Department:

Nursing Reports to:

RN Supervisor, Assistant Director of Nursing, and Director of Nursing Supervises:

No independent supervisory authority unless specifically delegated; collaborates with assigned nursing personnel and interdisciplinary departments. Position Summary The Licensed Vocational Nurse supports daily nursing operations by coordinating physician orders, admissions, medications, laboratory results, documentation, and communication among nursing personnel, providers, pharmacy, and other departments. The Desk Nurse ensures orders are received, clarified, entered, communicated, and implemented promptly. The Desk Nurse practices within the LVN scope and under the supervision of the RN Supervisor, Assistant Director of Nursing, or Director of Nursing. Concerns requiring RN assessment, higher-level clinical judgment, or emergency intervention must be referred promptly to the appropriate supervisor. Essential Responsibilities Physician Orders and Order Processing Receive and process physician orders within the LVN scope of practice, delegated authority, and facility policy. Review orders for completeness, including medication name, dosage, route, frequency, duration, monitoring requirements, and applicable parameters. Enter physician orders accurately into the electronic medical record and verify they appear correctly on medication and treatment administration records. Clarify incomplete, duplicate, conflicting, or illegible orders with the physician, pharmacy, or RN Supervisor. Communicate new, changed, and discontinued orders directly to the assigned medication nurse, treatment nurse, RN Supervisor, and other appropriate personnel. Identify required laboratory tests, follow-up appointments, monitoring, treatments, or other associated interventions. Track outstanding orders, report potentially unsafe orders immediately, and communicate unresolved issues before the end of the shift. Admissions and Readmissions Assist with coordinating new admissions and residents returning from the hospital. Review discharge paperwork, diagnoses, medication lists, treatment instructions, and follow-up recommendations. Identify missing information, unclear orders, medication discrepancies, unavailable medications, and equipment needs. Enter admission and readmission orders accurately and obtain clarification or approval consistent with facility policy and supervision requirements. Communicate admission information to the RN Supervisor, medication nurse, treatment nurse, CNAs, and applicable departments. Coordinate with pharmacy to obtain ordered medications, particularly time-sensitive medications. Communicate laboratory orders, treatments, special diets, equipment needs, monitoring requirements, and unresolved admission concerns. Notify the RN Supervisor immediately when an admission requires clinical assessment, urgent intervention, or further evaluation. Medication Reconciliation and Pharmacy Coordination Compare hospital medication lists, physician orders, and existing medication administration records to identify discrepancies. Report discrepancies to the RN Supervisor and coordinate clarification with the physician or pharmacy. Submit new medication orders and changes to the pharmacy promptly. Follow up on missing, delayed, discontinued, unavailable, or time-sensitive medications and communicate anticipated delays. Coordinate emergency medication delivery or approved backup access when appropriate. Verify medication changes are accurately reflected in the electronic medication administration record. Follow up on pharmacy recommendations, medication renewals, clarification requests, medication returns, and cart discrepancies as assigned. Immediately report concerns involving controlled substances, medication errors, or potentially inaccurate medication documentation. Laboratory and Diagnostic Coordination Process and coordinate ordered laboratory tests, imaging studies, and other diagnostic services. Communicate required preparation, collection times, specimen requirements, and pending test information to appropriate staff. Track pending results and forward available findings to the physician or authorized provider. Immediately notify the RN Supervisor of critical, significantly abnormal, or otherwise concerning results. Document provider notification and resulting instructions when authorized and appropriate. Enter and communicate new orders received in response to laboratory or diagnostic findings. Follow up on results that have not been received, reviewed, or addressed and include pending concerns in shift handoff. Physician, Provider, and Family Communication Serve as a communication resource among nursing staff, physicians, nurse practitioners, pharmacy, families, and other departments. Relay resident information, laboratory results, order clarification requests, and nursing concerns to the appropriate provider. Ensure provider communications include available relevant information supplied by the assigned nurse or RN Supervisor. Refer significant changes in condition or concerns requiring assessment to the RN Supervisor promptly. Document provider communication, instructions, and follow-up according to facility policy. Assist with family or responsible-party notifications regarding appointments, admissions, transfers, or orders when assigned. Escalate unanswered provider messages and urgent concerns to nursing leadership without unnecessary delay. Appointment and Transportation Coordination Assist with scheduling provider visits, specialist consultations, diagnostic appointments, and ordered follow-up care. Coordinate transportation with the designated staff member or department. Communicate appointment details to the resident, responsible party, assigned nurse, and relevant departments. Prepare or coordinate required paperwork, medication information, clinical records, equipment, escorts, or precautions. Track scheduled, missed, and rescheduled appointments and communicate follow-up recommendations. Enter and distribute new orders received after outside appointments or specialist visits. Documentation and Electronic Medical Records Maintain accurate, complete, and timely documentation related to physician orders, provider communication, admissions, pharmacy follow-up, and test results. Verify orders are entered under the correct resident and medication or treatment records are updated appropriately. Identify incomplete orders, missing signatures, documentation discrepancies, and conflicting information. Assist with physician-order recaps, medication reconciliation, chart audits, and medical record reviews as assigned. Ensure corrections and late entries follow facility policy and accurately reflect the information received. Protect resident health information and maintain an organized record of pending tasks and unresolved follow-up. Change-of-Condition Support Receive reports of resident symptoms or clinical changes and immediately notify the RN Supervisor of significant or potentially urgent concerns. Assist with gathering available vital signs, medication history, recent laboratory findings, existing orders, and other relevant information. Support provider communication after the RN Supervisor has performed the necessary assessment or provided direction. Enter and communicate resulting orders and coordinate ordered medications, laboratory tests, treatments, or transportation. Document communications and follow-up within the LVN scope and assigned responsibilities. Escalate worsening conditions, delayed provider responses, or concerns requiring emergency intervention promptly. Do not independently manage situations requiring RN assessment, emergency decision-making, or higher-level clinical judgment. Hospital Transfers and Returns Assist the RN Supervisor with coordinating hospital or emergency-department transfers. Prepare or obtain transfer documents, medication lists, physician orders, advance directives, and other required records. Communicate with transportation providers, receiving facilities, physicians, and responsible parties as assigned. Document transfer-related coordination and track residents expected to return from the hospital. Review return paperwork and communicate medication changes, treatment instructions, or discrepancies to the RN Supervisor and assigned staff. Enter and communicate readmission orders promptly and report unresolved issues. Care Plans and Interdisciplinary Communication Communicate new diagnoses, physician orders, treatment changes, and identified resident needs to the appropriate interdisciplinary personnel. Notify the RN Supervisor, treatment nurse, dietary department, rehabilitation team, or social services when orders affect their responsibilities. Assist with communicating information needed for care-plan updates and interdisciplinary follow-up. Participate in care conferences or interdisciplinary meetings as assigned. Report unresolved issues affecting resident care, medication access, discharge planning, or appointment coordination. Supply, Equipment, and Treatment Coordination Assist with obtaining supplies and equipment required for new admissions, ordered treatments, or changes in resident needs. Notify the appropriate department when residents need oxygen equipment, wound supplies, durable medical equipment, or other ordered items. Communicate treatment requirements to the treatment nurse and RN Supervisor. Follow up on unavailable supplies or equipment and escalate delays affecting resident care. Maintain an organized nursing station and assigned communication or documentation systems. Communication with Medication and Treatment Nurses Notify medication nurses promptly of new medications, dose changes, discontinued medications, and administration parameters. Notify treatment nurses of new or changed wound care, dressing orders, skin treatments, and other treatment requirements. Verbally communicate time-sensitive orders rather than relying solely on electronic record visibility. Clarify which nurse is responsible for implementing each new order. Follow up when ordered medications, treatments, or monitoring have not been initiated and report unresolved concerns to the RN Supervisor. Shift Organization and Handoff Maintain an organized list of pending orders, laboratory results, pharmacy deliveries, provider callbacks, admissions, appointments, and unresolved discrepancies. Prioritize urgent resident-care needs and time-sensitive orders. Communicate outstanding work and significant concerns to the RN Supervisor throughout the shift. Provide a complete handoff to the incoming desk nurse, RN Supervisor, or designated licensed nurse. Ensure urgent concerns are resolved or clearly assigned for continued follow-up. Notify the RN Supervisor when workload or pending tasks create a potential risk to resident care. Qualifications Current, active licensed vocational nurse license in the state where the facility operates. Experience in skilled nursing, long-term care, rehabilitation, or a related clinical setting preferred. Familiarity with physician orders, medication administration records, treatment administration records, and electronic medical records. Ability to identify medication discrepancies, incomplete orders, pending laboratory findings, and follow-up needs. Strong organizational, communication, prioritization, and time-management skills. Ability to communicate effectively with physicians, pharmacy, nursing staff, residents, families, and interdisciplinary departments. Ability to recognize concerns requiring immediate RN assessment, management intervention, or emergency response. Ability to maintain confidentiality and practice within the LVN scope, delegated authority, and facility policy. Performance Expectations Enter physician orders accurately, promptly, and under the correct resident. Communicate new, changed, and discontinued orders directly to the appropriate nursing personnel. Follow up on missing medications, pending laboratory results, provider callbacks, and unresolved physician requests. Identify medication discrepancies and escalate concerns appropriately. Support timely admissions, readmissions, appointments, hospital transfers, and transitions of care. Keep the RN Supervisor informed of significant clinical or operational concerns. Maintain accurate documentation, a current pending-task list, and a complete shift handoff. Practice within the LVN scope and refer matters requiring RN assessment or higher-level clinical judgment to the RN Supervisor. Role Distinction and Delegated Authority The Desk Nurse primarily coordinates physician orders, admissions, pharmacy communication, laboratory results, documentation, and nursing-station workflow. The RN Supervisor retains responsibility for shift-level clinical oversight, RN assessments, emergency decision-making, and staff supervision. The ADON and DON retain responsibility for department-wide management, formal employee discipline, and long-term corrective-action monitoring unless responsibilities are specifically delegated.

Pay:

$32.15 - $36.75 per hour

Work Location:

In person