The LPN delivers, coordinates, evaluates and is accountable for the total nursing care for residents/patients in the assigned area (approximately 20 to 25 beds) in accordance with current federal, state, and local standards, guidelines, and regulations and Keswick’s nursing care standards, in order to maintain or attain the highest practical level of functioning. The LPN functions are performed in collaboration with the Registered Nurse whose has ultimate accountability for the resident/patient.
ESSENTIAL JOB DUTIES
1. Resident/Patient Care: Performs nursing care according to established nursing standards and individualizes care based on the care plan and physician orders; performs nursing skills safely and proficiently; works collaboratively with other members of the interdisciplinary care team to provide holistic care; performs daily assessments according to facility standards to ensure resident/patient well-being and safety; addresses resident/patient emergent and urgent situations; completes required documentation within the expected timeframes. Adheres to facility policies and protocols regarding infection control.
2. Nursing Supervision: Functions as shift Charge Nurse as assigned and oversees care delivery and completion of nursing tasks by LPNs and GNAs; assists staff with resident/patient care and activities of daily living (ADLs) as necessary to ensure quality care; instructs staff on correct procedures as necessary; serves as a role model to assigned staff.
3. Assessments: Performs resident/patient assessments upon admission and per unit standards; completes documentation for assessments, treatments, reactions and outcomes; notifies appropriate resources (e.g. dietitian, physical therapist, etc.) of the need for evaluation; contributes to the development of care plans for identified resident/patients; evaluates resident/patient response to plan of care and recommends additional modifications as indicated.
4. Clinical Rounds: Performs clinical rounds to ensure patient safety, comfort and regulatory compliance; evaluates resident/patient physical and emotional status.
5. Clinical Records: Maintains resident/patient clinical records according to established policies and procedures; makes corrections and additions to medical records following facility standards and procedures.
6. Medication: Transcribes physicians’ orders to resident/patient charts, medication records etc. as required; administers medications and treatments according to regulations and established procedures; monitors administration of intravenous fluids and discontinues at the appropriate time; observes resident/patient reaction to medications and treatments; orders and stores medications according to established pharmaceutical policies and procedures; implements stop-order policy and removes all outdated and discontinued drug medication bins and places in designated area; maintains current scheduled and controlled drug record in accordance with state or federal laws; contacts Unit Manager or other nursing or medical staff if there are any questions regarding resident/patient medication or treatment.
7. Communication and Reporting: Receives report from off-going shift and gives report to oncoming shift during walking rounds; professionally communicates about resident/patient condition with other care staff on an ongoing basis throughout the assigned shift; communicates significant changes in resident/patient condition to the physician, family or responsible party; reports significant changes in resident/patient condition to Unit Manager or Nursing Supervisor; keeps Unit Manager informed of major or recurring problems.
8. Admission, Transfer and Discharge: Completes required documentation related to the patient admission, transfer, and discharge processes and ensures that all steps have been completed.
9. Compliance: Complies with regulatory and legislative requirements; participates as needed in federal, state and local surveys and inspections; follows any plans of correction; reports abuse, neglect or violence according to established procedures; addresses complaints from patients, families, or physicians or refers complaints to the Unit Manager.
10. Environment: Ensures the unit’s work areas, resident/patient rooms and treatment areas are maintained in a clear and sanitary manner in compliance with regulatory agencies and fire codes; monitors supplies and orders refills as needed; makes incidental assignments to GNAs such as cleaning baths, utility rooms, nurses’ stations and linen rooms; ensures that malfunctioning equipment is removed from service, tagged, the appropriate department is notified, and that a safe environment is maintained in resident/patient areas.
EDUCATIONAL REQUIREMENTS: Requires graduation from Licensed Practical Nurse program
LICENSURE, CERTIFICATION AND REGISTRATION: Active Licensed Practical Nurse licensure without disciplinary infractions by Maryland Board of Nursing. Current AHA HCP BLS certification required. IV insertion skills required.
WORK ORIENTATION & EXPERIENCE REQUIRED: At least 1 year prior continual experience with the same long-term care facility is required. 2 or more years of service are preferred.
Electronic Medical Record
Diseases And Disorders
Long Term Care
Maintain Patient Confidentiality