RN Unit Manager (LTC)

The RN Unit Manager assumes 24-hour responsibility and accountability for the nursing care of all residents on an assigned unit.  Supervises licensed nurses and other nursing personnel in the delivery of care and services according to each resident’s comprehensive resident assessment and plan of care.  Manages unit in accord with facility philosophy, in compliance with standards of professional nursing practice, and with all state and federal laws and regulations.  Utilizes resources in an efficient and economic manner to ensure that each resident achieves the highest practicable physical, mental and psycho-social well-being.

Makes daily rounds on unit to supervise, observe, examine, interview residents, to evaluate staffing needs, to monitor regulatory compliance, to achieve the care environment and to evaluate staff interactions and clinical skills competency.

Audits 24 hour report as completed by Charge Nurses and reviews clinical records to identify problems, to ensure timely responses to residents' needs, to evaluate documentation skills of unit nursing staff, and to evaluate regulatory compliance with documentation requirements.

Listens to verbal shift report making special note to follow up on significant changes in condition, admissions, transfers, discharges, initiation or use of physical or chemical restraints, unnecessary use of any drug, incidents, unexplained injuries, medication errors, loss of resident property or evidence of resident or family dissatisfaction.

Analyzes data gathered from rounds and record reviews and acts promptly to resolve problems and to continuously improve quality.  Participates in formal quality assessment and assurance activities as directed by the Quality Assurance Committee.

As the nurse with responsibility for the residents on the unit, conducts or coordinates the resident assessment process including accurate completion of the state-approved Resident Assessment Instrument.

Participates as member of interdisciplinary team in development of plan of care for each resident that assists the resident to attain or maintain the highest practicable physical, mental and psycho-social well-being.  Plans of care are developed with the participation, to the extent practicable, and consent of the resident and/or resident's interested family member, legal representative.  Plans of care include measurable objectives and timetables and accommodate residents needs and preferences including choices about preferred intensity of medical treatment.

Attends interdisciplinary conferences to plan care.  Elicits input from direct care staff on all three shifts and provides opportunities to attend and participate in interdisciplinary care conferences.

Supervises nursing staff in the implementation of plans of care to assist residents to attain or maintain highest practicable physical, mental and psycho-social well-being.

Maintains ongoing communication with other disciplines to evaluate resident responses to interventions, to suggest alternative approaches when indicated and to revise and update plans of care to reflect progress toward goals.  Facilitates interdepartmental communication to meet residents' needs.

Informs the resident in advance about care and treatment and any changes to the plan of care.

Immediately informs the resident, consults with the resident's physician and notifies the designated family member and/or the residents legal representative when there is an accident involving an injury which has potential for requiring physician intervention; a significant change in the residents physical, mental or psycho-social states; a need to alter treatment significantly or a decision to transfer or discharge the resident from the facility.  Promptly notifies the resident, designated family member and/or resident's legal representative when there is a change in room or roommate.

Interacts with residents, family members, legal representatives, surrogates to answer questions and resolve concerns.  Makes prompt attempts to resolve all resident grievances, seeking consultation or assistance from other departments or administration as appropriate.

Educates and develops unit nursing staff members by observing practice, interpreting facility policies and procedures, identifying learning needs and taking advantage of opportunities to teach on the unit.

Monitors unit nursing staff for correct, consistent application of infection control procedures.  Consults with Assistant Director of Nursing on questions related to infection control.

Assists Charge Nurses with the assignment of nursing staff to ensure sufficient number of staff.  Evaluates staffing patterns based on unit census, resident acuity, and other resident needs.  Adjusts staffing pattern accordingly.  Communicates difficulty meeting resident needs and maintaining regulatory compliance promptly to Director of Nursing.

Adjusts own work schedule to maintain direct contact with and to evaluate performance of nursing staff on all three shifts.

Conducts performance evaluations of unit nursing staff based on demonstrated competency to perform essential functions of the job.  Conducts skills observations of nurse aides.

Actively participates in long term care survey process.  Accompanies surveyors at all times while on unit.  Provides or offers supplemental information to ensure accurate survey results.  Responds to surveyor questions.  Records actions of survey team members and reports to Director of Nursing at end of each survey day.  Consults with Director of Nursing about undertaking corrections while survey is in progress.

Completes required documentation of care and services delivered during shift including subjective findings, objective symptoms, interventions and resident responses to interventions.  Completes required documentation of special circumstances including accident/incident reports m compliance with state and federal laws and regulations.

Reports relevant information to the Director of Nursing Services including interdisciplinary team functioning and communication, regulatory compliance issues, resident risk factors, sudden changes in resident behavior, expressed dissatisfaction by resident or family, reviews of treatment unexplained injuries, staff behavior (positive and negative), staffing needs, equipment and supply needs, opportunities to revise policies, procedures, improve quality.

Monitors staff for compliance with OSHA mandates on workplace safety including hazard communication and blood borne pathogens.  In cases of workplace exposure, provides immediate first aid and refers employee to appropriate facility staff member for post-exposure follow-up.

Supervises performance of unit clerk in all essential functions of that position, if applicable.

Reports all injuries to self or others to supervisor immediately.

Takes job actions with staff members under appropriate circumstances.  Applies facility policies about progressive discipline correctly.  Removes staff member from unit if necessary to avoid endangerment to health or safety of residents or other staff members.  Reports all job actions taken to Director of Nursing promptly.

Attends continuing professional education programs and in-service education.  Applies information to job responsibilities.

Participates in fire and disaster drills.  In the event of an emergency carries out assigned duties to assure resident safety.

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EDUCATION/ WORK EXPERIENCE REQUIREMENTS

 

1. Education/Training/Work Experience: 

Education: Graduate of an accredited school of nursing.

Certificate/Licenses:  Current active license as Registered Nurse OR LPN in state of employment.  Active CPR Certification is required.

Work Experience:  Two years professional nursing experience providing direct care in long term care facility, with 1 year supervisory or management experience with direct care staff.

Freedom from illegal use of drugs, and freedom from use and effects of use of drugs and alcohol in the workplace.

Persons who have been found guilty by a court of law of abusing, neglecting or mistreating individuals in a health care related setting are ineligible for employment in this position.

Specialized Knowledge & Skills:

Knowledge of geriatric and general chronic care nursing principles and professional standards of nursing practice and ability to apply to resident-specific circumstances.  Able to identify, implement and evaluate appropriate objectives and interventions for residents.

Demonstrated competency in clinical skills needed for facility resident population.

Demonstrated competency in physical, behavioral and functional capacity assessment of long term care residents including use of the state-approved Resident Assessment Instrument.

Current knowledge of laws and regulations that influence provision of care and services in nursing facilities.

Working knowledge and ability to interpret and demonstrate facility policies, procedures to direct care staff.

Sufficient organizational and interpersonal skills to assign, motivate staff, elicit work output, improve quality, interact effectively with residents, families, interdisciplinary team members, administration, government officials, consultants and others in addition to staff.

Carries out all duties in accord with the facility mission and philosophy.

Demonstrates knowledge of and respect for the rights, dignity and individuality of each resident in all interactions.  Able to act as role model for unit staff by protecting and promoting residents' rights in all interactions with residents and families.

Appreciates the importance of maintaining confidentiality of resident and facility information.

Demonstrates honesty and integrity at all times in the care and use of resident and facility property.

Able to understand and to follow written and verbal directions.  Able to communicate effectively with staff members and residents through verbal and/or written means.

Able to express self adequately in oral and written communication.  Able to communicate effectively within interdisciplinary care setting and to government agencies.

Knowledge of emergency and disaster procedures of facility.  Able to locate nearest exit, to understand and respond to written or oral instruction in case of emergency.

Sufficient mobility, and strength to move freely through the building, to assure resident safety at all times and to assist transfer or otherwise move residents of facility out of danger in case of emergency.

Demonstrates respect for co-workers and responds to needs of residents by complying with facility policies on attendance, punctuality and dress code.  Able to arrive and to begin work on time and to report for duty on all shifts, weekends and holidays.

Working knowledge and ability to comply with facility policies and procedures for workplace safety including infection control procedures, application of universal precautions for blood borne pathogens, use of personal protective equipment and handling of hazardous materials.

Demonstrates ability to prioritize responsibilities and complete projects within allotted time.

Able to respond to change productively and to handle additional tasks/projects as assigned.  Able to fulfill all essential functions of Unit Charge Nurse. 

Able to respond to unit needs on an on-call basis.

Knowledge of and ability to apply facility personnel policies to job actions without regard to race, religion, age, sex, national origin or disability.

Able to carry out the essential functions of this job (with or without reasonable accommodation) without posing specific, current risk of substantial harm to health and safety of self and others.

 

DUTIES:

1. Is knowledgeable of facility resident care policies as defined by the Director of Nursing Service.  Makes recommendations for revision as necessary.

1. Is knowledgeable of Nursing Department Personnel Policies and Procedures as defined by the Director of Nursing Service. Makes recommendations for revision as necessary.

2. Implements nursing care and nursing personnel policies on assigned unit 24 hours/day.

3. Designs staffing patterns for unit on day, evening, and night shift and implements (following approval of DON).  Re-evaluates staffing patterns based upon resident mix, level of care, census, and resident needs, and makes adjustments in staffing (following approval of DON).

4. Participates in pre-admission screening of residents who may be potential unit candidates.

5. Participates in development and revision of job descriptions for nursing department.

6. Performs routine unit nursing personnel evaluations.

7. Communicates directions in a clear and concise manner.

8. Performs unit nursing personnel counseling and disciplinary actions.  Pre-approves disciplinary actions with DON.

9. Writes monthly report to Director of Nursing Service regarding the status of unit, care issues, personnel issues, potential problems and concerns, Resident Roster, Census, and condition reports.

10. Helps nursing staff on unit to focus on Resident Rights and Quality of Care issues as they affect care delivery.

11. Pertinent to #10 and #11, guides staff in the aspects of providing individualized resident care and services enabling the resident to attain and maintain the highest practicable physical, mental, and psycho-social well-being.  Helps relate this to the comprehensive Plan of Care.  Discusses individual cases with staff to illustrate action.  Refers resident concerns, problems, or needs to other departments as appropriate and directs other unit nursing staff to consult with other departments as well.

12. Meets weekly with Charge Nurses to problem solve unit issues, gather input on need to modify nurse aid resident assignment groups, introduces/reinforces resident care or personnel policies, etc.  Documents meeting and place in unit posting book for all unit nurses to read, sign, and date.

13. Meets weekly with nurse aids (i.e. - small group from staff on duty) to problem solve unit issues, gather input on need to modify nurse aid resident assignment groups, introduces/reinforces resident care or personnel policies, etc.  Documents meeting and place in unit posting book for all unit nurses to read, sign, and date.

14. Audits resident care clinical records daily per 24 hour report for appropriate action and follow-up as well.  Follows up with any issues identified and commends staff when audits reveal acceptable practices.

15. Performs compliance rounds and follows through with staff as necessary.  Commends staff when rounds reveal acceptable practices.

16. Personally evaluates care of new residents with acute care issues (i.e. - residents with infections, decubiti, depression, behavior problems, recent/frequent falls, recent change in condition, etc.).

17. Ensures that unit is represented at Interdisciplinary Care Conferences (ICC) by appropriate Charge Nurse and Nursing Assistants.  Attends ICC as necessary.

18. Supports facility education policies and procedures with unit staff.  Performs one-to-one education with nursing assistants and nurses as situation requires.  Documents same.  Communicates issues to Staff Development Coordinator.

19. Supports facility Infection Control Program with unit staff.    Performs one-to-one education as situation requires.

20. Maintains an awareness of Quality Assurance issues related to nursing department.  Disperses information and needed changes to nursing staff on unit.

21. Is a role model for others - projects a professional, confident, and caring attitude.

22. Has the latitude to work any shift with prior notification of Director of Nursing Service.

23. Sets an example for other staff:

Remains calm in crisis.

Deals with those under her/his supervision fairly.

Follows chain of command.

Responds to questions and concerns in a fair and timely manner.

Acts as an advocate for residents and staff.

Respects confidentiality of residents, staff, family, and facility.

Works as a team member, willing to help others and cheerful in doing so.

Exercises safe work practices.

25. Performs other duties and responsibilities as directed by the DON.

Requirements/Qualifications:

• Must hold valid RN License for State of Florida
• Long Term Care Experience Preferred
• 5 years nursing experience in a hospital, nursing home or other healthcare setting and a 1-year experience as a nurse supervisor preferred
• Must be CPR/BLS certified
• Strong knowledge of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pertain to nursing care centers.