Licensed Vocational Nurse (LVN) Residential Care

Laugh, create, give, and love. These are just a few of the positive words of affirmation that describe the culture at Centre for Neuro Skills. We work together as a team and continually inspire each other to lead positive change, learn, and grow. Our commitment to research, innovation, and advances in technology drives us to reach for what could be possible. Every day is a new day to smile, do, and change. We are passionate about our work and making a difference in the lives of our patients and their families.

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 LVN/Direct Care.

Part time schedules available:

• Saturday & Sunday AM: 7:00am - 3:30pm
• PRN

As a Licensed Vocational Nurse/Direct Care (Neuro Rehabilitation Specialist), you render professional nursing care, and implement patient treatment programs at the residential site pursuant to the objectives and policies of the facility. Supervise and directly train patients with brain injuries with Activities of Daily Living (ADL's), and therapeutic home programs assigned by clinical therapists. Provide skilled instruction and supervision to patients in social, recreational, shopping, and entertainment activities in community settings.

For 40 years, 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, Dallas, Fort Worth, and Houston.

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.

Job Requirements:

Must possess excellent assessment skills, self-confidence and be assertive in advocating for good patient care in working independently. 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 or part time during the week and/or weekends. 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.

Performs nursing techniques for the comfort and well-being of the patient. In coordination with other nursing staff, supervises, assists with and delegates the distribution of medications to the appropriate residence of each patient. Administers or supervises the administration of prescribed medications and treatments. Performs medication counts of controlled medications each shift. 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 conference reports, make charting entries, communicate openly and clearly with associated staff at the residential site, formulate specific programs to outline particular patients’ needs in a format comprehended and utilized by the residential and clinic staff. Transports patients to medical appointments.

Provides emergency first-aid for patients and staff if needed. Administers TB tests and Hepatitis B vaccines for staff.

Observes, records and reports medical progress made to Nursing Department, residential supervisory staff, Case Managers, Director of Rehabilitation, Residential Rehabilitation Manager, 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.

Performs reporting procedures.

• Observes, records, and reports medical progress made to Physician, Director of Rehabilitation, Case Managers, other staff members, insurance carriers, and patients' families.
• Maintains medical records for each patient with nursing observations, interventions, patient reactions, tests, intake and emission of liquids and solids, temperature, pulse, and respiration rate documented. Requires visual and fine motor coordination, ability to read and write, and cognitive ability to observe and record data.
• Submits monthly conference reports for own patients.
• Reports verbally and/or in writing (according to patient/carrier/company needs) in conferences, staffings and other meetings to inform necessary personnel, insurance carriers, patients' families and patients (as appropriate) of patient testing, treatment and progress. Requires visual ability and fine motor manipulation to dictate and review/edit reports
• Consults with other nurses in Bakersfield clinic as necessary.

Teaches, monitors, administers and documents individual patient programs including ADL's (as outlined on the Needs and Services Plans) and therapeutic home programs in English.

• ADL's include such tasks such as providing training and assistance with bathing, grooming, hygiene, toileting, dressing, housecleaning, cooking, clothes washing and self-administration of medications. Lifts and carries laundry baskets and grocery bags, which weigh from 2 pounds to over 25 pounds.
• Trains patients on self-administration of prescription and nonprescription medications. Follows “7 rights of medication administration”. Ensures medications are kept in locked cabinet. May also have additional training on restricted health conditions, i.e. diabetes etc.
• Therapeutic home programs consist of physical exercises from Physical Therapy and Occupational Therapy, including walking, swimming in the on-site pool if applicable, vision exercises, math or reading exercises, money management skills and cognitive skills exercises from Speech/Education, which are assigned by clinical therapists to be followed in the Residential setting.
• Work is performed in the patients' apartments/residence. At some locations, some apartments may be accessed only by one flight of stairs; thus, requiring repeated walking and stair climbing.

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.

Provides for the safety of patients, visitors, staff and self when interacting with patients who may have behavioral outbursts.

• Must be able to recognize patient escalation, via verbal, physical and visual cues.
• 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 Crisis Assault Training (Pro-ACT) such as evasive self-defense (ability to get out of the way) and controlling self-defense (restraints).
• 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 150 pounds or more.

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 find motor manipulation, lifting, reaching, carrying, pushing and pulling when working with equipment.

A NRS/LVN working any shift may transport patients in company-owned or personal vehicle when company transportation vehicles are unavailable requiring transferring and driving abilities. NRS/LVN who transport patients must be a cleared driver, i.e. clear DMV report, registration, and insurance verification.

Attends staff meetings, in-services, and all scheduled shifts.

Performs other duties as assigned.

PREFERRED DUTIES AND REQUIREMENTS

May conduct visits at patient’s home as required to assess patients medical status. Requires standing, walking, bending, stooping and repeated stair climbing.

Performs other duties as assigned.

SPECIAL SKILLS UTILIZED, EDUCATION LEVEL, TRAINING

Current/clear Texas LVN licensure required. Blood Draw and IV certifications required.

Experience in skilled nursing and rehabilitation concepts preferred.

Successful completion of pre-employment, post-offer drug screen, health screen, including TB clearance, and fingerprint clearance.

Must attend and complete required orientation upon hire.

Successful completion of required NRS modules and tests for training topics which may include but not be limited to the following: documentation, ADL’s, Brain Injury Overview, Brain Injury Rehabilitation Principles and Techniques, Employee Handbook/HR policies, Fall Prevention, Medical, CPR/First Aid, Transfer Training, etc.

Successful completion of 20 hours of Pro-ACT training first time scheduled after hire.

Successful completion of 16 hours of Behavior Tools training.

Must successfully demonstrate competency within 3 months of hire on the following: Professionalism, Grocery Shopping, Transfer Techniques, Thick-It, Medications, Skin Care and Incontinence, ILS, Behavior, Client NET and Cooking.

Demonstrated ability to safely manage physical loads essential to performance of job.

Demonstrated fluency in English sufficient to communicate with patients with brain injuries and therapeutic staff in English, and to complete charts and documentation as described herein in English.

Must maintain CPR, First Aid, and Pro-ACT Certifications. To be a cleared driver, staff must maintain a good driving record and submit verification of driving record, registration and insurance.