LOCATION:           Bon Secours Maria Manor
DEPARTMENT:     Nursing
FLSA STATUS:     Exempt
REPORTS TO:      Administrator
SUPERVISES:       ADONs, Unit Managers, Nursing Supervisors, MDS Coordinators, Staff Development Coordinator

MINIMUM QUALIFICATIONS:
Education: Must possess, as a minimum, an A.S. Degree in Nursing, bachelor's degree preferred.
Licensure: Licensed Registered Nurse in the State of Florida.
Experience: Must have, as a minimum of 5 year(s) of experience as a ADON in a hospital, long-term or acute care facility.

SPECIFIC REQUIREMENTS: Must possess a current, unencumbered, active license to practice as a Licensed or Registered 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: Manages Nursing Department to maintain quality of standards of care 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. Advises medical staff, department heads and Administrator on matters related to nursing service.

DELEGATION OF AUTHORITY: As the DIRECTOR OF NURSING, 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, 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.

BON SECOURS MISSION & 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) Determine the staffing needs of the nursing service department necessary to meet the total nursing needs of the residents.
b) Recommend the number and level of nursing personnel to be employed.
c) Ensure that all nursing assistants are enrolled in or have graduated from an approved training program.
d) Ensure that a sufficient number of licensed practical and/or registered nurses are assigned to each tour of duty to maintain quality care.
e) Ensure that a sufficient number of certified nursing assistants for each tour of duty to be sure that routine nursing care is provided to meet the daily nursing care needs of each resident.
f) Ensure that all nurse aide trainees are under the direct supervision of a licensed nurse.
g) Delegate to nursing service supervisory personnel the administrative authority, responsibility, and accountability necessary to perform their assigned duties.
h) Assist the Human Resource Director in developing performance evaluation schedules, criteria, and
annual reviews for the nursing service department (e.g., RNs, LPNs, CNAs, medication aides, etc.).
i) 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.
j) Ensure absenteeism is monitored so that an adequate number of nursing care personnel are on duty at all times.
k) Review complaints and grievances made or filed by department personnel.
l) Provide complaint/grievance reports to the Administrator as required or as may be necessary.
m) Ensure that departmental disciplinary action is administered fairly and without regard to race, color, creed, national origin, age, sex, religion, handicap, or marital status.
n) 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) Provide the Administrator with information relative to the nursing needs of the resident and the nursing service department's ability to meet those needs.
c) Introduce self to new residents, families and responsible parties.
d) Schedule physician visits as necessary.
e) Oversee that the attending physicians record and sign progress notes, physicians' orders, etc., on a timely basis and in accordance with current regulations. 
f) Ensure that direct nursing care be provided by a licensed nurse, a CNA, and/or a nurse aide trainee qualified to perform the procedure.
g) Oversee 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.
h) Observe residents and to determine if nursing needs are being met in accordance with the resident's request.
i) Oversee medication passes and treatment schedules to ensure that medications are being administered as ordered and that treatments are provided as scheduled.
j) Oversee direct nursing care as necessary.
k) Authorize the use of restraints when necessary and in accordance with our established policies and procedures. l) Oversee that procedures are in place to frequently check residents who are unable to call for help.

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) Develop and maintain an effective orientation program that orients the new employee to the facility, its policies and procedures, and to his/her job position and duties.
c) Provide leadership training that includes the administrative and supervisory principles essential for Nurse Supervisors/Charge Nurses.
d) Attend and participate in outside training programs.
e) Assist the Administrator in developing and revising the nursing assistant training curriculum used by the facility. Submit to state agency for approval as required.
f) Assist in developing annual OSHA and CDC in-service training programs as required by State.
g) Assist in developing advance directive in-service training programs for the staff and community.
h) Assist in developing, implementing, and conducting in-service training programs that relate to the nursing service department.
i) Assist 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.
j) 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. 
k) Assist the Infection Control Coordinator in the development of a TB management program.

SAFETY AND SANITATION
a) Assist in developing safety standards for the nursing service department.
b) Ensure that the department's policy and procedure manuals identify safety precautions and equipment to use when performing tasks that could result in bodily injury.
c) 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.
d) Oversee 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.
e) Oversee 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.
f) Oversee nursing service personnel to ensure that they are following established safety regulations in the use of equipment and supplies.
g) Oversee that nursing service work areas (i.e., nurses' stations, medicine preparation rooms, etc.) are maintained in a clean and sanitary manner.
h) Oversee that all resident care rooms, treatment areas, etc., are maintained in a clean, safe, and sanitary manner.  i) Ensure that all nursing service personnel follow established departmental policies and procedures, including appropriate dress codes.
j) Ensure that nursing service personnel participate in and conduct all fire safety and disaster preparedness drills in a safe and professional manner.
k) Assist the Infection Control Committee in the development, implementation, and revising of written aseptic and isolation techniques.
l) Ensure the development and implementation of a program for monitoring communicable and/or infectious diseases, including TB, among the residents and personnel.
m) Oversee that nursing service personnel follow established infection control procedures when isolation precautions become necessary.
n) Oversee the implementation of procedures for reporting hazardous conditions or equipment.
o) Oversee 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) Oversee the implementation of procedures for the safe operation of all nursing service equipment.
e) Oversee that only trained and authorized personnel operate the department's equipment.
f) Oversee that all personnel operate nursing service equipment in a safe manner.
g) Oversee that nursing service supplies are used in an efficient manner to avoid waste.
h) Oversee that personal protective equipment used in the handling of infectious materials are available and easily accessible to nursing service personnel.
i) Ensure that appropriate MSDSs are on file for hazardous chemicals used in the nursing service department.

CARE PLAN AND ASSESSMENT FUNCTIONS
a) Oversee the development of preliminary and comprehensive assessments of the nursing needs of each resident. b) Responsible for Nursing staff 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) Monitor the Resident Assessment/Care Plan Coordinator in the scheduling of care plans and assessments to be presented and discussed at each committee meeting.
e) Review nurses' notes to determine if the care plan is being followed.
f) If needed, assist the Resident Assessment/Care Plan Coordinator in planning, scheduling, and revising the MDS, including the implementation of RAPs and Triggers. 
g) Monitor the care plan to ensure that a team effort is achieved in developing a comprehensive plan of care.
h) Ensure that medical and nursing care is administered in accordance with the resident's wishes, including the implementation of advance directives.

DELIVERY OF CARE
a) Monitors compliance with quality assurance standards, restorative protocols and sate, federal and local guidelines through auditing and frequent rounds.
b) Evaluates the effectiveness of care interventions, identifies problems/trends and develops alternative interactions.
c) Assesses, plans and evaluates the nursing interventions with family to assist them in coping with, participating in, and/or managing resident care.
d) Assesses resident care using Quality Assurance Standards; using QA/QI programs to trend/problems and assists in implementation of corrective action.
e) Institutes appropriate emergency interventions.
f) Makes frequent rounds to evaluate effectiveness of care delivery and performance of subordinates
to ensure compliance with Quality Assurance Standards.
g) Assists staff in employing methods to meet the resident's spiritual and psychological/social needs in conjunction with social services.
h) Ensures effective infection control practices and identifies potential environmental hazards.
i) Interprets nursing philosophy and establishes departmental goals and objectives.
j) Institutes organizational structure and communications systems which include all
evels of nursing staff to promote effective care delivery.
k) Maintains an "on call" status for emergencies on a rotating basis with other supervisory nursing personnel to ensure the continuity of resident care and supervision of the nursing program by a supervisory registered nurse on a 24 hour basis.

REPORTING OF INFORMATION
a) Assesses, plans, implements and evaluates 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, as  necessary for progress or lack of progress of care programs, internal lab results or incidents/accidents.
d) Coordinate/monitors the disseminate of information of changes in condition 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 or monitors House Supervisor of all pertinent resident care or personnel issues during assigned tour of duty.
g) Oversees that accurate and informative records are maintained for each resident.
h) Oversees the documentation by nursing staff and ancillary personnel.
i) Oversees that resident charts, monthly summaries and monitors physician orders and records are  accurate and consistence.
j) Consults with nursing personnel on specific nursing issues and interpretation of policies to insure resident needs are met.
k) Develops and implements Nursing policies and procedures.
l) Interprets policies and objectives of nursing service to staff and company groups.
m) Participates in planning, developing and implementing ongoing staff development programs.
n) Identifies and evaluates the significance of trends, and infection surveillance rates.
o) Plans corrective action steps to address concerns/trends and communicates areas of responsibility to appropriate nursing team members.
p) Communicates resident care concerns/issues with Medical Director, attending Physician, family, Administrator and other center departments, as needed.

SUPPORT OF OTHERS
a) Assess, plans, implements, and evaluates 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) Oversees that physicians rounds and examinations are coordinated.
d) Identifies staff development needs, and coordinates implementation of a comprehensive staff development program in coordination with other supervisory nursing personnel. 
e) Provides nursing support and input to Admission Director on possible admissions to determine the Nursing Department's ability to meet the Resident's needs and ensure availability of adequate supplies and equipment.
f) Participates as needed in coordinating Resident Care services to family questions, concerns and discharge planning.
g) Coordinates nursing support with Medical Director and attending physicians.
h) Coordinates nursing involvement in community projects and educational programs.
i) Participates in departmental meeting and coordinates nursing interaction between/among departments/services.
j) Participates in community organizations and programs.

DIRECTION OF OTHERS
a) Supervises, assigns, and evaluates the effectiveness of nursing intervention on resident outcome.
b) Assesses, plans, implements, and evaluates the Nursing Care giver's interaction with family members.
c) Assesses, plans, implements and evaluates 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) Oversees resident care responsibilities and supervises nursing subordinates on scheduled shift.
f) Oversees overtime authorization and time off.
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).
i) Resolves grievances of assigned staff.
j) Interviews applicants for employment for certain applicable positions in the nursing department.
l) Directs the nursing staff in its entirety; may exercise direction over the entire center staff in the absence of the Administrator.
m) Structures role and shift expectations for each position in the nursing department.
n) Sets meaningful individual objectives and specific job expectations and ensures that employees know what is expected and the standards by which they will be evaluated; Gives adequate guidance and supervision; Ensures that employees are adequately oriented and trained to perform their duties; Gives employees sufficient authority to make the necessary decisions to carry out their assignments.
o) Recommends promotions for employees who have demonstrated both a capability for a willingness to accept increased responsibilities; Ensures that individuals are properly paid for sustained performance.
p) Takes positive action to ensure equal opportunity in the conduct of all business activities without regard to race, religion, color, age, sex, marital status, national origin, handicap or veteran status.
q) Conducts departmental staff meetings.

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.

BUDGET AND PLANNING FUNCTIONS
a) Prepares the budget for the nursing department using corporate guidelines to ensure adequate resources for staffing, supplies and capital items needed to care for residents; Oversees the operation of the department in accordance with the budget.
b) Ensures that the appropriate amount of supplies and equipment are ordered to meet resident needs and monitors effective usage of Medicare, Medicaid, insurance and ancillary supply systems. 
c) Initiates studies to evaluate effectiveness of nursing services in relation to objectives and cost.