JCE & ASSOCIATES LLC Nursing Responsibilitues in PHARR, Texas

The main thing is to establish a rapport with the families and the doctors to ensure that they will assist us in every way possible to ensure that all of the individual s needs are met. Get letters out as soon as possible, introducing yourself and giving your pager/cell phone number Try to meet all the families within the first month and provide them with agency s contact numbers. Ensure that a Medical Consultation Form accompanies every individual to any medical appointment and that it is filled out and signed by the doctor and that it is returned to the office within 24 hours. It can be faxed if necessary and the original turned in later. Ensure that the families are informed that you must be notified of any medication change within one hour of the doctor s order. Review Medical Consultation Forms as they come in to the office and sign them and get them into the charts as soon as possible to keep up with doctor recommendations/medication changes/etc. Always administer the first dose of any medication that has not been prescribed in the past. You will initial the Medication Sheet and sign it at the bottom. Always in-service all caregivers (including day habilitation staff) on any possible side effects and the correct administration of the medication (right dose, right amount, right route, right person, and right time) and document on the Staff Training Verification Form. Always ensure that the nurse is the only person to write doctor s orders/medication changes on the monthly Medication Sheets. If a physician has given the family a verbal or telephone order, fax the Confirmation of Telephone/Verbal Orders to the physician to get signed and faxed back to you. Ensure that PRN medications are given as needed and that they are documented on the PRN Medication Sheet. Always have a progress note to back up any of the nursing duties that you perform. Have a Staff Training Verification Form that is pre-printed with all medical guidelines signed by all new staff and then renewed annually to keep the families and individuals reminded of their responsibilities. If there is ever a medication error, inform Program Director and/or Assistance Program Director, fill out the Medication Administration Incident Report, in-service the family on the administration of the medication and fill out the Staff Training Verification Form and turn in all forms to Program Director. Ensure that all Staff Training Verification Forms are turned into Program Director so they can be filed in the Special Needs Binder. Any invasive procedure (eye drops, ear drops, enemas, etc.) must be delegated to the caregiver by the RN and monitored by the LVN. Have a quarterly home visit, to address any ongoing medical needs, or more often if you or the team think that it is necessary. Participate in any Individual Service Plan meetings that have anything to do with the individual s health or medical concerns. MONTHLY Have a monthly progress note on every individual if there has been medical concerns or needs over the month. Review all monthly Medication Sheets to ensure that all dates have been initialed, they have been signed at the bottom, all medications are written as ordered, and any new medications have been added to the Medication Sheets. Keep a weight and blood pressure record on every consumer (If there are no problems noted, this can be kept quarterly). Turn in billable nursing units along with time sheets by Thursday of the week before payday. Paydays are every other Friday. QUARTERLY Complete a Quarterly Nursing Review of all medical/health concerns over the quarter, which is determined by the Annual Individual Service Plan date. ANNUALLY Participate in the Annual Individual Service Plan (ISP) meeting. Complete an Annual Health Service Summary in conjunction with the Annual ISP. Complete a Self-Administration of Medication Assessment Summary at least annually but always with