The charge nurse directs and supervises the provision of resident care services on a specific shift and/or unit. The charge nurse provides appropriate supervision to the nursing staff with responsibility and accountability for the assurance of quality services and nursing care, compliance with applicable rules and regulations, and laws, and adherence to facility policies and procedures on the shift or unit. The charge nurse will perform direct nursing services to residents, as identified in the individual plans of care and physician orders. Technical and professional assistance and guidance, as well as quality monitoring will be available and provided by the administrator, director of nursing, medical director and consultants. The charge nurse will operate under the general supervision of the Director of Nursing.

Training/Education/Licensure/Skills or Proficiency Requirements:

Current, valid license to practice as a Registered Nurse (RN) in the State of Iowa.

Functional literacy in written and spoken English.

Demonstrated effective communication and supervisory skills.

General Functions:

Functions as an in-house expert regarding standards of practice, Federal and State regulations and laws, and professional code of ethics governing nursing services.

Serves as a role model for nursing and other facility personnel by adhering to facility policies and procedures including the following;

Adheres to and enforces facility policies and procedures including but not limited to infection control, safety, resident rights, and chain of command and authority.

Assumes accountability for information in personnel policies and supervision.

Assumes accountability for using, maintaining and storing facility property according to established procedures.

Maintains strict confidentiality of resident, employee and facility information.

Reports to work as scheduled and consistently demonstrates dependability, punctuality and complies with attendance policies.

Accepts assigned duties, instructions, and/or correction in a cooperative manner, voicing concerns or disagreement in a professional manner through established chain of command.

Participates in in-service training and other educational programs and completing assignments, return demonstrations, etc. as necessary.

Consistently works with residents, families, staff, consultants, physicians and ancillary service providers in a cooperative manner.

Performs other duties and projects as assigned by supervisor.

Resident Care and Service:

Receives, transcribes, implements physician’s orders.

Makes rounds with physicians as necessary.

Reports changes in resident condition to Nursing Supervisors services, physician and residents responsible party according to facility policy and appropriate rules and regulations. Takes follow-up action as necessary.

Observes, evaluates, and documents resident condition or changes in resident condition.

Documents resident care provided and residents response or lack of response to care provided.

Identifies resident problems and emergency situations and initiates immediate measures as appropriate to the situation.

Administers and documents medications, enteral/parenteral nutrition, treatment as prescribed by the physician, administers PRN medications and treatments.

Counts narcotics and follows emergency kit procedures.

Accurately performs and documents comprehensive assessments, or parts of the comprehensive assessments, as assigned.

Implements admission/transfer/discharge procedures, coordinates with other departments, physicians, and ancillary service providers, documents in accord with facility policy and regulations.

Follows established standards of nursing practice and performs nursing skills knowledgeably and competently.

Supervises delivery of meals/proper diet, distribution of nourishment, application of postural supports and restraints.

Assists nursing assistants with resident care as necessary and required by circumstances.

Accepts responsibility for the safety of residents under his/her supervision.

Receives, investigates and resolves or reports to higher authority concerns from residents/families in accordance with positive customer relations principles. Listens to resident, family or physician concerns and initiates corrective action as necessary.

Participates in information exchange with staff of preceding and following shifts to assure continuity of care.

 Supervision and Direction of Required Services

Assumes responsibility for unit or shift compliance with facility policy and procedure, rules, regulations and standards of practice. Assures that residents receive needed nursing care and services to meet their needs according to the established plans of care and physician’s orders and instruction.

Interprets facility policy and procedures, rules and regulations to subordinate nursing staff, residents, families and appropriate medical and ancillary personnel.

Plans daily work assignments and schedules based on resident’s needs and available resources, effectively communicating to staff and monitoring staff compliance with assignments and schedules.

Provides corrective instruction to staff concerning quality of care and quality of life issues, and customer service and positive image issues.

Monitors and evaluates staff work behavior and performance of assigned duties, takes corrective counseling and disciplinary action according to established policy and procedures.

Identifies staff training needs.

Provides input to the performance appraisal process.

Monitors equipment condition, supplies, etc. and reports needs to Director of Nursing or Nursing Supervisors.

 Physical, Sensory/Cognitive, Emotional Requirements:

The following not meant to be all inclusive but rather exemplary of the types of activities involved in the performance of the position.

Reaching, handling, fingering and or feeling: Routinely uses tactile and manual activities to gather information about resident condition and environmental conditions.

Lifting, carrying, pushing, pulling (strength): Routinely engages in medium to heavy physical activity associated with providing nursing services, personal care and emergency procedures to residents, and monitoring activities of subordinates. Lifts up to approximately 50lbs. alone, with frequent lifting and/or carrying up to 25lbs. Routinely lifts/supports approximately 100lbs. or more with assistance in usual circumstances or alone in emergency situations. Routinely pushed or pulled occupied wheelchairs/Geri-chairs in excess of 100lbs.

Climbing or Balancing: Routinely maintains physical equilibrium to safely move through the facility, perform desk work, do lifting and carrying involved in nursing care. In emergency situations, may be called upon to climb and/or exercise greater than usual balance in order to assist individual(s) in distress.

Stooping, kneeling, crouching and/or crawling:  Occasionally engages in these activities as associated with getting items from low shelving or assisting with cares /treatments /emergency measures for individuals seated in low chairs or seated/lying on the floor.

 Recognition/vision and mental processing: Routinely reviews processes and produces large quantities of written information such as posted notices, instructional materials, staffing schedules, resident and employee records, physician’s orders, medications and treatment instructions /labels. Routinely observes and evaluates residents and employee actions, gestures, facial expressions, daily routine and habits. Observes, evaluates and exercises clinical judgment regarding signs and symptoms of resident health/medical condition. Observes and evaluates visual attractiveness of food served to residents. Observes and evaluates environmental health and safety circumstances.

Hearing: Routinely recognizes auditory call signals, alarms or signals on equipment, wander monitoring systems signals, soft voices of elderly, verbal communications within the workplace, telephone communications.

Smell:  Routinely observes for odors relevant to resident medical and personal care conditions, and environmental health and safety issues.

Verbal communications: Routinely interacts with individuals highly dependent on vocal communications (residents, families, staff and ancillary personnel) often in sensitive circumstances calling for higher levels of communications in order to assure understanding.

Emotional behavior: Routinely interacts with individuals (residents, family members, staff) who may be discourteous, tactless, demanding, verbally and/or physically threatening or abusive, angry or hostile, emotionally vulnerable or mentally ill, vulgar, and mean -natured. Routinely called upon to control own emotions and behavior to protect residents rights and to respond professionally with respect and dignity.

Environmental/Occupational Exposures:

Individuals must be able to use protective equipment and take proper precautions and emergency measures.

Is considered at risk for exposure to blood borne pathogens, infections and infectious waste, and minimal hazards re; chemicals used for cleaning/sanitizing/disinfecting.