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 (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
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) to ensure stable treatment therapy as indicated
Assesses patients response to hemodialysis treatment therapy, making 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, and 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 for Spectra or alternate lab
Ensures correct labs tubes are utilized for prescribed lab specimens and that lab draw and processing procedures are performed appropriately for all lab samples
Identifies and ensures appropriate follow-through regarding missed labs and specimens reported to be insufficient according to company policies and procedures
Ensures all specimens are appropriately packaged according to Department of Transportation (DOT) policies and procedures relating to shipment of blood or body fluid specimens and potentially hazardous material
Ensures that all labs are directed and delivered to appropriate labs
Reports alert/panic and abnormal labs 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
Act as a resource for other staff members
Routinely meets with the Clinical Manager to discuss personnel and patient care status, issues, and information
Collaborate and communicate 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, 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 as required by law
Assists with the coordination of patient transportation if necessary
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
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 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
Ensures and verify accuracy of Patient Care Technician documentation
Reviews and ensures appropriate daily completion of Hemodialysis Treatment Sheets by all patient care staff
Ensures that all appropriate procedures are followed regarding opening and closing procedures, inclusive of 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 information, 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 physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
The position provides direct patient care that regularly involves heavy lifting and moving of patients, and assisting with ambulation
Equipment aids and/or coworkers may provide assistance
This position requires frequent, prolonged periods of standing and the employee must be able to bend over
The employee may occasionally be required 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
The 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
Note that: Failing the Ishihara Test for Color Blindness does not preclude employment
The Company will consider whether reasonable accommodation can be made
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 in which he or she is 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
Employees have to 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
Must meet appropriate state requirements (if any)
ACKNOWLEDGEMENT: I acknowledge that I have read and accepted this job description
I understand what is expected of me in this position, and I am able to perform the essential functions as outlined with or without reasonable accommodation
Furthermore, I understand that the duties and responsibilities listed in this job description are intended only as illustrations of the various types of work that may be performed
The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position
If I have any questions about duties and responsibilities not specified in this job description that I am asked to perform, I should discuss them with my immediate supervisor or my Human Resources representative
ADDENDUM: Infusion Nurse Coordinator Coordinates and provides the delivery of patient services and the management of the POIC by performing the following duties personally or through subordinates
Standards of Practice Understands and conforms to the rules and regulations affecting the RN s current area of practice including federal, state and local laws
Know the rationale for and the effects of medications and treatments and shall correctly administer the same
Accurately and completely report and document
The client s status including signs, symptoms and responses
Care rendered
Physician orders
Administration of medications and treatments
Client response(s)
Contacts other health care team members concerning significant events regarding client s status
Respect the client s right to privacy by protecting confidential information unless obligated or allowed by law to disclose the information
Obtain instruction and supervision as necessary when implementing procedures or practices
Notify the appropriate supervisor when leaving an assignment
Know, recognize and maintain professional boundaries of the clinician-client relationship
Report unsafe nursing practice which a clinician has reasonable cause to suspect has exposed or is likely to expose a client unnecessarily to risk of harm as a result of failing to provide client care that conforms to the minimum standards of acceptable and prevailing professional practice
Be responsible for one s own continuing competence in clinical practice and individual professional growth
Ensures quality and safe delivery of OIC care service.Practice is guided by policies, procedures and standards of clinical practice
Understands and implements current standards of practice for infusion therapy
Adheres to policies related to medication safety, including documentation of orders, correct administration, double check procedures and other established policies and practices
Understands use of products and equipment
Observes and monitors OSHA, infection control and safety policies
Adopts practices to improve work processes, enhance customer/patient satisfaction and ensure excellence
Contributes to a safe and secure environment for patients, visitors and staff by following established procedures and protocols
Accurately documents, implements and evaluates Physician orders in a timely manner
Initiates teaching using patient teaching protocols and patient care standards
Identifies expected outcomes and nursing interventions to meet identified diagnosis
Implements nursing interventions to meet patient needs and changing conditions
Monitors patients for compliance with therapy
Completes all documentation accurately and timely
Maintains client/family rights and maintains confidentiality
Recognizes the nurse/patient/family relationship impacts the patient experience
Understands and respects nursing boundaries
Shows kindness and care with patient/family
Displays sensitivity to the needs and concerns of others
Drug Preparation and ManagementEnsures that drugs are ordered, received and stored properly
Maintains optimal drug and supply inventory and reports are submitted in a timely manner
Ensures that proper technique is used in the preparation of sterile products
Ensures that the mixing area is clean, neat and orderly at all times
Responsible for the accuracy of information recorded for proper patient billing
Ensures that all purchasing invoices and inventory records are completed and submitted in a timely manner
Participates in ongoing training and education
Referral ManagementSubmits referral timely and accurately
Notifies appropriate person of referral concerns
Roster is reviewed, updated and current
General Site ManagementCommunicates recommendations and requirements for additional services to appropriate individuals in a timely manner
Consistently addresses and communicates patient concerns to the Physician and OIC staff
Completes job tasks on time by planning and organizing the schedule of activities
Effectively communicates with Pharmacy for collaboration of protocols, patient care and Physician communication
Communicates with OIC staff, Division Managers, Physicians and Corporate clinical as necessary
Nursing calendar/ patient schedules reflects planned visits 2 weeks in advance
Delegates responsibilities appropriately
Performs nursing functions in staffing situations
Uses equipment and supplies effectively and efficiently
Monitors supplies to maintain appropriate inventory
Accurately performs drug and supply inventory
Nursing billing is accurate and timely
Ensures a RN is available at all times during OIC office hours
Ensures a RN is on call for emergencies involving patients 24 hours, if site not utilizing Healix Call Center Professional GrowthMonitors and maintains professional licensure and qualification of staff nursing
Participates in case conferences and staff meetings
Promotes importance of team collaboration and communications
Maintains professional competence, particularly in the areas of clinical knowledge
LeadershipPresents a positive image of the OIC at all times, and at professional functions, with patients, physicians, OIC staff, etc
Recognizes the impact of one s behavior of others
Deals with others in a pleasant and respectful manner
Assumes responsibility for improving care/services
Performs as a preceptor to other nurses
Monitors staff completion of assignments
Clearly defines work assignments
Resourceful in handling assignments and solving problems; flexible in adjusting to a new or changing work environment/requirement
Communicates with staff regarding assignments, as necessary
Performs Additional Assigned Responsibilities as necessaryFulfills additional responsibilities accurately and completely in a timely manner
Submits written reports in a timely manner
Cooperates with staff members according to OIC philosophy and objectives
Maintains consistent and concise lines of authority and responsibility
Participates in the development of patient education programs
Participates in establishing (written and instructing other staff) protocols for the initiation of new therapies or new care related programs
Participates in committee meetings
Actively participates in the CQI program through meetings and gathering of information
CORE DUTIES AND RESPONBILITIES Include the following basic performance factors all Healix, Inc
employees are expected to meet.Communicates with clients and fellow employees through written and verbal forms, clearly and timely
Interacts professionally with clients and fellow employees
Cooperates with team members to accomplish departmental goals
Accepts and incorporates changes or new ideas into daily work
Provides service in a responsive, timely and accurate manner to both clients and fellow employees
Understands and adheres to policies and procedures
Arrives at work as scheduled and notifies supervisors in a timely manner of any absences
Recognizes priorities and takes action; makes productive use of time
Strives to resolve problems and conflicts on his/her own initiative
Attempts to create new ideas or new procedures working as part of a group or individually
As a part of your job, you will receive protected health information
It is your responsibility to comply with HIPAA in using and disclosing health information
QUALIFICATIONS To perform this job successfully, an individual must be able to perform each essential duty satisfactorily
The requirements listed below are representative of the knowledge, skill and/or ability required
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
EDUCATION AND REQUIRED CREDENTIALS: BSN or AND or College or university program certificate; 2 4 years related experience and/or training; or equivalent combination of education and experience Applicable State License CPR certification OTHER SKILLS AND ABILITIES To perform this job successfully, an individual must have a minimum of two years recent clinical experience to include excellent IV skills One-year experience in Home Health Care or Home IV Therapy Management experience PHYSICAL DEMANDS AND WORKING CONDITIONS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
While performing the duties of this job, the employee is required to:Regularly use hands to finger, handle, or feel and talk or hear Frequently stand, walk, sit, reach with hands and arms, and stoop, kneel, crouch, or crawl Frequently lift and/or move up to 25 pound and occasionally lift and/or move up to 50 pounds Specific vision abilities required by this job include close vision WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
While performing the duties of this job, the employee is:Frequently exposed to blood borne pathogens Occasionally exposed to outside weather conditions The noise level in the work environment is usually moderate EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws
"The rate of pay for this position will depend on the successful candidate s work location and qualifications, including relevant education, work experience, skills, and competencies
Hourly Rate: $36.00 - $60.00"