. Implement and maintain established nursing objectives and standards.

j. Make periodic checks to ensure that prescribed treatments are being properly administered by certified nursing assistants and to evaluate the resident’s physical and emotional status.

k. 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.

l. Cooperate with and coordinate social and activity programs with nursing service schedules.

m Notify the resident’s attending physician and designated representative when the resident is involved in an accident or incident.

n. Notify the resident’s attending physician and designated representative when there is a change in the resident’s condition

. o. Carry out restorative and rehabilitative programs, to include self-help and care.

p. Inspect the nursing service treatment areas daily to ensure that they are maintained in a clean and safe manner.

q. Use restraints when necessary and in accordance with established policies and procedures.

r. Obtain specimens for diagnostic tests as ordered.

s. Monitor and record TPRs, blood pressures, etc., as necessary.

t. Check foods brought into the facility by the resident’s family/visitors. Report problem areas to the Nurse Manager or Supervisor and, if indicated, the Dietician.

u. Ensure that personnel providing direct care to residents are providing such care in accordance with the resident’s care plan and wishes.

v. Ensure that residents who are unable to call for help are checked frequently.

w. Meet with residents, and/or family members, as necessary. Report problem areas to Nurse Manager or Supervisor.

x. Admit, transfer and discharge residents as necessary.

y. Assist in arranging transportation for residents as necessary.

z. Ensure that discharged residents are escorted to the pick-up area.

aa.. Identify, manage, and treat specific skin disorders and primary and secondary lesions.

bb. Provide assessment and diagnostic services to residents. Perform an assessment evaluation using techniques including observation, inspection and palpitation.

cc. Ensure that residents with skin lesions receive appropriate prophylaxis and treatment, such as daily inspection, turning and activity, a well-planned diet, and maintaining a clean, dry bed.

dd.Give direct physical and psychological nursing care in emergencies, as well as in the presence of illness or disability in order to maintain life, provide comfort, reduce stress, and enhance the resident’s ability to cope.

ee. Work with other health agencies and family members in the physical and emotional transitions of admission, care, and discharge of residents as necessary.

ff. Assist in resident rehabilitation activities. Where required, perform range of motion, assist in ambulation, provide emotional support. Monitor the results of physical therapy activities.

gg Provide preventive health care services. Make recommendations to the resident concerning nutrition,prevention of common skin disorders, etc.

hh. Provide information to resident and family members of prevention techniques and other ways to maintain or improve the general health and psychosocial status of the resident.

ii. Confer with the Nurse Manager and/or other nursing personnel regarding the prevention and treatment of skin conditions and lesions of residents under your care.

jj. Implement and maintain established policies and procedures relative to skin care treatments. Interpret these to the physician, resident family members, and public as appropriate.

kk. Participate in educational programs for the residents and their family members relative to skin care when a resident is being discharged to home.

a. Participate in developing, planning, conducting, and scheduling in-service training classes that provide instructions on “how to do the job,” and ensure a well-educated nursing service department.

b. Participate in an effective orientation program that orients the new employee to your shift/unit.

c. Assist in standardizing the methods in which work will be accomplished.

d. Assist in training department personnel in identifying tasks that involve potential exposure to blood/body fluids.

e. Attend and participate in annual OSHA and CDC in-service training programs for hazard communication, TB management, and blood borne pathogens standard.

f. Attend and participate in advance directive in-service training programs for the staff.

g. Attend and participate in continuing educations programs designed to keep you abreast of changes in your profession, as well as to maintain your license on a current status.

a. Monitor your assigned personnel to ensure that they are following established safety regulations in the use of equipment and supplies.

b. Ensure that established departmental policies and procedures, including dress codes, are followed by your assigned nursing personnel.

c. 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.

d. Ensure that all personnel performing tasks that involve potential exposure to blood/body fluids participate in appropriate in-service training programs prior to performing such tasks.

e. Ensure that an adequate supply of personal protective equipment is on hand and is readily available to personnel who perform procedures that involve exposure to blood or body fluids.

f. Ensure that your assigned work areas (i.e., nurses’ stations, medication rooms, etc.) are maintained in a clean and sanitary manner.

g. Ensure that your unit’s resident care rooms, treatment areas, etc., are maintained in a clean, safe, and a sanitary manner.

h. Ensure that your assigned personnel follow established handwashing techniques in the administering of nursing care procedures.

i. Ensure that your assigned personnel participate in and conduct all fire safety and disaster preparedness drills in a safe and professional manner.

j. Participate in the development, implementation, and maintenance of the infection control program for monitoring communicable and/or infectious diseases among the residents and personnel.

k. Ensure that your assigned personnel follow established infection control procedures.

l. Ensure that nursing personnel follow established procedures in the use and disposal of personal protective equipment.

m. Participate in the development, implementation and maintenance of the procedures for reporting hazardous conditions or equipment.

n. Ensure that all personnel wear and/or use safety equipment and supplies (e.g., back brace, mechanical lifts, etc.) when moving or lifting residents.

o. Report missing/illegible labels and MSDSs to the safety officer or other designated person.

a. Recommend to the Nurse Manager or Supervisor the equipment and supply needs of your unit/shift.

b. Ensure that an adequate stock level of medications, medical supplies, equipment, etc., is maintained on your unit/shift at all times to adequately meet the needs of the residents.

c. Participate in the development and implementation of the procedures for the safe operation of all nursing service equipment.

d. Ensure that only trained and authorized personnel operate your unit’s equipment.

e. Ensure that all personnel operate nursing service equipment in a safe manner.

f. Monitor nursing procedures to ensure that nursing service supplies are used in an efficient manner to avoid waste.

a. Review care plans to ensure that appropriate care is being rendered.

b. Confer with Nurse Manager or Supervisor regarding any changes that have been made to the resident’s care plan.

c. Ensure that your nurses’ notes reflect that the care plan is being followed when administering nursing care or treatment.

d. Review resident care plans for appropriate resident goals, problems, approaches, and revisions based on nursing needs.

e. Ensure that your assigned certified nursing assistants (CNAs) are aware of the resident care plans. Ensure that the CNAs refer to the Resident’s Care Profile prior to administering daily care to the resident.

f. Assist the Nurse Manager in the identification and collection of information relevant to the completion of the MDS and RAPs.

g. Ensure the accuracy of The Resident Care Profile and completion of the CNA Accountability Record.

Resident Rights a. Maintain the confidentiality of all resident care information.

b. Monitor nursing care to ensure that all residents are treated fairly, and with kindness, dignity and respect.

c. Ensure that all nursing care is provided in privacy and that nursing service personnel knock before entering the resident’s room.

d. Ensure that all nursing service personnel is knowledgeable of the residents’ responsibilities and rights, including the right to refuse treatment.

e. Review complaints and grievances made by the resident and make a written/oral report to the Director indicating what action(s) were taken to resolve the complaint or grievance. Follow facility’s established procedures.

f. Report and investigate, as requested, all allegations of resident abuse and/or misappropriation of resident property.

g. Ensure that nursing staff personnel honor the resident’s refusal of treatment request. Ensure that such requests are in accordance with the facility’s policies governing advance directives.

a. Provide data to the Quality Assurance & Assessment Committee as requested.

a. Works in area(s) as well as throughout the nursing service area (i.e., medication rooms, nurses’ stations, resident rooms, etc.).

b. Moves intermittently during working hours.

c. Is subject to frequent interruptions.

d. Is involved with residents, personnel, visitors, government agencies/personnel, etc., under all conditions and circumstances.

e. Is subject to hostile and emotionally upset residents, family members, personnel, and visitors.

f. Communicates with the medical staff, nursing personnel, and other department supervisors.

g. Works beyond normal working hours and on weekends and holidays when necessary. On call 24 hours per day, seven days per week.

h. Is subject to call-back during emergency conditions (e.g., severe weather, evacuation, post-disaster, etc.)

i. Attends and participates in continuing education programs.

j. Is subject to injury from falls, burns from equipment, odors, etc., throughout the work day, as well as to reactions from dust, disinfectants, tobacco smoke, and other air contaminants.

k. May be subject to the handling of an exposure to hazardous chemicals.

l. May be subject to exposure to infectious waste, diseases, conditions, etc., including TB and the AIDS and Hepatitis B viruses.

m. Maintains a liaison with the residents, their families, support departments, etc., to adequately plan for the residents’ needs.

Must be a graduate of an approved LPN program.

None. On-the-job training provided.

a. Must possess a current, unencumbered, active license to practice as a Licensed Practical Nurse in New York State.

b. Must be able to read, write, speak and understand the English language.

c. Must possess the ability to make independent decisions when circumstances warrant such action.

d. Must possess the ability to deal tactfully with personnel, residents, family members, visitors, government agencies/personnel, and the general public.

e. Must be knowledgeable of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pertain to long-term care.

f. Must possess leadership and supervisory ability and the willingness to work harmoniously with and supervise other personnel.

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

h. Must have patience, tact, a cheerful disposition and enthusiasm, as well as the willingness to handle difficult residents.

i. Must be willing to seek out new methods and principles and be willing to incorporate them into existing nursing practices.

j. Must be able to relay information concerning a resident’s condition.

k. Must not pose a direct threat to the health or safety of other individuals in the workplace.

a. Must be able to move intermittently throughout the workday.

b. Must be able to speak and write the English language in an understandable manner.

c. Must be able to cope with the mental and emotional stress of the position.

d. 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.

e. Must function independently, and have flexibility, personal integrity, and the ability to work effectively with residents, personnel, and support agencies.

f. Must meet the general health requirements set forth by the policies of this facility which include a medical and physical examination.

g. Must be able to relate to and work with the ill, disabled, elderly, emotionally upset, and at times hostile people within the facility.

h. Must be able to push, pull, move and/or lift a minimum of 50 pounds to a minimum height of 3 feet and be able to push, pull, move, and/or carry such weight a minimum distance of 50 feet.

i. May be necessary to assist in the evacuation of residents during emergency situations.

I have read this job description and fully understand the requirements set forth therein. I hereby accept the position of Licensed Practical Nurse and agree to perform the identified essential functions in a safe manner and in accordance with the facility’s established procedures. I understand that as a result of my employment, Imay be exposed to blood, body fluids, infectious diseases, air contaminants (including tobacco smoke), and hazardous chemicals and that the facility will provide to me instructions on how to prevent and control such exposures. I further understand that I may also be exposed to the Hepatitis B Virus and that the facility will make available to me, free of charge, the hepatitis B vaccination.

I understand that, unless covered by a collective bargaining agreement, my employment is at-will, and thereby understand that my employment may be terminated at-will either by the facility or myself and that such notice can be made with or without notice.