Provide primary care to patients/residents in accordance with physician orders, facility protocols, and written plans of care.
Identify, manage, and treat patient/resident conditions, such as changes in vital signs, skin conditions (ulcers), alterations in mental status, and changes in nutrition, etc. Document patient/resident care problems, abnormal findings, and changes in resident’s condition, report to physician, supervisor, and/or resident/representative. Document all assessments in the medical record.
Confer with the care plan team in the development of the comprehensive care plan. Monitor implementation of preventive measures such as turning/positioning, pressure relief devices, nutrition/hydration measures, and toileting/incontinence care.
Provide education to resident/representative as identified on care plan. Topics include but not limited to nutrition, safety, medications, preventive measures, changes in mentation, and wound healing. Provide wound care, following manufacturer recommendations and appropriate techniques.
Assist with discharge planning through identification of discharge needs and providing education as needed.
Perform administrative duties as assigned including supervision of CNA, CNA/MT, and LPN.