Registered Nurse - RN - Dialysis

Travel off island is required for this position. Full‑time position requiring 40 hours of work per week. Employee must be able to travel to all Hawaii Region clinics including Guam. Travel assignments are assigned 1 month at a a time, at the minimum. Floating may be required during periods of low patient census or reduced need at the assigned clinic to ensure full utilization of scheduled hours. Shifts are rotational based on assigned clinic schedule. Purpose and Scope Functions as part of the hemodialysis health care team as a Staff Registered Nurse to ensure provision of quality patient care on a daily basis in accordance with FMS policies, procedures, and training. Supports the FMCNA’s mission, vision, values, and customer service philosophy. Supports the FMCNA commitment to the Quality Enhancement Program (QEP) and CQI Activities, including those related to patient satisfaction and actively participates in process improvement activities that enhance the likelihood that patients will achieve the FMCNA Quality Enhancement Goals (QEP). Adheres to all requirements of the FMCNA Compliance Program, and FMS patient care and administrative policies. Principal Duties and Responsibilities Directs Patient Care Technician’s provision of safe and effective delivery of chronic hemodialysis therapy to patients in compliance with standards outlined in the facility policy procedure manuals, as well as regulations set forth by the corporation, state, and federal agencies. Delegates tasks to all direct patient care staff including but not limited to LVN/LPNs, Patient Care Technicians, and Dialysis Assistants. Assesses daily patient care needs and develops appropriate patient care assignments. Routinely monitors patient care staff for appropriate techniques and adherence to facility policy and procedures. Participates in staff training and orientation of new staff as assigned; participates in all required staff meetings as scheduled. Ensures educational needs of patients and family are met regarding End Stage Renal Disease (ESRD); provides ongoing education to patients regarding their renal disease, vascular access and dialysis therapy, and other related health conditions. Discusses with patient, and records education related to diet/fluid and medication compliance. Provides patient specific detailed education regarding adequacy measures where applicable – Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM). Ensures transplant awareness, modality awareness, and drive catheter reduction; educates patients regarding laboratory values and the relationship to adequate dialysis therapy, compliance with treatment schedule, medications, and fluid. Accurately implements treatment prescriptions including Sodium (Na) modeling prescription, and Ultrafiltration modeling (where appropriate) to ensure stable treatment therapy as indicated. Assesses patients’ response to hemodialysis treatment therapy, makes appropriate adjustments and modifications to the treatment plan as indicated by the prescribing physician; communicates problems or concerns to the Team Leader or physician; identifies and communicates patient related issues to Team Leader or physician. Initiates Initial and Annual Nursing Assessment; performs ongoing evaluation and documentation of patient care needs according to FMC Policies and Procedures. Actively participates in the pre‑evaluation, initiation, monitoring, termination, access homeostasis, and post evaluation of patients receiving hemodialysis treatment therapy according to established FMC procedures. Takes appropriate intervention for changes in patient adequacy status and troubleshooting access flow issues as identified by OLC/AMP yellow lights; provides, supervises (if applicable), and monitors hemodialysis access care according to established procedures. Implements, administers, monitors, and documents patient’s response to prescribed interdialytic transfusions, including appropriate notification of adverse reactions to physician and appropriate blood supplier. Ensures accurate and complete documentation by Patient Care Technician on the Hemodialysis Treatment Sheet; reviews, transcribes, and enters physician lab orders accurately into the Medical Information System. Ensures appropriate preparation of lab requisitions, ensures correct lab tubes used, and that lab draw and processing procedures are performed appropriately for all lab samples. Ensures all specimens shipped according to Department of Transportation (DOT) policies and procedures relating to shipment of blood or body fluid specimens and potentially hazardous material. Reports alert/panic and abnormal lab results to appropriate physician; ensures lab results are forwarded to physicians as requested. Enforces all company approved policies and procedures, as well as regulations set forth by state and federal agencies and departments. Maintains overall shift operation in a safe, efficient, and effective manner; acts as a resource for other staff members; routinely meets with the Clinical Manager to discuss personnel and patient care status, issues, and information. Collaborates and communicates with physicians and other members of the healthcare team to interpret, adjust, and coordinate care provided to the patient. Provides assistance as needed to patients regarding prescription refills according to FMCNA Policies; ensures all physician orders are transcribed and entered into the Medical Information system in a timely manner. Oversees all documentation of patient information; maintains facility drug list for all required stock medications; maintains competency with all emergency operational procedures, initiates CPR and emergency measures in the event of a cardiac and/or respiratory arrest. Ensures vaccination, immunizations, and annual Tuberculosis (TB) testing; administers medications as prescribed or in accordance with approved algorithm(s), and documents appropriate medical justification if indicated. Maintains appropriate recording of controlled substances as required by law; assists with patient transportation when necessary; ensures a clean, safe, and sanitary environment in the dialysis facility treatment area; maintains competency in the operation of all dialysis‑related equipment safely and effectively. Ensures all patient stations, machines and chairs are clean and free of blood and placed appropriately; addresses blood spills according to FMCNA Bloodborne Pathogen Control Policies. Ensures all relevant data including physician orders, lab results, vital signs and treatment parameters, and patient status are documented appropriately and entered into Medical Information System. Ensures patient related treatment data is entered into the Medical Information System; implements correct patient admission, transfer, and discharge procedures; verifies accuracy of Patient Care Technician documentation. Reviews and ensures appropriate daily completion of Hemodialysis Treatment Sheets by all patient care staff; follows opening and closing procedures, including monitoring that all staff and patients have safely left the premises. Initiates, documents, and completes ongoing Continuous Quality Improvement (CQI) activities including monthly reports; completes monthly nurses’ progress note; ensures patient medical records are complete with appropriate documentation and identification on each page (Addressograph label is on all chart forms). Reviews transplant status and follows established procedure regarding appropriate action to be taken; completes patient care plans for new patients within the initial 30 days or any patients deemed unstable requiring monthly patient care plans. Completes any long‑term programs that are due; completes initial and annual Nursing History and Assessment physical; ensures completion of Annual Standing Order Review with each physician as required; performs additional duties as assigned. Physical Demands and Working Conditions The position provides direct patient care that regularly involves heavy lifting and moving of patients; assisting with ambulation. Requires frequent, prolonged periods of standing and the employee must be able to bend over. Employee may occasionally need to move, with assistance, machines and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. up as high as 5 feet. Work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. Employees are required to take the Ishihara’s Color Blindness test as a condition of employment; failing the test does not preclude employment. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and Required Credentials Graduate of an accredited School of Nursing. Current appropriate state licensure. Must meet the practice requirements in the state in which employed. Experience and Skills Minimum of one‑year medical‑surgical nursing experience preferred; hemodialysis experience preferred; ICU experience preferred. Successfully complete a training course in the theory and practice of hemodialysis. Successfully complete CPR certification. Employee must meet the necessary requirements of Ishihara’s Color Blindness test as a condition of employment. Provide coverage at any or all area facilities as required by management. Icd‑9 coding training, nurses technical training, and meet appropriate state requirements (if any). Compensation Hourly Rate: $42.00 – $60.00. Equal Opportunity Employer Fresenius Medical Care maintains a drug‑free workplace in accordance with applicable federal and state laws. Fresenius Medical Care is an equal opportunity employer and does not discriminate on the basis of race, color, religion, sexual orientation, gender identity, parental status, national origin, age, disability, military service, or other non‑merit‑based factors. #J-18808-Ljbffr