POSITION DESCRIPTION / PERFORMANCE EVALUATION

Job Title: Nursing Assistant

Prepared by: __________________________________
Date: ________________________________________

Supervised by: Director of Nursing

Approved by: ___________________________
Date: _________________________________

Job Summary: The nursing assistant is responsible for performing tasks which involve direct services for patients
delegated by a registered nurse and performed under the supervision of a registered nurse or licensed practical nurse.
Obtains and transmits urine, blood and other specimens for lab analysis.
DUTIES AND RESPONSIBILITIES:
Performance is clearly outstanding;Performance is superior it far exceeds standards
E = Excellent
or expectations;Performance is exceptional on a continuous basis.
G = Good
S = Satisfactory

Performance generally meets or exceeds standards or expectations;Attains all or nearly

all of position objectives.
Performance is adequate it meets standards or expectations, and is developing within
the position.

NI = Needs Improvement

Fails to meet one or more job expectations.

U = Unacceptable

Performance is below accepted levels;Fails to meet most job expectations.

NI

Performs assigned treatment or procedures accurately and with good

technique.

Makes observations of common changes in patients condition.

Reports observation to appropriate person.

Documents observation accurately.

Collects basic patient data as assigned such as vital signs, oral intake, and
output, etc.

Assists and accompanies patient in admission, transfer and discharge process.

Performs direct patient care as assigned to provide for the physical comfort of
the patient, in accordance with the nursing care plan.

Familiar with duties and performs them accurately, recognizing their

importance and relationship to patient care.

Responsible for completion of assignments without interference to quality of

work.

Contributes to the revision of the care plan by making suggestions.

Contributes to the evaluation of the response of the patient to his/her plan.

Contributes to the revision of the patient care plan according to changing

needs of the patient.

Demonstrates Competency in the Following Areas:

Assists licensed staff with patient care following directions and precise
manner.

Assists licensed staff in formation of nursing care plan.

Demonstrates Competency in the Following Areas:

NI

Reports malfunctioning equipment and safety hazards to appropriate person.

Assists in keeping stocked supplies clean and up to date.

Has current knowledge of proper equipment usage.

Able to perform in an accurate and precise manner in crises and emergency

situations when time is of the essence.

Able to adapt to change in workload or patient assignments.

Recognizes and performs duties which need to be performed although not

directly assigned.

Seeks guidance and direction as necessary for performance of duties.

Recognizes and responds to priorities in patient care process.

Maintains CPR skills.

Reports to work on time.

Provides proper notification for absence or tardiness.

Takes corrective action to prevent recurring absences.

Appearance and attitude conducive to good working relationship.

Observes hospital uniform code or dress guidelines and wears ID badge.

Establishes good rapport with patient, families, and visitors respecting patients
rights to privacy and confidentiality of information.

Provides direction to patients, families and visitors in a courteous, precise

manner with a positive tone.

Establishes good rapport and working relationships with co-workers, other

nursing personnel, physicians, and supervisory staff.

Attends staff meetings on regular basis (at least 8 per year).

Attends inservice offerings when appropriate.

Demonstrates understanding of emergency procedures, fire drills, evacuation

procedures and internal/external disaster plans and procedures.

Special Training (OB, ER) has been trained and performs to expectations.

Helps assure a clean, safe environment with well-stocked supplies and

functioning equipment.

Show initiative and sound judgment in routine situations as well as

during emergencies.

Prompt reliable and regular in attendance.

Keeps working knowledge current and changes when the need arises.

Professional Requirements:

NI

Adheres to dress code, appearance is neat and clean.

Completes annual education requirements.

Maintains regulatory requirements, including all state and federal regulations.

Adheres to the Group I level of HIPAA Minimum Necessary Standard when

using, disclosing or requesting Protected Health Information (PHI).

Reports to work on time and as scheduled.

Wears identification while on duty.

Attends annual review and performs departmental inservices.

Works at maintaining a good rapport and a cooperative working relationship

with physicians, departments and staff.

Represents the organization in a positive and professional manner.

Attends committee, CQI and management meetings, as appropriate.

Resolves personnel concerns at the departmental level, utilizing the grievance

process as required.

Ensures compliance with policies and procedures regarding department

operations, fire, safety and infection control.

Effectively and consistently communicates administrative directive to personnel

and encourages interactive departmental meetings and discussions.

Complies with all organizational policies regarding ethical business practices.

Communicates the mission, ethics and goals of the facility, as well as the focus
statement of the department.

Total Points

___

___

___

___

___

Education/Experience Requirements:

Able to communicate effectively in English, both verbally and in writing.

Self motivated and willingness to learn & be trained.

Current CPR, ACLS, & PALS required within 1 year.

Ability to work cooperatively with medical staff, patients and families.

Physical Demands:

Able to lift up to but not limited to 40 lbs.

For physical demands of position, including vision, hearing, repetitive motion and environment, see following
description.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential
functions of the position without compromising patient care.

=======================================================================================
I have received, read and understand the Position Description/Performance Evaluation above.

Name/Signature

Date Signed

DESCRIPTION OF
PHYSICAL DEMANDS
JOB TITLE: Nursing Assistant

DEPARTMENT: Nursing

NAME:

# HOURS/WORKDAY: 8

DEVELOPED BY:

DATE DEVELOPED: 1/7/05

MANAGER SIGNATURE:

DATE:

CHECK APPROPRIATE BOX FOR EACH OF THE FOLLOWING ITEMS TO BEST DESCRIBE THE EXTENT OF THE SPECIFIC
ACTIVITY PERFORMED BY THE STAFF MEMBERS IN THIS POSITION
This job requires exposure to the following environmental conditions.
Show the amount of time by checking the appropriate boxes below.

PHYSICAL DEMANDS
On-the-job time is spent in the following physical activities
Show the amount of time by checking the appropriate boxes below.

Stand:
Walk:
Sit:
Talk or hear:
Use hands to finger, handle or feel:
Push/Pull:
Stoop, kneel, crouch or crawl:
Reach with hands and arms:
Taste or smell:

Amount of Time
None up to 1/3 to 2/3 and
1/3
1/2
more
X
X
X
X
X
X
X
X
X

This job requires that weight be lifted or force be exerted. Show how
much and how often by checking the appropriate boxes below.

Up to 10 pounds:
Up to 25 pounds:
Up to 50 pounds:
Up to 100 pounds:
More than 100 pounds:

Amount of Time
None
up to 1/3 to 2/3 and
1/3
1/2
more
X
X
X
X

Wet, humid conditions (non-weather):

Work near moving mechanical parts:
Fumes or airborne particles:
Toxic or caustic chemicals:
Outdoor weather conditions:
Extreme cold (non-weather):
Extreme heat (non-weather):
Risk of electrical shock:
Work with explosives:
Risk of radiation:
Vibration:

The typical noise level for the work environment is:

Check all that apply.

Very Quiet

Loud Noise

Quiet

Very Loud Noise
x
Moderate Noise
Hearing:
x
Ability to hear alarms on equipment
x
Ability to hear patient call
x
Ability to hear instructions from physician/department staff

REPETITIVE MOTION ACTIONS

This job has special vision requirements. Check all that apply.

Repetitive use of foot control

A. Right only
B. Left Only
C. Both

x

x

x

x

Close Vision (clear vision at 20 inches or less)

Distance Vision (clear vision at 20 feet or more)
Color Vision (ability to identify and distinguish colors)
Peripheral Vision (ability to observe an area that can
be seen up and down or to the left and right while
eyes are fixed on a given point)
x
Depth Perception (three-dimensional vision; ability
to judge distances and spatial relationships)
x
Ability to Adjust Focus (ability to adjust eye to
bring an object into sharp focus)

No Special Vision Requirements

Repetitive use of hands

A. Right only
B. Left Only
C. Both
Grasping: simple/light
A. Right only
B. Left Only
C. Both
Grasping: firm/heavy
A. Right only
B. Left Only
C. Both
Fine Dexterity
A. Right only
B. Left Only
C. Both

Specific demands not listed: ________________________________

_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
Note:

Amount of Time
None Up to 1/3 to 2/3 and
1/3
1/2
more
X
X
X
X
X
X
X
X
X
X
X

Reasonable accommodations may be made to enable

individuals with disabilities to perform the essential functions of
this position.

WORK ENVIRONMENT
5

Number of Hours
1-2
3-4
5-6
7+

PERFORMANCE EVALUATION CONTINUATION PAGE

Staff Member: ___________________________________
Performance Evaluation Score:
# of total points achieved
___________

Job Title: ________________________

240 152 points = Excellent

151 144 = Good
143 96 = Satisfactory
95 48 = Needs Improvement
47 0 = Unacceptable

100%
100%
75%
50%
25%

merit increase
merit increase
merit increase
merit increase
merit increase

Supervisors Comments:

Recommended Goals/Actions:

Staff Member Comments:

Actions Recommended by Supervisor: Current Wage: _____________ New Wage: __________

Performance Review Only

Cost of Living Increase: __________

Next Performance Review on: __________

Acknowledgement of Job Description

Total Increase: __________

Salary Increase Denied

Salary Increase: __________

____________________________________________
Staff Member Signature

__________________________
Date

____________________________________________
Supervisor Signature

__________________________
Date

____________________________________________
Administrative Signature

__________________________
Date

PERSONNEL MEMBER
ANNUAL PROFESSIONAL PERFORMANCE AND COMPETENCY EVALUATION
As a member of the Okeene Municipal Hospitals personnel team, your comments and input are important
to both our continuing development and quality provision of patient care and services. Your continued
professional growth and job satisfaction are primary goals of the hospital. The administrative team and
your department supervisor are interested in your comments regarding the following:
1 - 5
(1 = poor, 5 = excellent)

1.

How would you rate your current job satisfaction level?

2.

How would you rate your current job performance?

3.

How would you rate the organizations provision of personnel benefits?

4.

How would you rate the organizations provisions for personnel continuing education?

5.

How would you rate the organizations physical working environment?

6.

How would you rate the organizations emotional working environment?

7.

List your professional goals:

8.

List any departmental goals that may differ from professional goals (include educational and
performance goals):

9.

Is there anything the organization can do to help you achieve any of these goals?

10.

If so, please describe:

11.

Comments you feel may assist the organization with improving personnel satisfaction levels:

Note: This organization pledges to utilize information provided for the sole purpose of improving
personnel satisfaction and assisting the author with achievement of advanced personal and/or
professional growth.