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Assistant Director of Nursing (ADON)

Location: County Jail / Correctional Healthcare Setting
Reports To: Director of Nursing (DON)
Classification: Full-Time Leadership Position

Position Summary

The Assistant Director of Nursing (ADON) provides  leadership, coordination, and oversight of nursing and clinical operations within the County Jail. The ADON is responsible for promoting safe, timely, and compliant healthcare delivery to the inmate population while ensuring nursing practices align with established medical protocols, facility policies, contractual requirements, and applicable correctional healthcare standards.

The ADON provides direct clinical and operational leadership to nursing staff, assists with daily staffing and workflow management, monitors clinical documentation and compliance, supports employee training and performance management, and works collaboratively with the DON, medical providers, correctional leadership, and other members of the interdisciplinary healthcare team.

The ADON serves as a key clinical leader within the facility and may assume the responsibilities of the DON during periods of absence or as otherwise assigned.

Essential Duties and Responsibilities

Clinical Leadership & Oversight

• Provide daily oversight and coordination of nursing services within the facility.
• Provide clinical guidance, leadership, and support to Registered Nurses (RNs), Licensed Practical Nurses (LPNs), and other healthcare staff.
• Promote consistent adherence to established nursing standards, medical protocols, policies, procedures, and provider orders.
• Serve as a clinical resource for nursing staff regarding patient care concerns, changes in condition, documentation, medication administration, emergency response, and other clinical matters.
• Identify, escalating, and resolving clinical concerns that may impact patient safety, continuity of care, or contractual compliance.
• Collaborate with medical providers and interdisciplinary team members to facilitate appropriate and timely healthcare services.
• Oversight of booking/intake medical screenings, health appraisals, sick call, medication administration, chronic care, detoxification protocols, restrictive housing assessments, and other required clinical services.
• Ensure nursing staff appropriately identify and escalate patients requiring emergency evaluation or a higher level of care.
• Assist with coordination of care for inmates requiring outside medical services, hospitalization, specialty care, or follow-up treatment.

Clinical Compliance & HealthSecure Monitoring

• Review designated HealthSecure reports and clinical workflows daily to identify incomplete, overdue, or noncompliant patient care activities.
• Monitor and follow up on clinical compliance areas including, but not limited to:
  • Annual physical examinations and health appraisals
  • TB screening requirements
  • Inmate kitchen worker health screenings
  • Medication delivery and administration
  • Incomplete non-medication orders
  • Detoxification assessments and monitoring
  • Medication renewals
  • Restrictive housing compliance
  • Pharmacy receipt reconciliation
  • Returned medication reconciliation
  • Clinical documentation and outstanding patient care tasks
• Work directly with nursing staff to correct identified deficiencies and ensure required documentation and patient care activities are completed within established timeframes.
• Conduct routine medical record reviews and audits to evaluate documentation accuracy, completeness, timeliness, and compliance.
• Monitor medication administration records (MARs), medical forms, clinical logs, and other required healthcare documentation.
• Identify trends in clinical errors or documentation deficiencies and assist the DON with developing corrective action, education, or process improvement plans.

Medication, Narcotic & Medical Equipment Oversight

• Oversee medication management processes and ensure medications are securely stored, administered, documented, reconciled, and maintained in accordance with applicable policies and protocols.
• Oversee or verify completion of required daily and weekly counts of narcotics, controlled substances, sharps, and other accountable medical items.
• Ensure discrepancies involving narcotics, medications, sharps, or other controlled items are immediately investigated, escalated, and documented according to policy.
• Monitor pharmacy receipt and returned medication reconciliation processes.
• Ensure required checks of medical refrigerators, oxygen tanks, emergency equipment, eye wash stations, radios, and other designated medical equipment are completed and documented.
• Maintain appropriate medication and medical supply inventory levels and identifying potential shortages.

Staffing & Daily Operations

• Ensure appropriate nursing coverage and staffing levels are maintained in accordance with the established staffing matrix and contractual requirements.
• Monitor daily staffing and proactively identify potential coverage gaps.
• Assist with scheduling, call-out coverage, shift adjustments, overtime management, and other staffing needs.
• Provide leadership support to nursing staff during assigned shifts and assist with resolving operational or clinical concerns.
• Participate in leadership coverage and on-call responsibilities as assigned.
• Coordinate with facility leadership when staffing, security, or operational concerns may impact healthcare delivery.
• Assume DON responsibilities when designated during the DON’s absence.

Quality Improvement & Regulatory Compliance

• Support compliance with applicable American Correctional Association (ACA), Virginia Department of Corrections (VADOC), Prison Rape Elimination Act (PREA), facility, contractual, and correctional healthcare requirements.
• Participate in the facility’s Continuous Quality Improvement (CQI) program.
• Assist with monthly clinical audits, medical record monitoring, data collection, and identification of trends or opportunities for improvement.
• Participate in development and implementation of corrective action and performance improvement initiatives.
• Monitor progress following corrective action to ensure sustained compliance.
• Prepare clinical information, audit findings, and supporting documentation for leadership and quality improvement meetings.
• Participate in Medical Audit Committee (MAC), CQI, clinical leadership, or other meetings as requested.
• Prepare for regulatory, contractual, accreditation, or client audits and site reviews.

Staff Training, Education & Competency

• Assist with orientation and training of newly hired nursing staff before independent assignment within the facility.
• Provide or coordinate training related to facility workflows, HealthSecure, clinical protocols, documentation requirements, medication administration, emergency procedures, and correctional healthcare practices.
• Serve as a preceptor or designate qualified preceptors for newly hired clinical staff.
• Evaluate staff competency and identify areas requiring additional training or remediation.
• Ensure nursing staff complete required annual education and competency requirements.
• Support compliance with the requirement for clinical employees to maintain documented continuing education in accordance with ACA standards.
• Provide real-time coaching and education when clinical or documentation deficiencies are identified.

Employee Performance & Accountability

• Monitor employee performance, professionalism, attendance, clinical practice, and compliance with facility and organizational expectations.
• Provide timely coaching and feedback to nursing staff when performance concerns are identified.
• Document performance concerns and communicate significant or recurring issues to the DON.
• Provide employee counseling, corrective action, and disciplinary processes when appropriate.
• Participate in employee evaluations and competency assessments as assigned.
• Recognize positive employee performance and promote a culture of accountability, teamwork, professionalism, and patient safety.
• Maintain confidentiality and professionalism when addressing employee relations and performance matters.

Correctional Environment & Security

• Maintain awareness of the unique safety and security requirements associated with providing healthcare within a correctional environment.
• Comply with all County Jail security policies, procedures, and directives.
• Work collaboratively with correctional officers and facility leadership while maintaining appropriate clinical independence and patient confidentiality.
• Ensure nursing staff follow security requirements when handling medications, sharps, medical equipment, keys, radios, and other controlled items.
• Immediately communicate safety, security, or patient care concerns through the appropriate chain of command.
• Maintain professional boundaries with inmates at all times.

Required Qualifications

• Current, unrestricted Registered Nurse (RN) license in the state in which services are provided.
• Current Basic Life Support (BLS) certification.
• Minimum of three years of professional nursing experience.
• Previous charge nurse, nursing supervisor, clinical leadership, or nursing management experience preferred.
• Correctional healthcare, emergency department, behavioral health, acute care, or other high-acuity nursing experience strongly preferred.
• Demonstrated knowledge of nursing standards of practice, medication administration, clinical documentation, infection prevention, emergency response, and patient safety.
• Ability to effectively supervise, coach, and provide clinical direction to nursing staff.
• Strong organizational, communication, critical-thinking, and problem-solving skills.
• Ability to work effectively in a multidisciplinary and correctional environment.
• Ability to read, write, speak, and comprehend English.
• Ability to successfully complete all required facility security clearance, background screening, drug screening, TB screening, orientation, PREA training, and other onboarding requirements.

Preferred Qualifications

• Bachelor’s Degree in Nursing (BSN).
• Previous Assistant Director of Nursing, Nurse Manager, Clinical Supervisor, or comparable leadership experience.
• Experience working within a jail, prison, detention center, behavioral health facility, or other secure healthcare environment.
• Experience with correctional healthcare accreditation and regulatory standards, including ACA and VADOC requirements.
• Experience with electronic medical record systems and clinical auditing.
• Experience with Continuous Quality Improvement (CQI) programs and performance improvement initiatives.

Knowledge, Skills & Abilities

The successful candidate will demonstrate:

• Strong clinical judgment and the ability to make sound decisions in a fast-paced environment.
• Effective leadership and the ability to hold staff accountable while maintaining a collaborative working environment.
• Ability to identify clinical risks and intervene appropriately.
• Strong attention to detail and ability to identify documentation or compliance deficiencies.
• Ability to prioritize multiple clinical, staffing, and administrative responsibilities.
• Effective verbal and written communication skills.
• Ability to communicate professionally with nursing staff, medical providers, correctional personnel, organizational leadership, and other stakeholders.
• Ability to maintain confidentiality and handle sensitive clinical and personnel matters appropriately.
• Ability to remain calm and provide leadership during emergencies, staffing challenges, and other high-pressure situations.

Working Conditions

• Work is performed within a secure county jail environment.
• Position requires regular interaction with incarcerated individuals, healthcare personnel, correctional officers, medical providers, and facility leadership.
• Must comply with all security procedures and maintain required security clearance.
• May require participation in after-hours or on-call leadership coverage.
• May require flexibility in scheduling based on staffing levels, clinical needs, emergencies, audits, or facility operations.
• Must be able to respond appropriately to medical emergencies and other urgent situations occurring within the facility.

Leadership Expectations

The Assistant Director of Nursing is expected to model professionalism, clinical excellence, accountability, teamwork, and respect. The ADON should maintain a visible presence within the clinical operation, proactively identify concerns, support nursing staff, and work collaboratively with the DON and facility leadership to ensure safe, consistent, and compliant healthcare delivery.

The ADON plays an integral role in maintaining continuity of operations and ensuring that clinical standards are consistently met across all shifts.

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