New Graduate Registered Nurse

About the Role

Functions as part of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a Staff Registered Nurse, to ensure provision of quality patient care daily. Supports the organization's mission, vision, values, and customer service philosophy. Supports the commitment to the Quality Enhancement Program (QEP) and CQI Activities, and actively participates in process improvement activities. Adheres to all requirements of the Compliance Program and patient care and administrative policies. Employees hired into this position will be required to obtain their nursing license and registration within the timeframe outlined in state specific regulations, or within 90 days from hire date, whichever comes sooner.

Key Responsibilities

Staff Related

• Directs Patient Care Technician’s provision of safe and effective delivery of chronic hemodialysis therapy.
• 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.
• Participates in all required staff meetings.

Patient Related

• 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, 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 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 their relationship to adequate dialysis therapy, compliance with treatment schedule, medications, and fluid.
• Provides safe and effective delivery of care to patients with ESRD.
• Accurately implements treatment prescriptions, including Sodium (Na) modeling prescription and Ultrafiltration modeling (where appropriate).
• Assesses patients’ response to hemodialysis treatment, making appropriate adjustments and modifications to the treatment plan. Communicates problems or concerns to the Team Leader or physician.
• Identifies and communicates patient-related issues to the Team Leader or physician.
• Initiates Initial and Annual Nursing Assessment, and ongoing evaluation and documentation of patient care needs.
• Actively participates in the pre-evaluation, initiation, monitoring, termination, access homeostasis, and post evaluation of patients receiving hemodialysis treatment.
• 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.
• Implements, administers, monitors, and documents patient's response to prescribed interdialytic transfusions, including appropriate notification of adverse reactions.
• Ensures accurate and complete documentation by Patient Care Technician on the Hemodialysis Treatment Sheet.

Laboratory-Related

• Reviews, transcribes, and enters physician lab orders accurately into the Medical Information System.
• Ensures appropriate preparation of lab requisitions for Spectra or alternate lab.
• Ensures correct lab tubes are utilized for prescribed lab specimens and that lab draw and processing procedures are performed appropriately.
• Identifies and ensures appropriate follow-through regarding missed labs and specimens reported to be insufficient.
• Ensures all specimens are appropriately packaged according to Department of Transportation (DOT) policies and procedures.
• Ensures that all labs are directed and delivered to appropriate labs.
• Reports alert/panic and abnormal lab results to the appropriate physician.
• Ensures lab results are forwarded to physicians as requested.

General Duties

• Enforces all company-approved policies and procedures, as well as 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.
• 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 patient care.
• Provides assistance as needed to patients regarding prescription refills.
• Ensures all physician orders are transcribed and entered into the Medical Information System in a timely manner.
• Oversees all patient information documentation.
• Maintains facility drug list for all required stock medications.
• Maintains competency with all emergency operational procedures, and initiates CPR and emergency measures in the event of a 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 algorithm(s), and documents appropriate medical justification if indicated.
• Administers PRN medications as prescribed and completes appropriate documentation of assessment of effectiveness.
• Maintains appropriate recording of controlled substances.
• Assists with the coordination of patient transportation if necessary.

Maintenance/Technical

• Ensures a clean, safe, and sanitary environment in the dialysis facility treatment area.
• Ensures competency in the operation of all dialysis-related equipment safely and effectively.
• Ensures all patient stations, including machines and chairs, are clean and free of blood and placed appropriately.
• Ensures that all blood spills are immediately addressed according to FMCNA Bloodborne Pathogen Control Policies.

Medical Records & Documentation

• Ensures all relevant data, including physician orders, lab results, vital signs, treatment parameters, and patient status, are documented appropriately and entered into the Medical Information System.
• Ensures all appropriate patient-related treatment data is entered into the Medical Information System.
• Ensures all FMCNA policies regarding patient admission, transfer, and discharge are appropriately implemented.
• Verifies accuracy of Patient Care Technician documentation.
• Reviews and ensures appropriate daily completion of Hemodialysis Treatment Sheets.
• Ensures that all appropriate procedures are followed regarding opening and closing procedures.
• 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 information, documentation, and identification.
• Reviews transplant status and follows established procedure regarding appropriate action.
• 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.

Other

• As a condition of continued employment, required to obtain and maintain any required credentials or certifications necessary for the position in an active and valid status.
• Capable of working in a challenging environment which requires the ability to handle demanding situations, multitasking, and remaining flexible to changing needs.
• Maintain regular and punctual attendance.
• Perform other related duties as assigned.

Physical Demands and Working Conditions

• Provides direct patient care that regularly involves heavy lifting and moving of patients and assisting with ambulation.
• Requires frequent, prolonged periods of standing and the ability to bend over.
• May occasionally be required to move, with assistance, machines and equipment of up to 200 lbs.
• May lift chemical and water solutions of up to 30 lbs. as high as 5 feet.
• May be exposed to infectious and contagious diseases/materials.
• Required to take the Ishihara's Color Blindness test as a condition of employment.

Requirements & Tech Stack

Education

• Graduated from an accredited nursing program within the past 12 months.

Experience & Skills

• Required to obtain nursing license and registration within the timeline defined by state regulations, or within 90 days of hire, whichever occurs first.
• Current appropriate state Temporary Permit.
• Must meet the practice requirements in the state in which he or she is employed.