Description

Overview
The Change Nurse provides, plans, coordinates, and manages nursing care, nursing services, and health education to nursing home residents. The Change Nurse cares for residents under the direction and supervision of the Director of Nursing. The position requires patience, compassion, and a desire to care for the elderly in a gentle and empathetic matter.

Supervisory Responsibilities:

• Supervises nursing care provided by nursing assistants and others for whom they are administratively or professionally responsible.
• Carries out supervisory responsibilities in accordance with the organizational policies and applicable laws.
• Supervisory responsibilities include:
  • Plans, assigns and directs work of nursing assistant.
  • Prepares work assignment sheets, taking into consideration safety, the educational preparation, experience, knowledge, and ability of the persons to whom the assignments are made.
  • Reports staff shortages to management.
  • Assists to prepare performance evaluations with the understanding such evaluations impact tenure of probationary employees and wage increases of non-probationary employees.
  • Participates and communicates employee actions that may result in reward or discipline.
  • Schedules and adjusts lunch and rest breaks according to resident needs and labor laws.
  • Receives and helps resolve employee complaints.
  • Monitors and corrects job performance of employees.
• Is in charge of facility in the absence of higher ranking management staff.
• Uses independent judgment and discretion on behalf of the organization in the performance of these duties.

Essential Functions and Responsibilities
To perform this job successfully, an individual must be able to perform each key function satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the key functions.

Care and Services:

• Coordinates the nursing care of residents on the unit assuring all residents are assigned a nurse aide capable of providing care to the resident.
• Provides safe and accurate medication related interventions to residents.
  • Administers and documents medications and treatments according to each resident’s medication schedule using current standards of medication pass technique. Medication administration includes:
    • Oral
    • Parenteral
    • Injection
    • Enteral
    • Inhaler
    • Eye drops
    • Ear drops
    • Rectal orifice
    • Topical
  • Knows the rationale for the effect of medications and treatments and correctly administers same.
  • Provides treatments per the physician order including wound care, urinary catheterization, oxygen care, tracheostomy care, etc.
  • Orders and receives medications from the pharmacy.
  • Conducts an accurate accounting of all narcotics, signing for count and exchange of keys to medication carts and medication room.
  • Promptly responds to resident requests for pain intervention and documents such in the resident record.
• Accurately transcribes and coordinates the implementation of physician orders, including but not limited to:
  • Scheduling labs, x-rays, physician or clinic visits.
  • Transfer of residents to hospitals/clinics.
  • Communicating with ancillary companies the need and use of services.
  • Changes in treatment, medication, or other physician services.
  • Restorative and rehabilitative care, including restorative nursing practices and equipment.
• Performs nursing assessments regarding the health status of residents. Notifies the physician of changes in status and promptly implements and documents new orders.
• Develops a plan of care based on assessment when implementing nursing care.
• Selects and institutes appropriate nursing interventions that might be required to stabilize a resident’s condition and/or prevent complications.
• Contributes to the resident’s assessment (MDS/RAPs) and the development of a plan of care.
• Consults with physician or licensed independent practitioner regarding general resident care needs.
  • Clarifies any order or treatment regimen believed to be inaccurate, non-effective, or contraindicated by consulting with the appropriate licensed practitioner and notifying the ordering practitioner when making the decision not to administer the medication or treatment.
• Accurately reports and documents the resident’ symptoms, responses, and status.
• Designs, promotes, and organizes resident education and counseling based on health needs.
• Informs the resident and/or legal representative of incidents or changes in condition and documents same in chart.
  • Collaborates with the resident, members of the healthcare team and, when appropriate, the resident’s legal representative/significant other in the interest of the resident’s health care.
• Consults with, utilizes, and initiates referrals to appropriate community agencies and healthcare resources to provide continuity of care.
• Makes resident rounds throughout the shift to assess physical and emotional status and to initiate any required nursing interventions.
• Responds to resident and family concerns promptly; ensures that each concern is documented and a resolution is initiated.
• Coordinates admission, discharge, and transfer of residents.
• Obtains report from nurse going off shift, provides report to nursing coming on duty and keeps the Director of Nursing (or others, as appropriate) informed about the status of resident and related matters.
  • Maintains an accurate 24 hour report and documents changes in resident conditions and significant issues needed for continuity of care and safety of residents.
• Monitors and assists with the serving of documentation of prescribed diets and fluid intake.
• Checks emergency equipment (oxygen and suction) and emergency medication kit (of applicable).
• Uses nursing equipment and supplies according to manufacturer’s guidelines.
• Accepts only those nursing assignments that are commensurate with one’s own education preparation, experience, knowledge, and ability; obtains instruction and supervision as necessary when implementing nursing procedures or practices.
• Follows the policies and procedures of the facility.
• Performs other duties or functions as directed by the Administrator or Director of Nursing.

Resident Rights
Promotes and protects residents’ rights; assists residents to make informed decisions; treats residents with dignity and respect; protects residents’ personal belongings; reports suspected abuse or neglect; avoids the need for physical restraints in accordance with current professional standards; and supports independent expression, choice, and decision-making consistent with applicable laws and regulations.

Qualifications

Qualifications:

• Must have a current state license to practice as a registered nurse (RN) or licensed practical nurse (LPN); current CPR certification and additional certifications in nursing specialties desired.
• Demonstrates knowledge of basic nursing practice with an interest in gerontological nursing; 2 years experience in a long term care setting preferred.
• Excellent communication and interpersonal skills.
• Ability to read, analyze, and interpret professional journals, technical procedures, or governmental regulations; ability to communicate orally and through written reports and other documents relating to resident, staff, and others; ability to effectively present information and respond to questions from groups of executives, managers, clients, customers, and the public.
• Ability to define and solve problems, collect data, establish facts, and draw valid conclusions; ability to interpret an extensive variety of technical journals and deal with several abstract and concrete variables.

Leadership
Demonstrates willingness to try new tasks; generates new ideas for change; evaluates and recognizes priorities; challenges others to learn; keeps current and integrates new information; communicates and models organizational values; and fosters high performance.

Process Improvement
Applies process improvement methods and techniques, and identifies processes for improvement in daily work.

Environment of Care
Demonstrates understanding of fire and emergency procedures; participates in fire and disaster drills; demonstrates understanding of safety and security procedures; applies safety and security precautions; demonstrates understanding of hazardous materials plan; and demonstrates proper use of equipment.

Infection Control
Applies handwashing principles during daily work; demonstrates understanding of isolation precautions; recognizes signs and symptoms of infection and complies with the employee health program; demonstrates understanding of the process for identifying and handling infectious waste; maintains personal hygiene; complies with OSHA standards in the work place; and demonstrates understanding of cross contamination.

Information Management
Enters or records data timely and accurately; protects confidentiality of resident information (in accordance with HIPAA policies); protects data against loss or destruction; reports suspected violation of security/confidentiality issues; logs onto the system using own password; logs off the system when leaving the work station; reviews data and identifies trends; and deletes passwords of employees no longer needing access to software programs.

Continuing Education
Attends inservice training programs, and attends continuing education required for maintenance of certification.

Physical Demands
The physical demands described here represent those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to stand, walk, use hands and fingers, reach with hands and arms, talk, and hear. The employee must be able to assist by lifting and/or transferring residents weighing between 100 to 250 pounds. Specific vision abilities required by this job include close vision, distance vision, and peripheral vision.