LOCATION:         BON SECOURS MARIA MANOR
DEPARTMENT:   NURSING
FLSA STATUS:   EXEMPT
REPORTS TO:    DIRECTOR OF NURSING
SUPERVISES:     CHARGE NURSES, C N A'S, CLERKS

MINIMUM QUALIFICATIONS:
Education: Must possess, as a minimum, a Nursing Degree from an accredited college or university.
Licensure: Registered Nurse or Licensed Nurse under the direction of a RN.
Experience: Must have, as a minimum, 5 year(s) of experience as a supervisor in a hospital, long-term care facility, or other related health care facility. Must have, as a minimum, 12 months training experience in rehabilitative and restorative nursing practices.

SPECIFIC REQUIREMENTS: Must possess a current, unencumbered, active license to practice as a Nurse 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.

POSITION SUMMARY: Coordinates activities of nursing personnel engaged in nursing services to insure resident's needs are met in accordance with professional standards of practice, physician orders, center policies and procedures, and state, federal and local guidelines.

DELEGATION OF AUTHORITY: As the Unit Manager, you are delegated the administrative authority, responsibility, and accountability necessary for carrying out your assigned duties. In the absence of the Director of Nursing, 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.

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. On call 24 hours per day, 7 days per week. 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. Maintains a liaison with the residents, their families, support departments, etc., to adequately plan for the residents' needs.

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, and/or lift a minimum of 25 pounds. May be necessary to assist in the evacuation of residents during emergency situations.

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 Administrator 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. Ensure that appropriate notices are given to residents before their room or roommate is changed. 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. Ensure that the facility's policies and procedures governing advance directives are reviewed with the resident and/or representative. Assist the Infection Control Coordinator in developing and implementing a resident TB management program.

The information provided within this position description depicts the assignment of essential and non-essential functions; it may not be all inclusive, and does not restrict the supervisor's right to assign or reassign functions at any time. Functions indicated are subject to change due to business necessity, including reasonable accommodation.

BON SECOURS MISSION AND VALUES
a) Consistently demonstrates full understanding of the mission and values of Bon Secours.
b) Treats residents, visitors and staff members in dignified manner with respect, kindness and understanding.
c) Is pleasant and professional at all times with all interactions.
d) Attends mandatory Mission inservices.
e) Uses time productively coordinating with others to achieve common goals and objectives.

PERSONNEL FUNCTIONS
a) Provide feedback to help determine the staffing needs of the nursing unit as necessary to meet
the total nursing needs of the residents. Keep DON abreast of changing acuities.
b) Assign a sufficient number of licensed practical and/or registered nurses for each tour of duty to ensure that quality care is maintained.
c) Assign a sufficient number of certified nursing assistants for each tour of duty to ensure that routine nursing care is provided to meet the daily nursing care needs of each resident.
d) Ensure that all nurse aide trainees are under the direct supervision of a licensed nurse.
e) Develop work assignments and schedule duty hours, and/or assist nursing supervisory staff in completing and performing such tasks.
f) Assist the Personnel Director in performance evaluations and annual reviews for the nursing service department (e.g., RNs, LPNs, CNAs, , etc.).
g) 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.
h) Assist ADON to ensure that an adequate number of nursing care personnel are on duty at and to monitor and address on unit absenteeism or tardiness.
i) Review complaints and grievances made or filed by department personnel.
j) Provide complaint/grievance reports to the DON as required or as may be necessary.
k) Ensure that departmental disciplinary action is administered fairly and without regard to race, color, creed, national origin, age, sex, religion, handicap, or marital status.
l) Assist the Infection Control Coordinator in establishing a TB management program for employees.
m) 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
a) Participate in the interviewing and selection of residents for admission to the facility, including PASARR screening.
b) Introduce self to new residents, families and responsible parties.
c) Inform nursing service personnel of new admissions, their expected time of arrival, room assignment, etc.
d) Ensure that rooms are ready for new admissions.
e) Greet newly admitted residents upon admission. Escort to room as necessary.
f) Make rounds with physicians as necessary. Schedule physician visits as necessary.
g) Encourage attending physicians to record and sign progress notes, physicians' orders, etc., on a timely basis and in accordance with current regulations.
h) Ensure that direct nursing care be provided by a licensed nurse, a CNA, and/or a nurse aide trainee qualified to perform the procedure. Refer concerns to RN Supervisor or designee as needed.
i) 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.
j) Schedule daily rounds to observe residents and to determine if nursing needs are being met in accordance with the resident's request.
k) Monitor medication passes and treatment schedules to ensure that medications are being administered as ordered and that treatments are provided as scheduled.
l) Provide direct nursing care as necessary.
m) Authorize the use of restraints when necessary and in accordance with our established policies and procedures.
n) Ensure that residents who are unable to call for help are checked frequently.

STAFF DEVELOPMENT
a) Develop and participate in the planning, conducting, and scheduling of timely in-service training classes that provide instructions on "how to do the job," and ensure a well-educated nursing service department.
b) Maintain an effective on unit orientation program that orients the new employee to the facility, its policies and procedures, and to his/her job position and duties.
c) Participate in leadership training that includes the administrative and supervisory principles essential for Nurse Supervisors/Charge Nurses as designated.
d) Assist in developing, implementing, and conducting in-service training programs.
e) Assist the In-service Director/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 licenses on an active status.
f) Attend and participate in continuing educational programs designed to keep you abreast of changes in your profession, as well as to maintain your license on a current status.
g) Assist the Infection Control Coordinator in the oversight of a TB management program.
h) Participate in job specific compentencies.

SAFETY AND SANITATION
a) Assist in developing safety standards for the nursing service department.
b) Assist the Infection Control Coordinator in identifying, evaluating, and classifying routine and job-related functions to ensure that tasks in which potential exposure to blood/body fluids are properly identified and recorded.
c) 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. 
d) Ensure that adequate supplies of personal protective equipment are on hand and are readily available to personnel who perform procedures that involve exposure to blood or body fluids.
e) Monitor nursing service personnel to ensure that they are following established safety regulations in the use of equipment and supplies. Monitor placement of food carts and linen barrels.
f) Ensure that nursing service work areas (i.e., nurses' stations, medicine preparation rooms, etc.) are maintained in a clean and sanitary manner.
g) Ensure that all resident care rooms, treatment areas, etc., are maintained in a clean, safe, and sanitary manner.
h) Ensure that all nursing service personnel follow established departmental policies and procedures, including appropriate dress codes. 
i) Ensure that nursing service personnel participate in and conduct all fire safety and disaster preparedness drills in a safe and professional manner.
j) Assist the Infection Control Committee in the implementation, and revising of written aseptic and isolation techniques.
k) Ensure that nursing service personnel follow established infection control procedures when isolation precautions become necessary. 
l) Maintain a procedure for reporting hazardous conditions or equipment.
m) Ensure that personnel wear and/or use safety equipment and supplies (e.g., back brace, mechanical lifts, etc.) when lifting or moving residents.

EQUIPMENT AND SUPPLY FUNCTIONS
a) Recommend to the Administrator the equipment and supply needs of the department.
b) Ensure that a stock level of medications, medical supplies, equipment, etc., is maintained on premises at all times to adequately meet the needs of the resident.
c) 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.
d) Implement procedures for the safe operation of all nursing service equipment.
e) Ensure that all personnel operate nursing service equipment in a safe manner.
f) Ensure nursing service supplies are used in an efficient manner to avoid waste.
g) Ensure that personal protective equipment used in the handling of infectious materials are available and easily accessible to nursing service personnel.
h) Ensure that appropriate MSDSs are on file for hazardous chemicals used in the nursing service department.

CARE PLAN AND ASSESSMENT FUNCTIONS
a) Assist in the development of preliminary and comprehensive assessments of the nursing needs of each resident.
b) Assist to develop 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.
c) Encourage the resident and his/her family to participate in the development and review of the resident's plan of care.
d) Assist or coordinate the Resident Assessment/Care Plan meeting.
e) 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/Cardex prior to administering daily care to the resident.
f) Review nurses' notes to determine if the care plan is being followed.
g) Coordinate with the Resident Assessment/Care Plan Coordinator in planning, scheduling, and revising the MDS, including the implementation of RAPs and Triggers or assume responsibilities as designated.
h) Develop and maintain a good rapport with all services involved with the care plan to ensure that a team effort is achieved in developing a comprehensive plan of care.
i) Ensure that medical and nursing care is administered in accordance with the resident's wishes, including the implementation of advance directives.
j) Monitor admission assessments for timely completion and comprehensive documentation.

DELIVERY OF CARE
a) Works with the IDCPT to assess resident's care needs, strengths and potential, and plans interventions to maximize resident's abilities to optimal level of function through the use of comprehensive assessment data base.
b) Plans nursing interventions for each resident based upon individual needs an monitors implementation of the approaches.
c) Monitors compliance with quality assurance standards, restorative protocols and sate, federal and local guidelines through auditing and frequent rounds.
d) Evaluates the effectiveness of care interventions, identifies problems/trends and develops alternative interactions.
e) Works with the IDCPT to assess, plan and evaluate the nursing interventions with family to assist them in coping with, participating in, and/or managing resident care.
f) Administers direct resident cares; provides treatments, administers medications, provides resident education and training, and oversees daily care routines.
g) Assesses resident care using Quality Assurance Standards; identifies trends/problems and assists in implementation of corrective action.
h) Institutes appropriate emergency interventions.
i) Makes frequent rounds to evaluate effectiveness of care delivery and performance of subordinates to ensure compliance with Quality Assurance Standards.
j) Assists staff in employing methods to meet the resident's spiritual and psychological/social needs in conjunction with social services.
k) Ensures effective infection control practices and identifies potential environmental hazards.

REPORTING OF INFORMATION
a) Works with the IDCPT to assess, plan, implement and evaluate resident care infractions (rounds, reports, assignments, medical record documentation, restorative programs, etc.) to accurately reflect current conditions.
b) Communicates with families about changes in condition, progress or lack of progress, care plans, incident reports, and discharge plans.
c) Communicates with physician during rounds and as indicated; keep physicians notified of any change in condition, reactions/responses to medications, treatments or restorative programs, progress or lack of progress of care programs, internal lab results or incidents/accidents.
d) Coordinates the dissemination of information of changes or response to medical treatment to other services or other departments.
e) Participates in organizing and implementing communication systems within the nursing department.
f) Informs House Supervisor or DON of all pertinent resident care or personnel issues during assigned tour of duty.
g) Oversees the maintainence of accurate and informative records for each resident.
h) Monitors documentation by nursing staff and ancillary personnel.
i) Evaluates resident charts, monthly summaries and monitors physician orders and records of accuracy and consistency.
j) Consults with nursing personnel on specific nursing issues and interpretation of policies to insure resident needs are met in conjunction with RN Supervisor or RN designee.
k) Submits weekly and monthly reports as designated.
l) Monitor quality indicators and work with staff to promote positive outcome.
m) Utilize the Medical Director as needed to address resident needs.

SUPPORT OF OTHERS
a) Works with the IDCPT to assess, plan, implement, and evaluate involvement and support of services or other departments in integrating resident care systems.
b) Coordinates and evaluates the services of others as they relate to nursing to assist the family in participating in coping with resident care.
c) Coordinates and implements the physician services for each resident.
d) Assists physicians with rounds and examinations.
e) Identifies staff development needs, and coordinates implementation of a comprehensive staff development program in coordination with other supervisory nursing personnel.
f) Plans activities of unit(s)/wing(s) and coordinates activities with other care units.
g) Coordinate referrals to the Ethics Committee as required.
h) Uphold Care of the Dying Philosophy. Provide referrals to Pastoral Care or other coordinated disciplines as required.

DIRECTION OF OTHERS
a) Supervises, (or if a LPN) assigns, and evaluates the effectiveness of nursing intervention on resident outcome.
b) Participates with the IDCPT, designated RN Supervisor or RN designee to assess, plan, implement, and evaluate the Nursing Caregiver's interaction with family members.
c) Participates with the IDCPT, designated RN supervisor or RN designee to assesse, plan, implement and evaluate the coordination and integration of nursing personnel with other services/departments in providing an interdisciplinary approach of care.
d) Participates in hiring, directing and assigning nursing staff; counsels and evaluates nursing personnel performance using quality assurance standards and established policies and procedures.
e) Assigns resident care responsibilities and supervises nursing subordinates on scheduled shift.
f) Authorizes overtime and grants time off during shift supervised.
g) Prepares written performance evaluations of subordinates.
h) Disciplines assigned staff with verbal and written warning, or suspense for balance of shift; recommends further discipline (up to discharge) to the Director of Nursing/Assistant Director of Nursing for review.
i) Resolves grievances of assigned staff at the first level with administrative support or reviewing.
j) Assists in interviewing applicants for employment in the nursing department and makes ecommendations to the DON/ADON with respect to hiring.
k) Assists with scheduling staff as directed by the Director of Nursing or RN Supervisor designee.

GENERAL REQUIREMENTS
a) Attends and participates in scheduled in-service programs and staff meetings.
b) Maintains confidentiality of necessary information.
c) Utilizes supplies and equipment properly and without waste.
d) Thinks and acts calmly and logically to meet unusual occurrences of the job without being thrown off stride.
e) Performs any miscellaneous work assignments as may be required.
f) Must be capable to execute all the terms and conditions set forth in the Employee Handbook.
g) Interacts in a tactful, diplomatic, and humanistic manner with residents, families, visitors, and coworkers to provide a safe , efficient, and therapeutically effective caring environment which insures the self-respect, personal dignity, rights and physical safety of each resident and center guest.
h) Maintains a dependable attendance record and adheres to standards of cleanliness, grooming, hygiene, and dress code.