Dialysis Nurse

Dialysis Nurse - Full Time - Day Shift - Monday - Friday

Education:

Graduate of an approved diploma, associate or bachelor nursing program.

Completion of accredited dialysis training program.

Experience:

One year dialysis experience

BLS certification to be obtained within first month of employment.

Current Georgia License as a Registered Nurse.

Duties and Responsibilities:

Demonstrates knowledge of Dialyzer and R/O.

Demonstrates competence in equipment setup: bicarb, chlorine test strips, priming, dialyzer, and bloodline, machine and alarm checks.

Demonstrates ability to administer IV solutions, medications, and blood during dialysis.

Possess competence in vascular access, dialysis catheters, fistula/graft, blood sample collection, and access site dressings and changes appropriately.

Utilizes standard precautions, transmission based precautions, hand hygiene, sterile technique/aseptic technique.

Monitors patient and adjusts equipment as necessary.

Monitors vital signs, blood flow rates, arterial/venous pressures, volume status, anticoagulation delivery, alarms, and ultrafiltration calculations.

Identifies irregular dialysis reaction and activates emergency procedure.

Records patient vital signs and reactions.

All required documentation is thorough including flowsheets, assessments, and interventions as well as maintains machine quality and maintenance checklists.

Entries are legible.

Demonstrates knowledge of HIPAA regulations.

Demonstrates knowledge of: access problems, airembolism, allergic reactions, arrhythmias, cardiac arrest, blood leak/loss, hypertension/hypotension, and seizures.

Maintains adequate levels of supplies.

Works with materials manager on establishing appropriate inventories.

Utilizes cephalo-caudal approach to physical assessment.

Develops assessments to include: Nutritional Screening, Fall/Risk, Functional, Pain, Skin Integrity, Cultural/Spiritual, Psycho-social, DVT Risk, Suicide, and Pneumococcal/Flu.

Identifies complex problems in the assessment and initiates the plan of care utilizing nursing problems when appropriate.

Notifies physician and charge nurse of any pertinent assessment findings.

Reviews and updates plan of care to reflect changes in patient status.

Demonstrates competency in clinical skills and knowledge pertinent to the practice and education of the Registered Nurse.

Implements the physician's orders promptly and appropriately with understanding of the purpose of each as it relates to the patient's plan of care.

Monitors the patient's condition and maintains accurate documentation (vital signs, alertness, mobility, condition of wound or operative site, etc.).

Reports abnormalities or instability of the patient's condition in a timely manner to appropriate persons (charge nurse, physician, director, administrative supervisor, CARE Team).

Ensures readiness of chart for procedure or surgery (pre-op checklist, lab, EKG, x-ray and documentation in the nurse's notes).

Responsible with assistance of patient and/or family for surgery site marking by provider if applicable.

Coordinates the care and preparation of patients for procedures, treatments or surgery (proper prep, dress and premedication).

Assesses the patient upon return from surgery or other procedures and documents findings in the patient care profile.

Performs verification (time out) prior to invasive procedures as designated by policy.

Responds appropriately and timely to clinical alarms (IV pumps, monitor alarms, bed alarms, etc.).

Implements Pain Management program.

Performs and documents hourly rounding, or as appropriate for unit.

Ensures the patient's hygienic needs are met (AM care, PM care, toileting, etc.).

Implements and monitors restraint use per policy.

Consults other disciplines as indicated by assessment findings.

Administers emergency resuscitation of patients in cardiac arrest.

Implements and maintains standard or high fall risk precautions as indicated.

Confirms two patient identifiers (name, date of birth and/or hospital number) when providing care and specimen collection.

Charge Nurse Responsibilities:

Makes appropriate staff assignments to include coverage for patient care during meals and breaks.

Acts as liaison between physicians, patients, visitors and staff.

Demonstrates ability to make prompt decisions based on sound judgment.

Demonstrates critical thinking skills.

Assumes responsibility for completeness and quality of nursing care provided by staff assigned to the unit

Administers medications in a safe, timely manner and correctly documents their administration.

Utilizes two patient identifiers before giving medication according to policy.

Records the patient's response to the medications in the patient care profile when appropriate.

Uses 5 "R"s for administering medications.

Demonstrates knowledge of drugs used.

Identifies and reports adverse drug reactions per policy.

Demonstrates proper use of pyxis: Resolves all discrepancies before end of shift. Utilizes override feature in appropriate situations.

Performs venipuncture per policy.

Maintains and accesses central lines/PICC's.

Administers blood products.

Checks and documents status of IV/INT per department policy.

Demonstrates proper use of IV equipment.

Adheres to medication reconciliation policy.

Adheres to principles of medication security.

Obtains narcotics from PYXIS/Pharmacy and documents administration and wastes per policy.

Assesses/monitors PCA patients per policy.

Gathers information pertinent to the medication(s) ordered: actions, purpose, normal dosage and route, common side effects, time of onset and peak action, nursing implications.

Performs real-time documentation.

Conforms to department documentation standards.

Reports and records pertinent information related to nursing plan of care.

Demonstrates proficient use of computer and adheres to departmental policy.

Records accurately in the medical record nursing actions: Reflect care given to the patient, Observations made about the patient, Patient's response to treatments or medications, Restraints, Pain Management.

Complies with "Do Not Use Abbreviations".

Repeats and verifies all verbal/phone orders and test results.

Provides the patient with an explanation of his/her condition and written information when possible.

Participates in pre and post-operative teaching of surgical patients.

Includes family and/or significant other in health teaching when possible.

Plans with the patient, family, and/or significant other for discharge.

Reviews home care instructions with patient or responsible party and document same in the patient care profile/discharge form.

Initiates consultation with other health care professionals.

Extends courtesy and demonstrates cooperation while communicating with others.

Gives a concise, pertinent report to the oncoming nurse providing opportunity for questions.

Utilizes effective communication skills with patients, families, Charge Nurse, Medical Staff, Director, Administrative Supervisor, peers and co-workers in a pleasant positive manner.

Accepts suggestions and criticisms and whenever necessary undertakes to change personal behavior or seek further guidance.

Delivers hand off communication when care provided or level/location of care changes.

Effectively leads and directs activities of others in a positive manner.

Assumes relief charge nurse, team leader or patient care responsibilities as necessary.

Demonstrates flexibility and adaptability rotating to another shift or unit when need arises.

Supports the philosophy, policies and procedures of the Division of Nursing.

Assumes responsibility for completeness and quality of nursing care provided by his/her team members including private duty nurses, nursing students and supplemental staff.

Demonstrates skill in supervising subordinates in performing their duties.

Participates in Nursing Service Quality Improvement activities in evaluating patient care (QI studies, monthly monitoring, etc.)

Participates in the orientation process of new employees.

Maintains BLS certification.

Possesses certification in