Registered Nurse - Residential
Centre for Neuro Skills (CNS) helps people with brain injury find hope, independence and a meaningful life - and you can play a key role in that journey as a Staff Nurse.
The Staff Nurse - Residential renders professional nursing care at the residential site pursuant to the objectives and policies of the facility. Must possess excellent assessment skills, self-confidence and be assertive in advocating for good patient care in working independently as a nurse. Must be highly organized and prioritize all nursing tasks and procedures in a shift. Education of patients and staff is a vital component of this position. Work is full time with work during the week and some weekends. Some on-call work is required. Work is performed at the residential site. The residential site may be a home and/or an apartment complex which may have two stories; if two stories, the top story is accessible by one flight of stairs.
A high degree of accuracy in documentation and observation, adaptability to a variety of situations, strong organizational and communication skills, decision making and an ability to evaluate situations as they occur is needed for this position.
For over 35 years, Centre for Neuro Skills (CNS) has provided post-acute medical treatment, rehabilitation and disease management, and offers residential, inpatient, outpatient and assisted living programs. Locations include Bakersfield, Los Angeles, San Francisco and Dallas.
Our facilities have been honored many times by the prestigious Commission on Accreditation of Rehabilitation Facilities (CARF International) for excellence in therapeutic programs, staff education, patient treatment, and leadership. We also conduct research on brain injury and recovery, with a dedicated, in-house team of Ph.D. researchers who collaborate with major U.S. universities. Please see our moving corporate video, "The Story of Centre for Neuro Skills" at http://www.neuroskills.com/about-us/tour-cns.php.
Full or part time shifts available, options include:
- AM Staff Nurse - Residential site -7 AM to 3 PM
- PM Staff Nurse – Residential site - 3 AM to 11:30 PM
- Overnight Staff Nurse - Residential site - Friday and Saturday 11 PM - 7:30 AM
Work is normally performed at the CNS sites, including clinic, residential and in the community.
The company offers a competitive salary and benefits, paid time off, extended sick leave, medical insurance, paid holidays, and 401(k).
1. Performs nursing techniques for the comfort and well-being of the patient. Administers or supervises the administration of prescribed medications and treatments. Takes vital signs, including temperature, pulse, respiratory rate, and blood pressure regularly to detect deviations from normal and monitors the medical progress of patients, double checks and follows physician's orders and individual nursing care plans, including assisting patients with daily routines, catheter irrigating and assisting with respiratory treatments. Requires basic computer skills to complete conferences, make charting entries, communicate openly and clearly with associated staff at the clinic and residential site, formulate specific programs to outline particular patients needs in a format comprehended and utilized by the residential and clinic staff. In coordination with other nursing staff, supervises, assists with and delegates the distribution of medications to the appropriate residence of each patient. Requires fine motor manipulation, hearing and speaking, visual ability, and numerical ability to administer medications, treatments and tests. Also requires repeated stair climbing, walking, standing, bending and stooping.
2. Observes, records and reports medical progress made to Nursing Department, residential supervisory staff, Residential Treatment Coordinators, Residential Programming Manager, Case Managers, Director of Rehabilitation and patients' families if indicated. Maintains medical records for each patient with nursing observations and interventions documented.
Assessment: Vital signs, head to toe assessment, listening to the patient’s comments and questions about the patient’s health status, observing the reactions with others. Be cognizant of assessing the 5th vital sign, pain. This involves asking pertinent questions about the signs and symptoms and listening carefully to the answers in conjunction with information presented by therapeutic staff. Objectively observing patient facial expression, body language, in conjunction with utilization of a pain scale in properly assessing any patient for appropriate pain management is paramount.
Nursing Diagnosis: After identifying problems related to health status, formulating a plan to address this problem or potential problem in promoting an expected outcome.
Planning: Setting goals to improve the outcomes for the patient are a primary focus of the nursing process. This directly equates with improving the quality of life for the patient and what the patient needs to do to improve his/her health status or better cope with concerns identified.
Implementation: Setting nursing plans in motion and delegating responsibilities for each step. Communication is essential to the nursing process. All members of the health care team should be informed of the patient’s status, health concerns and goals of care. In return, nursing should receive feedback from the healthcare team including observations and interventions as well as patient’s outcomes and responses.
Evaluation: The nursing process is ongoing. Evaluation not only analyzes the success of goals and interventions but examines the need for adjustments and changes as well. The evaluation incorporates all input from the entire rehabilitation team, including the patient.
Follow-up: Part of the ongoing process is performing follow-up on sick/ill patients prior to ending of shift/leaving.
3. Informs each new patient and their family of the residential nursing role.
Assists in the department’s organization by monitoring and ordering supplies, organizing new patient charts, thinning charts and breaking down charts of discharged patients, and cleaning out cupboards/refrigerator on a monthly basis. Requires fine motor manipulation, visual ability, and numerical ability to administer assess needs and manipulate supplies and files.
5. Trains new orientees on basic care techniques. May also conduct other inservices for staff and/or patients.
6. Assists with the medical management of patients.
a. Directly reports to the physician any changes in medical status observed by nursing for appropriate orders. Implements orders and communicates actions to nursing staff.
b. Attends medical appointments to improve continuity of proper nursing care and ensure follow up is scheduled as needed.
c. Works closely with clinic nursing staff to update and keep current any medication changes and makes entries into medication data base. Ensures that needed medications are obtained from the pharmacy.
d. Changes nursing orders as needed to provide for fluent communication with Registry nursing staff and/or allied CNS staff.
7. In California, is a Mandated Abuse Reporter. Completes training, including viewing DOJ video, Your Legal Duty, and corresponding materials, etc.
8. Provides for the safety of patients, visitors, staff and self when interacting with patients who may have behavioral outbursts, which can include yelling, exiting, hitting, kicking, biting, spitting, scratching, and throwing objects.
a. Must be able to recognize patient escalation, via verbal, physical and visual cues.
b. Must be able to attempt to verbally and physically de-escalate patient using Behavior Modification techniques according to each patient's program, which may include Professional Assault Crisis Training (Pro-ACT) such as evasive self-defense (ability to get out of the way) and controlling self-defense (restraints).
c. Physical intervention and restraints can include calling for help, lifting, standing, walking, running, stooping, bending, kneeling, squatting, carrying, pulling, pushing and assisting with the restraint of patients weighing up to 200 pounds or more.
9. Performs toilet and chair transfers with assistance for patients up to 150 pounds utilizing approved transfer techniques. Transfer techniques include standing, walking, stooping, bending, kneeling, squatting, lifting, carrying, pushing and pulling. Patients requiring moderate to maximum assistance and weighing over 150 pounds are lifted and/or transferred by two or more persons.
10. Uses special equipment as required by each patient including, but not limited to wheelchairs, tracheostomy tubes, gastric feeding tubes, and external catheters, at any given time according to the outline of each patient's program. May require fine motor manipulation, lifting, reaching, carrying, pushing and pulling when working with equipment.
11. Maintains professional and ethical relationships with staff, patients, patient families, and other visitors.
12. Attends staff meetings, in-services, and all scheduled shifts.
13. Comprehends and follows instructions:
a. Maintain attention and concentration for necessary periods
b. Apply common sense understanding and carry out instructions (written, oral or diagrammatic)
c. Adapt to situations requiring the precise attainment of set limits, tolerances or standards
14. Performs simple and repetitive tasks:
a. Ask simple questions or request assistance when needed
b. Perform routine, concrete, organized activities
c. Remember locations and work procedures
d. Make decisions based on simple sensory data
15. Maintains work pace appropriate to given work load:
a. Perform activities on schedule, maintain regular attendance, and be punctual within specified tolerance
b. Complete normal workday and/or week, perform at a consistent pace without excessive rest periods
16. Performs complex or varied tasks:
a. Synthesize, coordinate and analyze data
b. Perform job requiring precise attainment of set limits, tolerances or standards
17. Relates to other people beyond giving and receiving instructions:
a. Can get along with co-workers or peers without exhibiting behavioral extremes
b. Maintain open door policy to encourage active, empathetic listening
c. Perform work activities requiring negotiating, instructing, supervising, persuading or speaking with others
d. Respond appropriately to criticism from a supervisor and/or other staff member(s)
18. Effectively influences people on a consistent basis:
a. Convince or redirect others
b. Understand the meaning of words and use them effectively
c. Interact appropriately with people which includes the provision of appropriate internal and external customer service
19. Makes generalizations, evaluations or decisions without immediate supervision:
a. Recognize potential hazards and observe appropriate precautions
b. Understand and remember detailed instructions
c. Make independent decisions or judgments based on sensory data or known guidelines
20. Accepts and carries out responsibility for direction, control and planning:
a. Set realistic goals or make plans independently of others
b. Negotiate, instruct or supervise people
c. Respond appropriately to changes in the work setting
PREFERRED DUTIES AND REQUIREMENTS
1. Meets the educational needs of each patient, family members and residential staff through spontaneous and scheduled health teaching.
2. Takes patient(s) to doctor/hospital if medically required.
Performs other duties as assigned.
SPECIAL SKILLS UTILIZED, EDUCATION LEVEL, TRAINING
1. Current RN or LVN licensure in state employed is required.
2. Experience in general rehabilitation is preferred.