Dialysis RN - Full Time - Day Shift (4/10's)

Dialysis Registered Nurse

The Dialysis Registered Nurse provides and coordinates safe, evidence-based nursing care for patients requiring acute dialysis services at Bay Area Hospital. The RN is responsible for the assessment, planning, implementation, monitoring, and evaluation of dialysis treatment while managing the patient's clinical condition, vascular access, prescribed therapies, and dialysis equipment.

The Dialysis RN serves as a clinical resource for nursing staff, providers, patients, and families and supports the safe and effective operation of Bay Area Hospital's dialysis program. This position participates in staff education, competency validation, policy and procedure development, regulatory compliance, quality assurance and performance improvement activities, and ongoing evaluation of dialysis services.

Principle duties and responsibilities include:

• Providing safe, competent, and evidence-based nursing care to patients receiving hemodialysis and other assigned renal replacement therapies in accordance with provider orders, Hospital policies, standards of nursing practice, and applicable regulatory requirements.
• Performing comprehensive and ongoing patient assessments before, during, and following dialysis treatment, including evaluation of hemodynamic status, vascular access, fluid status, treatment response, and potential complications.
• Developing, implementing, evaluating, and documenting individualized nursing plans of care in collaboration with physicians, primary nurses, and other members of the interdisciplinary care team.
• Initiating, monitoring, adjusting, and discontinuing dialysis treatments in accordance with provider orders, approved protocols, established competencies, and RN scope of practice.
• Monitoring vascular access and recognizing signs of access dysfunction, infection, bleeding, infiltration, or other complications and initiating appropriate intervention and escalation.
• Administering medications, blood products, and prescribed fluids associated with dialysis treatment in accordance with Hospital policy and provider orders; monitoring and documenting patient response and promptly addressing adverse reactions.
• Recognizing changes in patient condition and initiating appropriate interventions, including emergency response measures, provider notification, and collaboration with the patient's interdisciplinary care team.
• Providing age-appropriate patient and family education regarding dialysis treatment, kidney disease, vascular access care, treatment expectations, and other identified learning needs.
• Coordinating dialysis care with physicians, nursing units, pharmacy, laboratory, Case Management, and other Hospital departments to promote continuity, timely treatment, and safe transitions of care.
• Serving as a clinical resource to Hospital staff regarding dialysis procedures, renal patient care, dialysis order sets, treatment requirements, and appropriate escalation of clinical concerns.
• Maintaining clinical competency and expertise in dialysis nursing practices, equipment, technology, infection prevention, emergency procedures, and applicable regulatory requirements.
• Performing required dialysis equipment and water-quality safety checks in accordance with Hospital policy, manufacturer requirements, and applicable standards, including appropriate testing, documentation, and escalation of results outside established parameters.
• Ensuring dialysis equipment, supplies, medications, and treatment areas are appropriately prepared, maintained, cleaned, and stored in accordance with infection prevention, safety, manufacturer, and regulatory requirements.
• Providing appropriate clinical direction and delegation to other members of the patient care team within applicable scope-of-practice requirements.
• Supporting orientation, competency validation, education, and ongoing development of staff involved in the care of dialysis patients.
• Providing dialysis-related education to Hospital staff when new processes, equipment, regulatory requirements, or standards of care are implemented.
• Participating in the development, review, and implementation of dialysis policies, procedures, protocols, order sets, competencies, and standards of care.
• Participating in chart audits, documentation review, regulatory readiness activities, and evaluation of compliance with established dialysis standards.
• Collecting, monitoring, and analyzing dialysis quality and operational data and assisting with identification and implementation of performance improvement initiatives.
• Participating in the Dialysis Quality Assurance and Performance Improvement program and recommending actions to improve patient safety, clinical outcomes, regulatory compliance, and program effectiveness.
• Participating in dialysis program meetings, safety reviews, quality initiatives, and interdisciplinary planning activities.
• Identifying and communicating quality, safety, equipment, supply, staffing, or operational concerns through appropriate Hospital channels.
• Maintaining complete, accurate, and timely documentation in the electronic medical record and other required clinical or quality systems.
• Maintaining compliance with infection prevention practices, including appropriate use of personal protective equipment, isolation precautions, and bloodborne pathogen standards.
• Participating in on-call coverage, including nights, weekends, and holidays, based on departmental and patient care needs.
• Performing other duties as assigned.

Skills and abilities include:

• Demonstrating strong clinical assessment, critical thinking, and decision-making skills in the care of medically complex dialysis patients.
• Demonstrating knowledge of hemodialysis principles, vascular access management, fluid and electrolyte balance, dialysis equipment, water-quality requirements, and potential treatment complications.
• Recognizing changes in patient condition and responding appropriately to urgent and emergent clinical situations.
• Communicating clearly, respectfully, and collaboratively with patients, families, physicians, nursing staff, and interdisciplinary team members.
• Demonstrating the ability to prioritize multiple responsibilities and adapt effectively to changing patient acuity and operational needs.
• Demonstrating effective leadership, delegation, organization, education, and clinical resource skills.
• Using quality and clinical data to identify opportunities for improvement and supports implementation of sustainable solutions.
• Demonstrating competency in electronic health records and technology necessary to support patient care and dialysis program operations.
• Maintaining regular, consistent, and punctual attendance at the assigned job location.

Education/certifications/licenses/degrees:

• Graduate of an accredited school of nursing, required
• Current, unencumbered Oregon Registered Nurse license, required
• Current American Heart Association Healthcare Provider Basic Life Support (BLS) certification, required
• Bachelor of Science in Nursing (BSN), preferred
• Certified Dialysis Nurse (CDN), Certified Nephrology Nurse (CNN), or other nationally recognized nephrology nursing certification, preferred
• Advanced Cardiac Life Support (ACLS) certification as appropriate to the assigned patient population and departmental requirements, preferred

Experience:

• Minimum one (1) year of Registered Nurse experience, required
• Dialysis experience or completion of a Bay Area Hospital-approved dialysis training and competency program prior to independently providing dialysis treatment, required
• One (1) year of dialysis/nephrology nursing experience, preferred
• Acute/inpatient hemodialysis experience, preferred
• Critical care, emergency, or other acute-care nursing experience, preferred
• Experience with dialysis equipment, vascular access management, and dialysis water-quality monitoring, preferred
• Experience participating in quality improvement, staff education, or dialysis program development, preferred

General information:

• Union Affiliation: ONA
• The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and job skills required.
• Physical/mental/environmental requirements include:
• Ability to perform the physical activities necessary to provide direct patient care, including prolonged standing and walking, bending, reaching, positioning patients, and assisting with patient mobility using appropriate equipment and assistance.
• Ability to safely move and operate dialysis machines, treatment equipment, supplies, and other patient-care equipment using appropriate mechanical aids and/or assistance when required.
• Ability to perform work requiring sustained attention, critical thinking, rapid clinical decision-making, and appropriate response to changes in patient condition and emergency situations.
• Potential exposure to blood, body fluids, blood products, medications, infectious or contagious diseases, cleaning agents, and other materials commonly encountered in an acute healthcare and dialysis environment; appropriate PPE is required.
• Ability to work in an environment involving medical equipment, alarms, moderate noise, frequent interruptions, computer use, and interaction with patients, families, physicians, and staff.
• Ability to participate in departmental scheduling requirements, including on-call coverage, nights, weekends, and holidays, based on patient care and operational needs.