Occupation Description: Responsible for providing nursing care to residents.
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1 NOC: 3152 (2011 NOC is 3012) Occupation: Registered Nurse Occupation Description: Responsible for providing nursing care to residents. Key essential skills are: Document Use, Oral Communication, Problem Solving. Essential Skills Reading Text Writing Document Use* Computer Use Oral Communication* Money Math Scheduling or Budgeting and Accounting Measurement and Calculation Data Analysis Numerical Estimation Job Task Planning and Organizing Decision Making Problem Solving* Finding Information Working with Others Continuous Learning These Essential Skills are not ranked by complexity level. The skill levels represented in the table above illustrate full skill ranges for experienced workers in their roles, and not for individuals preparing for entrance into this occupation for the first time. Below are examples for each essential skill category representing a sampling of the possible duties and tasks for this role within the industry and the corresponding essential skill level. All examples will not necessarily apply to every organization. Reading Text Review regarding professional development opportunities. ( 1) Read instructions to ensure proper directives are followed in preparation for laboratory testing for residents. ( 1) Review medication or product labels to ensure proper instructions are followed. ( 1) Stay abreast of current healthcare policies, standards, trends, practices and techniques by consulting bulletins from national or provincial professional associations. ( 2)
2 Writing Review protocols for treatment plans or assessment procedures to consider resident queries when assessing medical conditions. ( 3) Consult policies and procedures manuals and documentation to verify rules and regulations. ( 3) Consult reference books such as the Merck Manual of Diagnosis and Therapy to gather information on diagnosis and medications. ( 3) Review nursing and medical handbooks and manuals to gain information about specific diseases, procedures and conditions. This information will be utilized to aid in assessment or when developing treatment plans. ( 4) Consult reference material such as the Compendium of Pharmaceutical and Specialties (CPS) manual to gather information about medications, side effects, contraindications, interactions and administration requirements. ( 4) Review resident files to determine status, appropriateness of care and further treatment or action planning. ( 4) Stay abreast of new industry development by reading nursing, medical and clinical journals. ( 5) Compose brief s to request information from colleagues or other healthcare professionals. ( 1) Write short notes as reminders or note requests from residents. Note daily activities in log books. ( 1) Fill out laboratory requisition forms. ( 2) Update resident files with information such as observations, test results and physician s requests. Documentation must be such that it is comprehensible by other healthcare professionals with the intent of making treatment recommendations or decisions. ( 3) Compose detailed assessments, including outlines of protocols, recommendations discussed as well as well as any new pertinent information. These assessments may be utilized by other healthcare professionals. ( 4) Document procedures and protocols for resident assessments or elaboration of treatment plans using organization s established guidelines. ( 4) Compose reports upon transfer or discharge of resident, summarizing the data collected by all healthcare professionals involved in the care of the resident. Reports include treatments administered as well as recommendation for follow up. ( 4) Document Use Review information on medication labels to verify resident, dosage, scheduling, ingredients and reconstitution instructions. ( 1) Requisition specific tests, utilizing the appropriate paperwork. ( 1) Interpret flowcharts to ensure appropriate sequencing of tasks and support decision making processes. ( 2)
3 Record a variety of measurements such as vital signs, blood pressure, temperature, respiratory rates, pulse rates, oxygen saturation levels, fluid intake and outputs, etc. in specific format in resident files to aid in quick retrieval or recognition by other healthcare professionals. ( 2) Use a variety of visual aids to communicate with patients. ( 2) Record vital signs using a line graph to monitor trends and track changes. This information will be used to assess resident condition and identify the need for intervention. (level3) Utilize anatomical drawings and diagrams to explain medical conditions or processes to residents and/or their families. ( 3) Interpret graphs or other visuals in medical and nursing journals representing research findings. ( 3) Review readings and test results in tabular format to establish appropriate treatment and/or interventions. This requires an understanding of the testing procedures and the relationship between results. ( 3) Interpret information from medical forms, graphs and other reports comprising a resident file to assist in determining care priorities and prepare test requisitions as directed. ( 4) Computer Use Use electronic spreadsheets. ( 1) Create letters, memos and reports or update comments in resident files using word processing software. ( 1) Utilize internet search engines to locate information on specific topics. ( 2) Use computer and software applications. ( 2) Use databases. ( 2) Send health-related attachments and documents using software. ( 2) Use graphics software to create clinical presentations. ( 2) Oral Communication Discuss medical equipment options with suppliers. ( 1) Inform pharmacists of errors on medication orders, obtain information on specific medications or request orders for residents. ( 2) Interact with other nurses to discuss work assignments and care procedures. ( 2) Negotiate pricing and services for residents with regard to purchase of specific medical equipment. ( 2) Present to small groups on a variety of health topics pertinent to the facility or residents. ( 3)
4 Money Math Interact with residents to obtain current information, explain procedures, respond to questions or assist with concerns regarding health or treatment. Empathy and compassion are needed for these conversations as the resident may be emotional depending on the nature of the communication. ( 3) Communicate with other healthcare providers, such as exchange treatment plan information, request tests, recommend referrals, communicate strategies involving the resident and/or family, etc. ( 3) Actively participate in meetings with other healthcare providers to discuss observations and information relating to resident progress. ( 3) Record clinical notes for transcription or review by other healthcare professionals, or retrieve clinical notes via audiotape. ( 3) Communicate and coordinate with co-workers in an emergency situation, providing updates on resident status or directions on how to proceed. ( 4) Communicate with emergency personnel when interacting with a resident who is threatening to harm themselves or others, ensuring established protocols are observed and that information is provided efficiently and with utmost accuracy. ( 4) Convey potentially emotional and distressing information to residents and family, ensuring appropriate language and tone are used and acknowledging the reaction of the recipients. ( 4) Calculate cost of items when preparing expense reports. ( 1) Determine charges for travel reimbursement. ( 1) Scheduling or Budgeting and Accounting Review daily plans to determine assignments and schedule breaks. ( 1) Reschedule as needed to accommodate unexpected interruptions or emergency/crisis situations. ( 2) Select supplier for medication with consideration given to costs and availability. ( 2) Arrange for residents to attend external appointments or consultations. ( 2) Measurement and Calculation Measure medication dosages in milligrams. ( 1) Take body measurements using accepted tools and techniques. ( 1) Calculate the rate of depletion of intravenous medication. ( 2) Determine intravenous drip rates to ensure the resident is receiving the correct amount of fluids and medication. ( 3) Determine the drug amount to be administered when reconstituting from solid to liquid. ( 3) Take measurements such as blood sugar level, temperature and oxygen saturation levels using accepted tools and techniques. ( 3)
5 Data Analysis Compare measurements and results to established norms to assess whether or not readings are within acceptable ranges. ( 1) Graph or chart resident height and weight, tracking changes over time to ascertain health status. ( 1) Compare resident data such as blood sugar levels and protein levels with established norms to assess whether or not results fall within acceptable ranges. ( 2) Track fluid input and output over a time period to determine if resident s intake is sufficient, or if they are retaining fluids. ( 2) Monitor fluctuations in vital signs to assess medical conditions or identify trends. ( 2) Conduct and analyze responses to resident care satisfaction surveys; this may include compilation and determination of future care direction based on the information gathered. ( 3) Numerical Estimation Touch residents forehead to estimate body temperature. ( 1) Estimate the length of time required to complete rounds with consideration given to medical conditions, accessibility, time of day and possible interruptions. ( 2) Job Task Planning and Organizing Organize tasks with consideration given to workload assignments, resident needs, prioritization and efficient sequencing of tasks. Established processes and protocols should be taken into consideration, as well as the mission statement of the organization. Medication and treatment schedules must be considered, as well as resident appointments in other areas. Registered nurses must be flexible in order to accommodate unplanned events, emergencies and interruptions from colleagues, residents and other healthcare professionals. They must respond appropriately to emergencies, as well as to residents or other healthcare professionals. Tasks may require delegation to others and senior nurses may need to organize daily schedules and determine priorities for co-workers. Work is coordinated with other healthcare professionals and colleagues to ensure efficient care is provided to residents. ( 3) Decision Making Access the appropriate community resources to gather information on specific health issues. ( 1) Determine appropriate timing to order medication from the pharmacy, taking into account current inventory levels and anticipate quantity required in the short term. ( 2) Assess the need to transfer a resident to hospital. ( 2) Prioritize resident visits taking into account health status and potential emergencies or critical cases. ( 2)
6 Determine dosages for non-prescription medication to recommend to residents with consideration given to age, weight and condition, etc. ( 3) Determine if a change in protocol is required when assessing a resident medical condition over the phone. Information provided by the resident will be considered in conjunction with observations such as tone of voice, responses and attitude. ( 3) Adjust Oxygen provided to resident by analysis of Oxygen saturation readings. ( 3) Determine when it is necessary to escalate to a physician. ( 4) Problem Solving Equipment required for a specific situation is not available. Equipment must be requested and modifications or substitutions made as appropriate until the correct equipment is received. ( 1) Request missing information in order to ensure resident files are complete. ( 1) Investigate and initiate resolution when incorrect medications are received. ( 2) React with urgency and appropriately in an emergency situation. ( 2) Ensure proper protocols are followed in patient care such as proper lift and/or repositioning procedures. ( 2) In the case of lack of response, or insufficient response to treatment, cease treatment as appropriate and notify the attending physician. ( 2) Contact authorities as appropriate in situations where elder abuse is suspected. ( 2) Follow established protocols in the event of a sudden deterioration in resident medical condition. ( 3) Interact with potentially agitated family members over the telephone, ensuring correct information is gathered, as well as probing for the underlying issue using a series of probing questions. Consideration should be given to escalating or referring the call to a supervisor as appropriate. ( 3) Consult colleagues or interpreters for assistance with residents in the event of a communication barrier due to language or disability. ( 4) Finding Information Access organizational databases to search for lab test results or treatment paths. ( 1) Consult the Compendium of Pharmaceutical and Specialties (CPS) manual to obtain information about medications. ( 1) Seek advice or input from other registered nurses or healthcare professionals with regard to treatment plans, procedures or protocols. ( 2) Review resident files to gather health information to guide decision making concerning treatment plans or follow up schedules, ensuring that data from multiple sources is cross-referenced. ( 2) Access policy and procedure manuals to verify rules and regulations. This may involve review of multiple pages or sources to locate particular information.( 2)
7 Gather health-related information from residents for consideration in the development of treatment plans. ( 3) Research available government and community services using the internet. ( 3) Use internet search engines to research medical conditions, treatments and recommended medications, analyzing and comprehending the information found. ( 3) Research unusual cases or diseases using a variety of resources and reference materials. Information found must be compiled and analyzed to identify appropriate next steps. ( 4) Working with Others May work independently or as part of a team. Work independently when meeting with residents, organizing daily tasks or developing individualized treatment plans, or when there are limited healthcare resources. May provide mentoring and support to new employees. Coordinate activities with other nurses and health professionals when providing health care to residents in larger facilities. For example, consulting other health professionals to get details on resident s medical conditions before deciding on treatment plans. May work in a team with registered nurses and other health professionals to ensure that appropriate and timely care is provided to residents. Coordinate and integrate team tasks and responsibilities to ensure that health services are effective and efficient. Participate in supervisory or leadership activities. o Participate in formal discussions about work processes or product improvement. o Monitor the work performance of others. o Inform other workers or demonstrate to them how tasks are performed. o Select contractors and suppliers. o Assign routine tasks to other workers. o Assign new or unusual tasks to other workers. o Identify training that is required by, or would be useful for, other workers Continuous Learning Participate in on-going training and learning in the field of nursing. Upon graduation, registered nurses are not necessarily familiar with all the protocols and procedures that may be specific to certain situations, organizations or establishments. Stay abreast of new technologies, diseases, practices and treatments by attending conferences, seminars and workshops or by reading medical and nursing journals, books, professional association bulletins or papers on the internet. Access or participate in on-site learning from other more experienced nurses or health professionals. Maintain CPR certification according to provincial regulations.
8 Primarily responsible for setting learning goals, although some provincial nursing associations may have specific requirements. For example, some nursing associations may require registered nurses to participate in conferences or professional development seminars and give credits for these participations.
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