Director of Nursing (DON)

DIRECTOR OF NURSING
Department: Nursing Service/Administration
Supervisor: Executive Director
Shift: Regular hours, Monday – Friday
FLSA Status: Exempt

EDUCATION & CREDENTIALS:
RN graduate from an accredited school of nursing required. BSN preferred, but not required. Current licensure as an RN in the State of Iowa by the Iowa Board of Nursing, without restrictions, is required. Current CPR certification required. Failure to maintain current licensure and certification in good standing without restrictions will result in termination. May not be a debarred provider.

REGULATORY COMPLIANCE REQUIREMENTS:
The Director of Nursing is required to report any arrest, charge, or conviction of a crime other than a traffic violation, and receipt of notice of any agency investigation or charge, including investigations relating to licensure, certification status, or dependent adult or child abuse within 48 hours and may not perform services pending such report. Failure to report such an arrest, charge, conviction, investigation or similar issue may result in termination.
The Director of Nursing must understand the nature of resident care and resident rights and comply with these requirements at all times.
A Director of Nursing who reasonably believes a dependent adult has suffered dependent adult abuse is required to report suspected abuse to the Administrator within twenty-four (24) hours.
During the course of employment, the Director of Nursing is also required to report any information that may impact patient/resident care, including, but not limited to, violations of resident rights and HIPAA violations to his/her supervisor.

CONTINUING EDUCATION REQUIREMENT:
The Director of Nursing is required to complete annual 12 hour in service training programs as well as any CEU required for licensure. Failure to complete the 12 hour in service training program or required CEU’s, or any other requirement under internal policies, local, state or federal law may result in termination.

WORK EXPERIENCE:
Experience equal to three years of full-time supervisory/management nursing experience preferred. Applicants also with geriatric experience or certification are preferred.

GENERAL JOB SUMMARY
The Director of Nursing (DON) develops and maintains nursing service objectives and standards of nursing practice, develops nursing service policies and procedures and writes job descriptions for nursing service personnel. Recommends establishment or revision of policies and develops organizational structure and standards of performance. Interprets policies and objectives of nursing service to staff and coordinates with other departments.
The DON assists in preparation of the department budget and maintains final responsibility for stock levels of supplies and adequate equipment easily and readily available. Establishes personnel qualification requirements, drafts procedure manuals, initiates in-service programs, installs record and reporting systems and performs other personnel management tasks. Initiate studies to evaluate effectiveness of nursing services in relation to their objectives and costs.
The DON organizes, develops and provides supervision and administration of quality resident nursing care for the facility by the nursing staff. Regularly inspects nursing units for sanitation, order, safety and proper working condition of equipment. Orients, instructs and conducts in-service education and training programs.
The DON regularly inspects facility and nursing practices for compliance with federal, state and local standards and regulations. Responsible for the execution of resident care in the absence of a physician.
The DON makes independent decisions, reports to administration, attends department head meetings and communicates with medical staff, other department heads, nursing personnel, residents and families.
The DON will evaluate, supervise and direct nursing staff in providing a physical, social and psychological environment conducive to maintaining the highest level of independent function and well being for all residents of the facility.
The DON will generally be the designated person in charge of the health center upon absence of the Administrator.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
1. Ability to effectively plan, direct and coordinate nursing services.
2. Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals.
3. Ability to write routine reports and correspondence.
4. Ability to draft budget and participate in budget process.
5. Ability to work with and train staff on nursing and care issues as well as systems and policy compliance.
6. Ability to speak effectively before groups of residents, family or employees.
7. Ability to utilize and manage resources to attain results.
8. Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardizations exist.
9. Ability to interpret a variety of instructions furnished in written, oral, diagram or schedule form.
10. Ability to understand and appreciate different and opposing perspectives, to adapt own approach to changing situations and to change or easily accept changes in own organization or job requirements.
11. Work and communicate with internal and external clients and customers to meet their needs in a polite, courteous and cooperative manner.
12. Commit to quality service.
13. Display a high level of initiative, effort and commitment towards completing assignments efficiently.
14. Work with minimal supervision.
15. Demonstrate responsible behavior and attention to detail.
16. Align behavior with the needs, priorities and goals of the organization.
17. Encourage and facilitate cooperation, pride, trust and group identity.
18. Express information to individuals or groups effectively, considering the audience and nature of the information.
19. Listen to others and respond appropriately.
20. Capacity to grasp new theories and principles and implement them.
21. Membership in professional organizations as appropriate.
22. Attendance at workshops and institutes in the field of nursing.
23. Directly supervise professional nursing staff, provide guidance and support through reviews and discipline actions.
24. Complete health assessments on all residents at time of admission to establish initial care plan and then regularly thereafter.
25. Coordinate health care services and make referrals when appropriate.
26. Monitor care plans for appropriate services to meet resident needs.
27. Assist with the development, implementation and evaluation of the care plans for each resident in accordance with other health care providers and physicians.
28. Demonstrate effective supervisory skills and instructs/delegates to staff based on the individual needs of each resident.
29. Maintain records of procedures/training/delegation.
30. Complete appropriate audits or reports in a timely and accurate fashion.
31. Assess and evaluate residents and staff in health emergencies.
32. Perform or monitor Mantoux testing for employees and new residents and document results.
33. Establish and monitor employee health program.
34. Assist in the establishment of a disaster, fire and safety program in cooperation with administration.
35. Ensure proper handling and emergency care of residents, personnel and visitors involved in accidents while on the job or in the building.
36. Attend conferences and attend/plan in-services as required.
37. Maintain good public relations with local physicians and other care providers.
38. Willing to work flexible hours to meet requirements of the job.
39. Supervise and evaluate the work of subordinate staff; effectively recommend personnel actions related to selection, disciplinary procedures, performance, leaves of absence, grievances, work schedules and assignments and administer personnel and related policies and procedures.
40. Establish and maintain guidelines for staffing to ensure adequate nursing coverage for all resident areas.
41. Initiate action to alleviate barriers to delivery of care by identifying, defining and resolving problems.
42. Promote and evaluate the nursing department standards, philosophy, goals and objectives to assure the optimum level of wellness for residents.
43. Administer special programs such as infection control, staff development, nursing quality improvement and utilization review.
44. Draft, implement and ensure participation and enforce infection control policies and procedures.
45. Meet all submission timelines of reports/records/documentation as required by state and federal rules, regulations and laws for health care facilities.
46. Monitor accrediting/surveying/regulatory body criteria to maintain compliance.
47. Ensure facility orders/receives all necessary supplies, equipment, medications and other materials needed to meet resident care needs while maintaining cost efficacy.
48. Monitor and control department costs to maintain expenditures within allocations.
49. Keep current in the field of nursing through attendance at meetings, conferences, conventions and workshops; reading current literature pertaining to all aspects of resident care and restoration/rehabilitation; maintaining membership in professional organizations.
50. Evaluate resident needs, conditions and care in order to develop nursing care plans for individual residents, including rehabilitative/restorative instructions for self-help activities.
51. Communicate with family members regarding the condition and progress of the resident, including in-person and telephone discussions.
52. Review for prompt implementation of physicians’ orders, review and evaluate all residents’ medication sheets, treatment sheets and other charting for accuracy and completion as performed by nursing staff.
53. Prepare orientation and training programs for new employees and for monthly in-service education for nursing staff.
54. Ensure implementation and compliance of nursing staff with facility policies and procedures as well as applicable laws.
55. Ability to reasonably conform to all rules and policies of the facility.
56. Plan and organize activities related to specified clinical services to ensure resident needs are met in accordance with professional standards of medical and nursing care.
57. Coordinate activities with other departments, ambulance services, medical staff, families, law enforcement officers, clergy, morticians, media and other health facilities.
58. Develop, implement and coordinate quality management, utilization review and discharge planning programs.
59. Consult with other health care providers on resident care problems and interpretation of facility policy to ensure resident needs are met.
60. Abstract and code diagnoses, operations and procedures from health records by using appropriate classification systems, standards and procedures.
61. Prepare statistical reports required by applicable legal, accrediting, and/or licensing regulations and facility policy.
62. Compile information and data from health records and computer systems for use in the evaluation of quality of care and utilization review.
63. Monitor completion of medical records in accordance with time standards.
64. Confer with physicians, nurses and other health personnel to assure complete, current and accurate medical records.
65. Compile and maintain logs, reports and statistical records, and research records to locate health data as requested.
66. Operate computer to process, store and retrieve health information.
67. Recommend establishment or revision of policies, procedures and methods and develop organizational structure and standards of performance.
68. Perform duties of staff nurse whenever and wherever required.
69. On-call for emergencies.
70. Maintain reference library or written nursing materials and laws governing nursing care.
71. Other duties as assigned.

PHYSICAL ACTIVITY REQUIREMENTS

Lifting Requirements: The DON may be called upon to lift equipment or supplies weighing up to 50 lbs. The DON may occasionally be required to assist with lifting residents. Push/pull requirements of 40 lbs. are common.

Carrying Requirements: The DON will frequently be required to carry objects including charts and equipment up to 15 lbs. The DON may occasionally be called upon to carry equipment up to 30 lbs. Carrying equipment in excess of 30 lbs. is not required.

Safety: Various safety protocols and assistive devices are utilized to perform job functions such as Hoyer lifts and gait belts. The DON must be capable of using all such devices efficiently and safely and all such devices must be used pursuant to facility policies. The DON must be familiar with and follow all facility safety policies.

Sight Requirements: The DON is required to have vision corrected to average in order to assess and respond to residents, family members, physicians, co-workers and others. Specific vision abilities required by this job include close vision, peripheral vision and ability to adjust focus.

Hearing Requirements: The DON is required to have an average range of hearing, as corrected, in order to assess and respond to residents, family members, physicians, co-workers and others.

Socialization Requirements: The DON is required to work with all other persons in the facility and the ability to get along with others and to socialize with others is essential. In addition, the DON is responsible for meeting and dealing with residents and their families requiring excellent communication and socialization skills.

Other Physical Requirements: While performing the duties of this job, the DON is frequently required to stand, sit, handle or feel, and talk or listen. The DON will be called upon to perform twisting, bending, squatting, kneeling or crouching when assisting with resident care needs. The DON is occasionally required to reach with hands and arms.
Environment:
• Exposure to general resident care environment.
• Exposure to resident variables such as inappropriate language or physical behaviors due to compromised mental capacity.
• Moderate exposure to temperature variations.
• Exposure to pharmacological preparations, biologicals, and potential biohazard materials including blood and other bodily fluids and medical sharp objects.
• May be exposed to miscellaneous office and cleaning chemicals or machinery.
• Frequent work interruptions occur.
• Must work well independently and as a team member.
• Must be able to give clear and concise direction to staff and others.
• Extended or variable hours may be required.