Outpatient Registered Nurse - RN

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. 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 facility policy procedure manuals and regulations set forth by the corporation, state, and federal agencies. Delegates tasks to all direct patient care staff including LVN/LPNs, Patient Care Technicians, and Dialysis Assistants. Assesses daily patient care needs and develops appropriate patient care assignments. 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. Attends 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 renal disease, vascular access and dialysis therapy, and other related health conditions. Discusses and records education related to diet/fluid and medication compliance. Provides patient‑specific detailed education regarding adequacy measures such as Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), and Urea Kinetic Modeling (UKM). Ensures transplant and modality awareness and drives catheter reduction. Educates patients on laboratory values and their relationship to adequate dialysis therapy, treatment schedule compliance, medications, and fluid restriction. Delivers safe and effective care to patients with ESRD. Accurately implements treatment prescriptions, including Sodium modelling and Ultrafiltration modelling where appropriate. Assesses patients’ response to hemodialysis treatment, making appropriate adjustments and modifications to the treatment plan as indicated by the prescribing physician and communicates problems or concerns to the Team Leader or physician. Initiates the Initial and Annual Nursing Assessment and documents ongoing evaluation of patient care needs according to FMC Policies and Procedures. Participates in pre‑evaluation, initiation, monitoring, termination, access homeostasis, and post‑evaluation of patients receiving hemodialysis treatment according to established FMC procedures. Takes appropriate intervention for changes in patient adequacy status and troubleshoots access flow issues identified by OLC/AMP alerts. Supervises and monitors hemodialysis access care according to established procedures. Administers and documents patient response to prescribed interdialytic transfusions, including notification of adverse reactions to physician and blood supplier. Ensures accurate and complete documentation by Patient Care Technician on the Hemodialysis Treatment Sheet. Transcribes physician lab orders accurately into the Medical Information System. Prepares lab requisitions for Spectra or alternate labs and ensures correct lab tubes are used and draw/processing procedures are followed. Tracks and follows up on missed labs and specimens that are insufficient, in compliance with company policies and procedures. Packages specimens in accordance with DOT policies and procedures. Ensures that all labs are directed and delivered to appropriate labs and that abnormal results are reported to the appropriate physician. Enforces all company‑approved policies and procedures, and regulations set forth by state and federal agencies. Maintains overall shift operation in a safe, efficient, and effective manner. Acts as a resource for other staff members. Meetings with the Clinical Manager to discuss personnel and patient care status, issues, and information. Collaborates with physicians and other members of the healthcare team to interpret, adjust, and coordinate care for the patient. Assists patients with 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 the facility drug list for required stock medications. Maintains competency with all emergency operational procedures and initiates CPR and emergency measures during cardiac and/or respiratory arrest. Ensures verification and availability of adequate emergency equipment. Ensures provision of appropriate vaccinations, immunizations, and annual Tuberculosis (TB) testing. Administers medications as prescribed or in accordance with approved algorithms and documents appropriate medical justification if indicated. Administers PRN medications, completing appropriate documentation of assessment of effectiveness. Maintains controlled substance records as required by law. Assists with coordination of patient transportation when necessary. Ensures a clean, safe, and sanitary environment in the dialysis facility treatment area. Operates all dialysis‑related equipment safely and effectively. Ensures that all patient stations, including machines and chairs, are clean, free of blood, and appropriately positioned. Immediately addresses all blood spills according to FMCNA Bloodborne Pathogen Control Policies. Documents all relevant data – physician orders, lab results, vital signs, treatment parameters, and patient status – in the Medical Information System. Ensures accuracy of Patient Care Technician documentation and reviews completion of Hemodialysis Treatment Sheets. Follows proper opening and closing procedures, ensuring all staff and patients have safely left the premises. Initiates, documents, and completes ongoing CQI activities, including monthly reports. Completes monthly nurse progress notes. Ensures patient medical records are complete with appropriate identification on each page. Reviews transplant status and follows established procedures for appropriate action. Completes patient care plans for new patients within 30 days or for patients deemed unstable requiring monthly plans. Completes any long‑term programs that are due. Completes initial and annual Nursing History and Physical assessments. Completes annual standing order review with each physician as required. Performs additional duties as assigned. Physical Demands and Working Conditions Direct patient care involving heavy lifting and moving of patients, and assistance with ambulation; may lift up to 200 lbs. and chemical solutions up to 30 lbs. up to 5 feet. Frequent, prolonged periods of standing; ability to bend over is required. Work environment characteristic of a health care facility with controlled air temperature and moderate noise levels; exposure to infectious and contagious diseases/materials is possible. Color‑blindness testing is a condition of employment; reasonable accommodation may be provided. Supervision None. Education and Required Credentials Graduate of an accredited School of Nursing. Current appropriate state licensure. Must meet the practice requirements in the state of employment. Experience and Skills Minimum of one‑year medical‑surgical nursing experience preferred. Hemodialysis experience preferred. ICU experience preferred. Successful completion of a training course in the theory and practice of hemodialysis. CPR certification. Completion of Icd‑9 coding training. Completion of nurses technical training. Ability to provide coverage at any or all facility locations as required by management. Fresenius Medical Care maintains a drug‑free workplace in accordance with applicable federal and state laws. EOE, disability/veterans. #J-18808-Ljbffr