Travel Cart Nurse - LPN/RN

Position Summary

The Travel Cart Nurse/Medication Nurse is responsible for providing direct nursing care to residents as prescribed by the physician and in accordance with resident care plans, established facility policies and procedures, and all applicable local, state, and federal regulations.This position is specifically assigned to cart nurse responsibilities. The Travel Cart Nurse will administer medications and treatments, monitor resident conditions, complete required documentation, carry out physician orders, and provide direction and supervision to Certified Nursing Assistants in the delivery of resident care.

Accountability

• R.N. Supervisor
• Assistant Director of Nursing
• Director of Nursing

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Assess the overall condition and status of assigned residents and document identified medical needs, changes, interventions, and plans for treatment or resolution in the resident’s medical record.
• Monitor resident activity and provide nursing care in accordance with physician orders, resident care plans, applicable regulations, professional nursing standards, and established facility policies and procedures.
• Administer medications and treatments accurately and timely in accordance with physician orders, medication administration records, treatment administration records, pharmacy instructions, and facility protocols.
• Document all medications, treatments, assessments, interventions, observations, and resident responses accurately and within the required timeframe.
• Maintain responsibility for the assigned medication cart throughout the shift, including medication security, cleanliness, organization, stocking, and proper storage.
• Count controlled substances with the off-going and on-coming licensed nurse at the beginning and end of each shift and immediately report any discrepancy according to facility policy.
• Review the Medication Administration Record and Treatment Administration Record for accuracy and completeness and promptly address any missing medications, unavailable treatments, order discrepancies, or documentation concerns.
• Order medications and supplies from the pharmacy in a timely and accurate manner. Notify nursing leadership or administrative staff immediately of any barrier that may delay medication availability or the timely processing of an order.
• Carry out physician orders accurately and promptly, including completing laboratory requests, diagnostic imaging requests, medication changes, treatment orders, and updates to the Medication Administration Record.
• Monitor residents for medication effectiveness, adverse reactions, side effects, contraindications, allergies, and changes in condition. Notify the physician, nursing supervisor, administrative on-call staff, pharmacy, and resident representative as appropriate.
• Receive a complete nursing report at the beginning of each shift and provide an accurate and timely report to the on-coming nurse at the end of the shift. Shift report shall be a primary focus to ensure resident needs, new orders, changes in condition, follow-up requirements, and pending concerns are communicated appropriately.
• Review the 24-Hour Report and other required communication tools at the beginning of the shift to remain informed of resident changes, new physician orders, incidents, treatments, appointments, admissions, transfers, and discharges.
• Visit and observe all assigned residents at appropriate intervals throughout the shift.
• Take, monitor, and document vital signs, blood glucose readings, weights, oxygen saturation levels, pain assessments, and other clinical measurements as ordered or indicated.
• Identify and respond promptly to changes in a resident’s physical, mental, emotional, or functional condition. Notify the RN Supervisor, physician, administrative on-call staff, resident representative, and other appropriate individuals as required.
• Coordinate and assist with resident admissions, readmissions, transfers, discharges, appointments, hospital transfers, and returns to the facility.
• Complete admission assessments, medication reconciliation, physician order verification, and other required admission documentation within the established timeframe.
• Communicate professionally and effectively with residents, family members, physicians, pharmacies, providers, nursing leadership, Certified Nursing Assistants, therapy staff, dietary staff, social services, and other members of the interdisciplinary team.
• Provide direction, supervision, education, and performance accountability to Certified Nursing Assistants assigned to the unit.
• Make or assist with Certified Nursing Assistant assignments as directed and ensure assignments are appropriate based on resident needs, staffing levels, and facility operations.
• Monitor the completion and quality of resident care provided by Certified Nursing Assistants and promptly address concerns related to resident safety, care delivery, documentation, attendance, or performance.
• Supervise and assist with resident meals and feeding as needed. Administer tube feedings and related medications and treatments in accordance with physician orders and facility protocol.
• Prepare residents for approved passes, appointments, transfers, and other planned absences from the facility. Ensure medications, instructions, documentation, and required supplies are prepared accurately.
• Complete routine nursing documentation, skilled nursing notes, change-in-condition documentation, chart checks, Medicare documentation, and other records required by facility protocol.
• Complete Incident/Accident Reports and all associated clinical documentation for incidents involving residents, employees, or visitors as required.
• Immediately report suspected or alleged abuse, neglect, exploitation, mistreatment, injuries of unknown origin, or misappropriation of resident property in accordance with facility policy and applicable reporting requirements.
• Assist with emergency situations, disaster procedures, resident evacuations, and emergency transfers as directed.
• Answer the telephone promptly and professionally using respectful language and appropriate communication practices.
• Maintain the nurses’ station and medication cart in a clean, sanitary, organized, secure, and well-stocked condition for the on-coming shift.
• Follow infection prevention and control practices, standard precautions, transmission-based precautions, hand hygiene requirements, medication preparation standards, and personal protective equipment requirements.
• Report occupational exposures and work-related injuries immediately in accordance with facility procedures for Workers’ Compensation reporting. During off-hours, notify the appropriate administrative or on-call staff immediately.
• Participate in resident care plan meetings, MDS-related processes, quality improvement activities, nursing meetings, education, and in-service training as requested or assigned.
• Maintain knowledge of and promote resident rights, dignity, privacy, confidentiality, independence, choice, and quality of life.
• Promote a safe, clean, respectful, and comfortable environment in which residents may live and receive care.
• Follow all HIPAA requirements and maintain the confidentiality of resident, employee, and facility information.
• Remain on the assigned unit and medication cart unless relieved, directed by nursing leadership, or required to respond to an emergency.
• Complete any other duties and responsibilities requested by the Director of Nursing, Assistant Director of Nursing, RN Supervisor, or Administrator.
• Become an active and cooperative member of the facility team, with resident safety, care, dignity, and well-being as the first priority.

MINIMUM QUALIFICATIONS

• Must be a Licensed Practical Nurse or Registered Nurse currently licensed and in good standing with the Board of Nursing in the state of Alabama.
• Must maintain all licenses, certifications, and credentials required for the position throughout the duration of the contract.
• Must have current CPR or Basic Life Support certification, as required by facility policy.
• Previous experience in a skilled nursing facility, long-term care facility, rehabilitation center, or similar healthcare setting is preferred.
• Previous medication administration or cart nurse experience is strongly preferred.
• Must be able to safely and accurately administer medications, complete treatments, perform nursing assessments, recognize changes in condition, and provide appropriate clinical follow-up.
• Must be able to learn and use the facility’s electronic medical record, medication administration system, and other required documentation systems.
• Must successfully complete all required background checks, health screenings, drug screenings, exclusion checks, competencies, orientation requirements, and facility-specific training before beginning the assignment.
• Must be dependable and available to work the agreed-upon schedule for the full 8–12 week contract period.

PHYSICAL REQUIREMENTS 

The employee must be able to:

• Hold and handle equipment and supplies.
• Lift and carry residents, equipment, medications, and supplies within the limits established by facility policy.
• Reach at, above, and below shoulder height.
• Push and pull medication carts, wheelchairs, beds, equipment, and other objects.
• Grasp and handle pens, paperwork, medication packaging, syringes, medical equipment, and small items.
• Sit, stand, and walk for prolonged periods.
• Twist, bend, stoop, kneel, crouch, and squat.
• Demonstrate fine hand and motor coordination.
• Read and write legibly.
• Comprehend and follow verbal and written instructions.
• Assist with resident transfers, repositioning, mobility, and emergency procedures as required.
• Tolerate prolonged standing and walking during a 12-hour shift.

Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of the position. 

COGNITIVE AND SENSORY REQUIREMENTS 

Communication: Must be able to communicate with residents, families, physicians, visitors, providers, and staff in a professional and easily understood manner. Must use good judgment when sharing information and communicate concerns in a respectful, positive, and non-threatening manner.

Hearing: Must be able to hear and understand instructions, resident requests, alarms, emergency announcements, telephone communications, overhead pages, and changes in resident condition.

Vision: Must have sufficient vision to perform medication administration, read physician orders, review medication labels, complete documentation, observe residents, and perform job duties safely and accurately.

Smell: Must be able to detect odors that may indicate infection, incontinence, smoke, gas, spoiled food, environmental concerns, or other potential safety issues.

Touch: Must be able to detect changes in temperature, skin condition, pulse, swelling, pain response, and other physical findings.

Judgment: Must be able to prioritize resident needs, respond appropriately to emergencies, make sound nursing decisions within the nurse’s scope of practice, and seek additional guidance when necessary. 

OCCUPATIONAL EXPOSURE

• Tasks and procedures performed by the employee involve occupational exposure classified by the Centers for Disease Control and Prevention as Category I. 
• The employee may have direct contact with blood, body fluids, secretions, excretions, contaminated materials, sharps, medications, and other potentially infectious substances. Standard precautions, personal protective equipment, infection prevention practices, and facility exposure-control procedures must be followed at all times.

WORK ENVIRONMENT AND OTHER REQUIREMENTS

• The employee must be able to tolerate the fast-paced and changing environment typical of a skilled nursing and long-term care facility.
• The employee must be able to receive and provide instructions appropriately, manage interruptions, prioritize multiple resident needs, and remain calm during emergency or high-stress situations.
• The employee must demonstrate patience, professionalism, dependability, flexibility, compassion, and a genuine interest in working with elderly and disabled residents.
• The employee must report to work on time, remain for the entire scheduled shift unless properly relieved, and follow the facility’s attendance, call-in, scheduling, and timekeeping procedures.
• As a temporary contract employee, the Travel Cart Nurse is expected to follow all Cavalier Healthcare of Trussville policies, procedures, clinical standards, documentation requirements, and standards of conduct throughout the assignment.