Bedrock Care Registered Nurse in Williamsport, Pennsylvania
Makes daily compliance rounds on assigned unit at least at beginning and at end of shift to observe, examine or interview residents, to verify information from ongoing shift, to monitor regulatory compliance, to determine staff assignments, and provides / receives report.
Develops and distributes resident care assignments to direct care staff. Assignments match resident needs with skills of direct care staff, and maintain consistency to the extent practicable. Adjusts assignments according to availability of qualified staff. Changes assignments if necessary during shift to meet resident needs.
Provides orientation to unit and unit routines to new staff members or staff from temporary agencies.
Describes care plan goals and approaches to direct care staff so that care plan is consistently implemented on all shifts by all caregivers. Seeks input from nurse aides about residents’ condition, functional abilities, preferences and alternative approaches to care. Monitors 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. Administers medications, treatments and provides direct care to residents on unit according to physician orders and in compliance with facility policies and procedures.
Performs physical assessment (or gathers appropriate data) of new admissions and current residents as indicated by change in condition or as required by regulation. Completes assigned sections of resident assessment instruments used in facility.
With participation of interdisciplinary team members and resident, to the extent practicable, develops, implements, evaluates and revises plans of care with measurable objectives and timetables to assist each resident to attain or maintain highest practicable physical, mental and psycho-social well-being. Coordinates care and delivery of services with all disciplines. Consults with and refers relevant resident care issues to attention of interdisciplinary care team members.
Modifies approaches in plans of care to accommodate resident needs and preferences, to manage risk factors for functional decline and to improve functional abilities.
Respects rights of residents regarding freedom of choice, consent for care and services, refusals of treatment and implementation of advance directives if any. Promptly consults with nursing supervisor or Unit Manager and Social Worker if unsure of proper course of action that respects resident's rights, complies with facility policies and procedures and that is consistent with state and federal laws and regulations.
Trains and develops staff by conducting skills observations of nurse aides identifying learning needs and taking advantage of opportunities to teach on the unit. Reports information to Unit Manager as part of staff performance evaluations.
Completes required documentation of care and services delivered during shift including subjective findings, objective symptoms, interventions and resident responses to interventions. Completes required documentation of special circumstances including accident/incident reports in compliance with state and federal laws and regulations.
Completes written 24 hour facility report. Gives and listens to verbal shift report making special note of significant changes in condition, admissions, transfers, discharges, initiation or use of physical or chemical restraints, unnecessary use of any drug, incidents, medication errors, loss of resident property or evidence of resident or family dissatisfaction.
Informs the resident in advance about care and treatment and any changes to the plan of care.
Immediately informs the resident, consults with the resident's physician and notifies 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, i.e, 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 notifies the resident, designated family member and/or resident's legal representative when there is a change in room or roommate.
Reports relevant information to the Unit Manager including, interdisciplinary team functioning and communication, regulatory compliance issues, resident risk factors, sadden changes in resident behavior, expressed dissatisfaction by resident or family, refusals of treatment, unexplained injuries, staff behavior (positive and negative), staffing needs, equipment and supply needs, opportunities to revise policies, procedures, improve quality.
Monitors staff for compliance with OSHA mandates on workplace safety including hazard communication and blood borne pathogens. In cases of workplace exposure, provides immediate first aid and refers employee to appropriate facility staff member for post-exposure follow-up.
Reports all injuries to self or others to supervisor immediately.
Takes job actions with staff members under appropriate circumstances. Applies facility policies about progressive discipline correctly. Removes staff member from unit if necessary to avoid endangerment to health or safety of residents or other staff members. Reports all job actions taken to Unit Manager promptly.
Attends in-service education programs as assigned. Applies information to job tasks.
Assists Unit Manager with preparation for long-term care survey. Attends survey training, interacts with state surveyors as instructed by supervisor.
SPECIFIC EDUCATIONAL/VOCATIONAL REQUIREMENTS:
Graduate of an approved school of nursing is required.
Must be currently licensed by the State Board of Nursing.
Experience is preferred in rehabilitative or geriatric nursing
Comprehensive knowledge of nursing principles required, including the ability to recognize and identify symptoms and manage emergency situations.
Knowledge of medications, their proper dosage, and expected results
Ability to coordinate, delegate and supervise unlicensed nursing functions.
Ability to create a resident-centered environment
Basic knowledge of computer use.
This position requires that the employee is able to read, write, speak and understand the spoken English language to ensure the safety and well being of our patients and visitors at the work site when responding to their medical and physical needs.
Must provide verification of TST (tuberculin skin test) as required by state law and in accordance with Company policy. TSTs will be administered at the work site if required.