Unit Manager

Purpose of Your Job Position

A professional nurse employed to supervise the total nursing activities of the assigned unit around the clock. To ensure that each patient receives treatments, medication, and diet as prescribed, and rehabilitative nursing care as needed, receives proper care to prevent decubitus ulcers and deformities, and is kept comfortable, clean, well groomed and protected from accidents, injury and infections. The Unit Manager also performs direct nursing care to patients and residents. The Unit Manager serves as a liaison between all other departments and personnel on the unit.

Delegation of Authority

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

Job Functions

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, is an essential function of the position or as needed for the administration of the facility.

Duties and Responsibilities

Administrative Functions

· Twenty for hour responsibility for all nursing care on unit.

· Direct standardization, enforces policy and procedures. Develop and adapts work techniques and methods of resolving nursing service problems.

· Plans nursing care to meet the total needs of the patient.

· Initiate the plan of care for the patient through assessment and interview of the patient on admission; assures completion of 5 admission assessment: Pain, side rail, fall risk assessments, Incontinent, Mini-Mental. Assesses completion of admitting nursing notes to reflect information needed to complete MDS. The information will be the basis for the plan of care.

· Complete the Braden scale for all admission & readmission and assure that resident has proper mattress and seat cushion as applicable.

· Head care plan conference weekly with interdisciplinary team. Follow-up on recommendations of Care plan Committee.

· Adjusts care plan when indicated. Care plans can and should be updated by the Unit Manager as situations present.

· Initiate the ICP summary and have ready for discussion at the care plan meeting.

· Responsible for weekly wound rounds. Submit copy of wound report to DON, MDS coordinator, Rehab and dietician on a weekly basis, if there is no designated wound nurse. Coordinate wound rounds with wound nurse.

· Assist MD with floor rounds providing information on status of resident.

· Responsible for the proper transcription and execution of physician’s orders, accurate documentation, maintenance of the clinical record completeness and accuracy of medication record through chart auditing.

· Supervises CNA performance and assists with completions of annual evaluations.

· Initiates disciplinary action of CNA’s when warranted.

· Holds unit meetings with Nurses and CNA’s as needed.

· Addresses resident and staff concerns to promote quality care.

· Complete room rounds to observe and evaluate resident’s physical/emotional state and safety. Has knowledge of resident’s condition at all times. Ensure rooms are clean and neat and presentable at all times.

· Provide direct patient care when needed.

· Answer call bells as needed.

· Keeps Director of Nursing informed of status of patient and other related matters.

· Adjusts CNA’s assignments when warranted.

· Assumes responsibility of Assisting Managerial Staff with staffing issues when warranted.

· Nursing on call rotation.

· Assures completion and proper follow through of doctors call list daily.

· Directly supervises staff nurses to ensure their completion of duties as well as the direct supervision of CNA’s.

· Charts audits.

· Participates in Daily/weekly/monthly meetings as necessary.

· Other assignments may be given as deemed necessary by the DON.

Committee Functions

· Attend various committee meetings of the facility (i.e., Infection Control, Policy Advisory, Pharmaceutical, Quality Assessment, etc.) as required.

· Assist in preparing written and/or oral reports of the nursing service programs and activities to submit to such committee(s) as directed.

· Provide information to the Quality Assurance and Performance Improvement Committee as requested.

· Knowledgeable in data collection, data analysis methodology, and performance improvement methods needed to support and lead performance improvement projects

· Collaborate with the quality committee and senior leaders to prioritize and develop QAPI efforts

· Lead performance improvement projects and provide education and coaching in order to build needed skills in others to lead PIPs

· Participate in multidisciplinary QAPI activities

· Knowledge of current Performance Improvement Initiatives

· Participate in developing the agenda for the Care Plan Committee meetings as necessary.

· Participate in regularly scheduled reviews of the discharge plans and make such plans available to the Care Plan Committee as required or as may be necessary.

· Implement recommendations from established committees as instructed by the Director.

Personnel Functions

· Ensure that a sufficient number of licensed practical and/or registered nurses are available for your tour of duty to ensure that quality care is maintained.

· Ensure that a sufficient number of certified nursing assistants are available for your tour of duty to ensure that routine nursing care is provided to meet the daily nursing care needs of each resident.

· Develop work assignments, and/or assist in completing and performing such tasks.

· Delegate to each Nurse the administrative authority, responsibility, and accountability necessary to perform his/her assigned duties.

· Ensure that all nurse aide trainees are under the direct supervision of a licensed nurse.

· Make daily rounds of the nursing service department to ensure that all nursing service personnel are performing their work assignments in accordance with acceptable nursing standards. Report findings to the Director.

· Monitor absenteeism to ensure that an adequate number of nursing care personnel are on duty at all times. Report problem areas to the Director.

· Ensure that established policies and procedures, including dress codes, are followed by all departmental personnel.

· Review complaints and grievances made or filed by department personnel. Make appropriate reports to the Director as required or as may be necessary.

· Develop and maintain a good working rapport with inter-department 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.

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

· Meet with your shift on a regularly scheduled basis to assist in identifying and correcting problem areas and/or to assist in the improvement of services.

· Review and evaluate your department's work force and make recommendations to the Director.

· Participate in employee performance evaluations, determining your shift's staffing requirements, and making recommendations to the Director concerning employee dismissals, transfers, etc.

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

· 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.

Nursing Care Functions

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

· Ensure that rooms are ready for new admissions.

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

· Make rounds with physicians as necessary.

· Encourage attending physicians to record and sign progress notes, physicians' orders, etc., on a timely basis and in accordance with current regulations.

· Inform the Director when physician visits are not made in a timely manner.

· Consult with the resident, his/her family, and the resident's physician in planning the resident's care, treatment, rehabilitation, etc., as necessary.

· Notify the resident's attending physician and next-of-kin when there is a change in the resident's condition.

· Visit residents to observe and evaluate each resident's physical and emotional status.

· 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.

· Review nurses' notes to ensure that they are informative and descriptive of the nursing care being provided, that they reflect the resident's response to the care, and that such care is provided in accordance with the resident's wishes.

· Provide direct nursing care as necessary.

· Start IVs, obtain sputum, urine and other specimens for lab tests as ordered.

· Take TPRs, blood pressures, etc., as necessary.

· Admit, transfer and discharge residents as necessary.

· Answer call bells regardless of assignment.

· Report problem areas to the Director. Assist in developing and implementing corrective action.

· Keep the Director informed of the status of residents and other related matters through written/oral reports.

· Assist the Nurses in monitoring seriously ill residents.

· Authorize the use of restraints when necessary and in accordance with our facilities policies and procedures.

· Ensure that all RNs and LPNs on your shift comply with written procedures for the administration, storage, and control of medications and supplies.

· Monitor medication passes and treatment schedules to ensure that medications are being administered as ordered and that treatments are provided as scheduled.

· Review medication cards for completeness of information, accuracy in the transcription of physician orders, and adherence to stop order policies.

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

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

· Meet with residents, and/or family members, as necessary. Report problems to the Director.

· Assist in arranging transportation for discharged residents as necessary.

· Inform family members of the death of the resident.

· Call funeral homes when requested by the family.

Staff Development

· 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.

· Develop, implement, and maintain an effective orientation program that orients the new employee to your shift, its policies and procedures, and to his/her job position and duties.

· Provide leadership training that includes the administrative and supervisory principles essential for your Nurses.

· Encourage your Nurses to attend and participate in outside training programs. Schedule times as appropriate.

· Assist the Director in developing and revising the nursing assistant training curriculum used by the facility.

· Assist the Director in planning clinical supervision for nurse aide trainees.

· Assist the Clinical Educator in developing annual OSHA and CDC in-service training programs for hazard communication, TB management, and bloodborne pathogens standard.

· Assist the Clinical Educator in developing advance directive in-service training programs for the staff and community.

· Assist support services in developing, implementing, and conducting in-service training programs that relate to the nursing service department.

· Assist the Clinical Educator in the development of in-service training programs for the nursing staff. Ensure that these programs meet the continuing education requirements which allow licensed personnel (e.g., RNs, LPNs, CNAs, etc.) to keep their license on an active status.

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

Safety and Sanitation

· Assist the Safety Officer in developing safety standards for the nursing service department as necessary.

· Assist the Director and/or Infection Preventionist 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.

· 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.

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

· Ensure that personnel follow established procedures for the use and disposal of personal protective equipment.

· Monitor your shift's personnel to ensure that they are following established safety regulations in the use of equipment and supplies.

· Ensure that all nursing service personnel comply with established departmental policies and procedures.

· Ensure that nursing service work areas (i.e., nurses' stations, medicine preparation rooms, etc.) are maintained in a clean and sanitary manner.

· Ensure that all resident care rooms, treatment areas, etc., are maintained in a clean, safe, and sanitary manner.

· Ensure that nursing service personnel follow established hand washing procedures.

· Ensure that nursing service personnel participate in and conduct all fire safety and disaster preparedness drills in a safe and professional manner.

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

· Ensure that nursing service personnel follow established infection control procedures when isolation precautions become necessary.

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

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

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

Equipment and Supply Functions

· Recommend to the Director the equipment and supply needs of the department.

· Ensure that an adequate stock level of medications, medical supplies, equipment, etc., is maintained on premises at all times to meet the needs of the resident.

· Assist the Maintenance Director in developing a preventive maintenance program for maintaining the nursing service department's equipment and supplies in a safe and operable manner.

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

· Ensure that only trained and authorized personnel operate the nursing service department's equipment.

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

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

· Ensure that appropriate MSDSs are on file for hazardous chemicals used in the nursing service department.

Care Plan and Assessment Functions

· Participate in the development of written preliminary and comprehensive assessments of the nursing needs of each resident as necessary.

· Participate in the development of a written plan of care (preliminary and comprehensive) for each resident that identifies the problems/needs of the resident, indicates the care to be given, goals to be accomplished, and which professional service is responsible for each element of care.

· Encourage the resident to participate in the development and review of his/her care plan.

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

· Ensure that all personnel involved in providing care to the resident are aware of the resident's care plan. Ensure that nursing personnel refer to the resident's care plan prior to administering daily care to the resident.

· Review nurses' notes to determine if the care plan is being followed.

· Assist the Resident Assessment/Care Plan Coordinator in planning, scheduling, and revising the MDS, including the implementation of CAAs and Triggers.

· Review resident's medical and nursing treatments to ensure that they are provided in accordance with the resident's care plan and wishes.

Budget and Planning Functions

· Keep abreast of economic conditions/situations, and recommend to the Director adjustments in nursing services that ensure the continued ability to provide quality care.

· Recommend to the Director the equipment needs of the nursing service department.

Resident Rights

· Maintain the confidentiality of all resident care information.

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

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

· Ensure that all nursing service personnel are knowledgeable of the residents' responsibilities and rights including the right to refuse treatment.

· 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.

· Maintain a written record of the resident's complaints and/or grievances that indicates the action taken to resolve the complaint and the current status of the complaint.

· Report and investigate all allegations of resident abuse and/or misappropriation of resident property.

· 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.

Working Conditions

· Works in office area(s) as well as throughout the nursing service area (i.e., drug rooms, nurses' stations, resident rooms, etc.).

· Moves intermittently during working hours.

· Is subject to frequent interruptions.

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

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

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

· Works beyond normal working hours and on weekends and holidays when necessary.

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

· Is involved in community/civic health matters/projects as appropriate.

· Attends and participates in continuing educational programs.

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

· Is subject to exposure to infectious waste, diseases, conditions, etc., including TB and the AIDS and Hepatitis B viruses.

· May be subject to the handling of and exposure to hazardous chemicals.

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

Education

· Must possess, as a minimum, a Nursing Degree from an accredited college or university.

Experience

· Must have, as a minimum, one year(s) of experience as a supervisor in a hospital, long-term care facility, or other related health care facility.

· Must have training in rehabilitative and restorative nursing practices.

Specific Requirements

· Must possess a current, unencumbered, active license to practice as an RN or LPN/LVN in this state.

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

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

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

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

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

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

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

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

· Must be able to relate information concerning a resident's condition.

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

Physical and Sensory Requirements

(With or Without the Aid of Mechanical Devices)

· Must be able to move intermittently throughout the workday.

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

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

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

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

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

· Must be able to push, pull, move, lift and carry.

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

Regulatory Compliance - QAPI

· Recognize your role as part of the QAPI efforts of your organization.

· Attend trainings to build understanding and capacity to undertake QAPI work.

· Carry out QAPI roles and responsibilities as assigned.

· Follow established policies and procedures in support of QAPI efforts.

· Look for and share with leadership ideas for improvement in the organization.

· Communicate to leadership upon witnessing a positive outcome of a QAPI project or detecting barriers preventing project success.

· Support QAPI efforts both verbally and non-verbally (i.e., via actions and attitude), including adjusting performance and practice in accordance with QAPI initiatives and findings.