Reports to: Director of Nursing

Department: Nursing

Description of Position:

The primary purpose of your job is to assist the Director of Nursing in planning, organizing, developing and directing the day-to-day functions of the Nursing Service Department in accordance with current federal, state, and local standards, guidelines and facility policy and procedures and as may be directed by the Administrator, the Medical Director, and/or the Director of Nursing Services, to ensure that the highest degree of quality care is maintained at all times.

Delegation of Authority

As the Assistant Director of Nursing Services, you are delegated the administrative authority, responsibility, and accountability necessary for carrying out your assigned duties. In the absence of the Director of Nursing Services, you are charged with carrying out the resident care policies established by this facility.

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, or is an essential function of the position.

Duties and Responsibilities

Administrative Functions

• Assist the Director of Nursing Services in planning, developing, organizing, implementing, evaluating, and directing the nursing service department in accordance with current rules, regulations, and guidelines that govern the long-term care facility.
• Participate in developing, maintaining and updating written policies and procedures that govern the day-to-day functions of the nursing service department.
• Interpret the department’s policies and procedures to personnel, residents, visitors, and government agencies as required.
• Participate in developing, maintaining, and periodically updating the written job descriptions for each level of nursing personnel.
• Ensure that the reference material (i.e., PDR’S, Federal and State Regulations, etc.) maintained at the nurses’ stations is current. Recommend to the Director written material that will assist the nursing service department in meeting the day-to-day needs of residents.
• Ensure that the Nursing Policy and Procedures Manual is current at all times and reflects the day-to-day nursing care procedures used by this facility.
• Make written and oral reports/recommendations to the Director as necessary/required, concerning the operation of the nursing service department.
• Assist in developing methods for coordinating nursing services with other resident services to ensure the continuity of the residents’ total regimen of care.
• Participate in the development, maintenance, and implementation of the facility’s quality assurance program.
• Participate in facility surveys (inspections) made by authorized government agencies.
• Participate in the interviewing and selection of residents for admission to the facility.
• Participate in developing, implementing, and periodically updating the resident’s discharge plan and ongoing plan of care. Assist the resident and Discharge Planning Coordinator and the IDT in planning the nursing services portion of the resident’s discharge plan.
• Perform administrative duties such as completing medical forms, reports, evaluations, studies, charting, etc., as necessary.

Committee Functions

• In the absence of the Director, serve on, participate in, and attend various committees of the facility (i.e., Infection Control, Policy Advisory, Pharmaceutical, Budget, Quality Assurance & Assessment, etc.).
• Serve on the Quality Assurance and Assessment Committee as directed. Assist the Director in preparing written and/or oral reports of the nursing service programs and activities to submit to such committee(s).
• Participate in the development, maintenance, implementation, and updating of the written policies and procedures for the administration, storage, and control of medications and supplies.
• Evaluate and implement recommendations from established committees as they may pertain to nursing services.

Personnel Functions

• Assist the Director in determining the staffing needs of the nursing service department.
• Assist the Director in the recruitment and selection of nursing service personnel.
• Ensure that a sufficient number of licensed vocational and/or registered nurses are available for each tour of duty to ensure that quality care is maintained.
• Ensure that a sufficient number of certified nursing assistants are available for each tour of duty to ensure that routine nursing care is provided to meet the daily nursing care needs of each resident. Monitor absenteeism. Report problem areas to the Director.
• Make daily rounds of the facility to ensure that all nursing service personnel are performing their work assignments in accordance with acceptable nursing standards. Report findings to the Director.
• Ensure that all nursing service personnel are following their respective job descriptions.
• Review complaints and grievances made or filed by department personnel. Make appropriate reports to the Director as required or as may be necessary.
• Meet with the nursing staff, as well as support personnel, in planning the department’s services, programs, and activities.
• 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.
• Participate in employee performance evaluations and make 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 fluid, 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 daily rounds to observe residents and to determine if nursing needs are being met. Report problem areas to the Director. Assist in developing and implementing corrective action.
• Ensure that direct nursing care is being 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.
• Ensure that residents who are unable to call for help are checked frequently.
• Monitor medication passes and treatment schedules to ensure that medications are being administered as ordered and that treatments are provided as scheduled. Report medication errors to the Director.

Staff Development

• Assist the Staff Development Director, as needed, in the development, 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.
• Ensure that these programs meet the continuing education requirements which allow licensed personnel (e.g., RNs, LVNs, CNAs, etc.) to keep their license on an active status.

Safety and Sanitation

• Assist the Safety Officer in developing safety standards for the nursing service department.
• 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 procedures for reporting hazardous conditions or equipment.
• Monitor nursing service personnel to ensure that they are following established safety regulations in the use of equipment and supplies i.e. ensure that all personnel wear and/or use safety equipment and supplies (e.g., back brace, mechanical lifts, etc.) when moving or lifting a resident.
• Ensure that appropriate MSDSs are on file for hazardous chemicals used in the nursing department.
• Report missing/illegible labels and MSDSs to the safety officer or other designated person.
• Participate in the development, implementation, and maintenance of the infection control program for monitoring communicable and/or infectious diseases among the residents and personnel.
• Assist the 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.
• 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.
• Assist the Infection Control Committee in the development, implementation, and revising of written aseptic and isolation techniques.
• Ensure that nursing service personnel follow established infection control procedures when isolation precautions become necessary.
• Monitor nursing service work areas (i.e., nurses’ station, 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.

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 adequately meet the needs of the resident.
• Assist the Maintenance Director in developing a preventive maintenance program for maintaining the nursing 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 department’s equipment. Ensure that all personnel operate nursing service equipment in a safe manner.

Care Plan and Assessment Functions

• Participate in the development of written preliminary and comprehensive assessments of the nursing needs of each resident as necessary.
• Assist the Resident Assessment/Care Plan Coordinator in planning, scheduling, and revising the MDS, including the implementation of RAPs and Triggers.
• Participate in the development of a written care plan (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.
• 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.
• 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.

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.

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 to 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.

Qualifications for the Position

Education

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

Experience

• Must have, as a minimum, 2 years if experience as a supervisor in a hospital, long-term care facility, or other related health care facility.
• Must have, as a minimum, 6 months experience in rehabilitative and restorative nursing practices.

Specific Requirements

• Must possess a current, unencumbered, active license to practice as a Registered Nurse or Licensed Vocational Nurse in the state.
• Must be able to read, write, speak, and understand the English language
• Must posses 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 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 time, hostile people within the facility.
• Must be able to push, pull, move, and/or lift a minimum of 50 pound to a minimum height of 3 feet and be able to push, pull, move, and /or carry such weight a minimum distance of 10 feet.
• Must be able to assist in the evacuation of residents during emergency situations.