Director of Nursing

Job Purpose

The Director of Nursing (DON) provides leadership and oversight of nursing operations and the implementation of medical and nursing policies and procedures within the program. The DON is responsible for ensuring safe, consistent, high-quality nursing care; effective medication management; appropriate monitoring of client vitals, laboratory work, routine health assessments, and other nursing needs; and compliance with applicable organizational, regulatory, licensing, and accreditation requirements. The DON serves as the primary nursing liaison between the program and the Medical Director and other medical providers, coordinates nursing and medical communication across the interdisciplinary team, and directly supervises nursing department staff. The DON is accountable for nursing implementation, monitoring, coordination, escalation, and follow-through while collaborating with the Medical Director and other licensed providers on matters requiring medical-provider evaluation or decision-making. Overall, the DON is responsible for ensuring that the program provides safe, responsive, and effective medical and nursing support to clients.

Duties and Responsibilities

Duties and responsibilities include, but are not limited to, the following:

Nursing and Medical Policy, Procedure, and Operations

• Maintain a thorough understanding of current and future policies and procedures applicable to employees and clients.
• Provide primary nursing ownership of medication management policies and procedures, including ensuring policies are communicated, trained, implemented, monitored, enforced, and updated as required.
• Oversee nursing processes related to client vitals, laboratory work, routine health assessments, nursing assessments, and other medical monitoring required by program policy and client need.
• Ensure client vitals and other required medical monitoring are completed and documented according to established policy and procedure.
• Review and audit nursing assessments and nursing documentation on all clients at least weekly and ensure appropriate follow-up occurs.
• Identify opportunities for nursing process improvement and implement or coordinate corrective actions as needed.
  
  

Medical Director and Provider Coordination

• Serve as the primary nursing point of contact between the program and the Medical Director and other medical providers.
• Coordinate timely communication regarding routine and urgent medical needs, changes in client medical status, medical emergencies, critical incidents, medication needs, follow-up care, and other matters requiring provider awareness or direction.
• Ensure medical orders, recommendations, and follow-up needs are communicated to appropriate team members and implemented within the nursing scope of responsibility.
• Coordinate medical care between clients and external medical professionals, acute care providers, laboratories, pharmacies, and other healthcare partners when required.
  
  

Admissions and Medical Clearance

• Review pre-admission medical clearance information and other relevant medical records in a timely manner to assess medical appropriateness for the residential level of care within established admission criteria.
• Provide timely nursing/medical acceptance or denial recommendations and communicate identified concerns to the appropriate admissions and clinical team members.
• Consult with or escalate to the Medical Director or other appropriate medical provider when admission decisions require provider-level medical evaluation or when medical risk is unclear.
  
  

Client Medical Care and Safety

• Oversee the delivery of nursing care, including but not limited to phlebotomy, vital signs, first-line review of laboratory results for client safety needs, routine health assessments, and weekly nursing assessments.
• Monitor client health and welfare through standardized nursing and medical assessment processes and ensure emerging concerns are appropriately addressed and escalated.
• Exercise nursing judgment regarding medical or environmental safety conditions that may affect client participation in outings, equine therapy, walks, or other activities, and recommend modification or cancellation when warranted for client safety.
• Ensure medical emergencies and critical incidents are responded to, reported, documented, communicated, and followed through according to policy.
  
  

Medication Management

• Coordinate timely acquisition of prescription and non-prescription medications.
• Ensure medication storage, documentation, administration, reconciliation, and related nursing processes are accurate and consistent with policy and applicable requirements.
• Ensure medication errors are documented through the Critical Incident Reporting process and that appropriate investigation, provider notification, follow-up, resolution, and process improvement occur.
• Review medication-management practices and lead ongoing process improvement to promote safety and reduce risk.
  
  

Interdisciplinary Treatment and Discharge Planning

• Attend treatment team, leadership, and other required interdisciplinary meetings as the representative of the nursing/medical department.
• Ensure the nursing and medical portions of each client's weekly interdisciplinary treatment plan are accurate, current, clinically meaningful, and completed within required timeframes.
• Participate in discharge planning and ensure medical and nursing needs, follow-up recommendations, medication information, and continuity-of-care needs are accurately documented and communicated.
• Act as a communication liaison for medical and nursing matters among clinical, recovery, nutrition, business, admissions, and other relevant staff to support coordinated client care.
  
  

Nursing Leadership, Staffing, and Personnel Management

• Directly supervise nursing department staff and provide ongoing leadership, coaching, clinical oversight, and performance management.
• Interview, select, onboard, and support nursing department team members in collaboration with Human Resources and organizational leadership.
• Maintain and update nursing job descriptions in collaboration with Human Resources and organizational leadership as needed.
• Conduct required performance evaluations and address performance concerns, corrective actions, and employment recommendations in accordance with organizational policy and Human Resources processes.
• Monitor and manage nursing shift coverage and PTO requests and maintain required 24/7 nursing coverage.
• Create, maintain, and communicate the nursing on-call rotation and on-call protocol.
• Provide required nursing staffing, on-call, and provider-utilization reports to Human Resources and/or administration within established timeframes.
  
  

Staff Training and Competency

• Maintain primary responsibility for the quality and consistency of training related to nursing and medical procedures, including vital signs, EHR documentation, medication administration and management, first aid, emergency response, and other medically related competencies.
• Provide or coordinate first aid and medication administration training for applicable staff as required.
• Identify training and competency needs, develop or obtain appropriate educational content, and deliver or coordinate training necessary to sustain and improve safe care delivery.
• Ensure nursing staff complete required RELIAS assignments, competencies, orientation requirements, annual trainings, and other required education within established timeframes.
• Ensure completion of required nursing and medical training is appropriately documented in the designated electronic training and development platform.
• Develop and maintain nursing group curriculum and facilitate the group or supervise the nurse responsible for facilitation, as applicable.
  
  

Regulatory, Accreditation, and Quality Compliance

• Maintain oversight of nursing and medical compliance with applicable accreditation, regulatory, licensing, organizational, and policy requirements.
• Ensure required nursing and medical logs, audits, records, medication documentation, monitoring tools, and other compliance documentation are completed accurately and within required timeframes.
• Monitor adherence to applicable Joint Commission and other relevant medical and nursing standards and coordinate corrective action when deficiencies are identified.
• Participate in quality improvement, survey readiness, corrective action planning, and other compliance activities related to nursing and medical operations.
  
  

Supplies, Equipment, Vendors, and Department Resources

• Order, maintain, and monitor adequate nursing and medical equipment, supplies, medications, and other resources required for safe client care.
• Manage relationships with medical and nursing vendors, including laboratory, EHR, pharmacy, supply, and equipment vendors.
• Develop and maintain effective relationships with local pharmacies and other healthcare partners to support timely access to medications and services.
• Monitor nursing department spending, communicate budget or resource concerns to the Founder & Executive Director, and obtain required approval for unapproved vendors or expenditures.
• Identify facility or operational discrepancies that may affect medical or nursing care and communicate needs to appropriate administrative or business staff.
  
  

Qualifications

• Graduation from an accredited or state-approved nursing program.
• Current, unrestricted Tennessee nursing licensure appropriate to the position.
• At least 1 year of Director of Nursing or comparable nursing leadership experience.
• Training and experience in eating disorder treatment strongly preferred; demonstrated knowledge of the medical and nursing needs associated with eating disorders is expected for successful performance in the role.
• Demonstrated ability to lead nursing staff, coordinate interdisciplinary medical care, maintain regulatory and accreditation compliance, and respond effectively to medical and operational concerns in a residential treatment environment.
  
  

Working Conditions

Residential treatment services operate 24 hours per day, 7 days per week, 365 days per year. Employees may be required to work nights, weekends, holidays, or provide after-hours leadership support depending on the needs of the role and program.

The program serves clients with eating disorders and co-occurring behavioral health conditions, which may include significant trauma histories and complex medical and psychiatric needs. Employees are expected to maintain professional boundaries, utilize appropriate self-awareness, and seek appropriate support when personal circumstances could affect their ability to safely and effectively perform job responsibilities.

As an eating disorder treatment facility, employees in client-facing roles may be expected to participate in supported meals or snacks with clients and to model behaviors consistent with treatment standards.

Physical Requirements

• Ability to walk up and down stairs.
• Ability to lift up to 25 pounds.
• Ability to perform the essential nursing and administrative functions of the position with or without reasonable accommodation.
  
  

Direct Reports

• Staff Nurses
  
  

Compensation

• $90,000 - $110,000