By slFullAdmin | March 10, 2025
Provide direct and individualized nursing care to assigned residents based on established nursing protocol. Observe and assess for: pain/discomfort, oxygen therapy, all drainage, all dressings, and any incontinent elimination which may have occurred. Provide ignition and ongoing systematic assessment of the physical, emotional, social, educational, and functional needs of the resident/family through observation, interview, and physical examination. Interpret assessment data and information to assist in developing a plan of care. Assure medical orders are transcribed and processed accurately and timely and integrate the medical care plan into the provision of nursing care. Assure that medication administration is correct, according to the established nursing policies and procedures. Provide accurate and timely documentation consistent with the resident plan of care. Administer medication per physician orders. Document properly on MOR. Observe for any adverse reaction. Assemble resident charts, resident records, and assure all necessary form are completed in a timely manner. Assure all monthly summaries are completed in a timely manner for assigned residents. Prepare incident/accident reports for residents as needed per policy, notify AL Director, physician, and family post incident per policy and document accordingly. Assist resident in learning self-care activities. Supervise all resident assignments to nursing team members, and assure special instructions are given to team members. Observe and supervise all meals to ensure residents receive the proper diet and any assistance required. Monitor and organize all material resources necessary for meeting needs of assigned unit. Recognize emergencies and life-threatening situations and initiate appropriate action. Ensure that resident call lights are promptly answered, and their needs are addressed timely and appropriately. Assist with the orientation of new staff members. Ensure that all scheduled activities take place on assigned unit by utilizing activity personnel and/or nursing personnel.
