New Graduate Nurse

Fresenius Medical Care•Newport News, VA

About The Position

Functions as part of the hemodialysis health care team as a Registered Nurse Applicant under the direction or supervision of a Staff Registered Nurse, providing daily quality patient care in accordance with company policies, procedures, and training. Supports the company’s mission, vision, values, customer service philosophy, Quality Enhancement Program, and continuous quality improvement activities. Follows the Compliance Program and patient-care and administrative policies. The employee must obtain a nursing license and registration within the timeframe required by state regulations or within 90 days of hire, whichever comes first. The role supports staff and patient care across hemodialysis treatment, patient and family education, laboratory processes, medication administration, emergency readiness, facility safety, and medical record documentation. It includes assessing patient needs, delegating and monitoring staff activities, coordinating care with physicians and other healthcare professionals, and completing required daily, monthly, and annual clinical documentation and quality activities. The position involves direct patient care, including heavy lifting and moving patients and assisting with ambulation. It requires frequent, prolonged standing and bending. With assistance, the employee may occasionally move machines and equipment weighing up to 200 pounds, and may lift chemical and water solutions weighing up to 30 pounds to heights of up to five feet. The healthcare-facility environment has controlled air temperature and moderate noise; exposure to infectious and contagious diseases or materials may occur. An Ishihara color blindness test is required as a condition of employment, but failing the test does not preclude employment; reasonable accommodation may be considered. The position has no supervisory responsibility.

Requirements

Graduated from an accredited nursing program within the past 12 months.
Obtain nursing license and registration within the timeframe defined by state regulations or within 90 days of hire, whichever occurs first.
Current appropriate state Temporary Permit.
Meet practice requirements in the state of employment.
Maintain any credentials or certifications required for the position in active and valid status, including timely renewal.
Able to handle demanding situations, multitask, and remain flexible as needs change.
Maintain regular and punctual attendance.
Able to perform the described physical demands, including frequent prolonged standing, bending, heavy patient lifting and moving, and occasional assisted movement of equipment and lifting of solutions.

Responsibilities

Direct Patient Care Technicians’ provision of safe and effective chronic hemodialysis therapy in accordance with facility procedures and applicable regulations.
Delegate tasks to direct patient-care staff, including LVN/LPNs, Patient Care Technicians, and Dialysis Assistants.
Assess daily patient-care needs and develop patient-care assignments.
Monitor patient-care staff techniques and adherence to facility policies and procedures.
Participate in staff training, new-staff orientation, and required staff meetings as assigned or scheduled.
Educate patients and families about end-stage renal disease, renal disease, vascular access, dialysis therapy, related health conditions, diet and fluid intake, medication compliance, adequacy measures, transplant and modality awareness, catheter reduction, laboratory values, and treatment compliance.
Provide safe and effective care to patients with ESRD and implement treatment prescriptions, including sodium and ultrafiltration modeling where appropriate.
Assess patient response to hemodialysis, adjust or modify treatment plans as indicated by the prescribing physician, and communicate issues to the Team Leader or physician.
Initiate initial and annual nursing assessments and perform ongoing evaluation and documentation of patient-care needs.
Participate in pre-evaluation, initiation, monitoring, termination, access homeostasis, and post-evaluation of hemodialysis treatment according to established procedures.
Intervene as appropriate for changes in patient adequacy status and troubleshoot access-flow issues identified by OLC/AMP alerts.
Provide, supervise when applicable, and monitor hemodialysis access care.
Implement, administer, monitor, and document prescribed interdialytic transfusions, including notification of the physician and blood supplier about adverse reactions.
Ensure Patient Care Technician documentation on Hemodialysis Treatment Sheets is accurate and complete.
Review, transcribe, and enter physician laboratory orders into the Medical Information System; prepare lab requisitions and ensure appropriate tubes, draw and processing procedures, packaging, and delivery of specimens.
Follow up on missed or insufficient laboratory specimens, report alert, panic, and abnormal results to the appropriate physician, and forward results to physicians as requested.
Enforce company policies and procedures and applicable state and federal regulations, and maintain safe, efficient, and effective shift operations.
Serve as a resource for other staff and meet routinely with the Clinical Manager regarding personnel and patient-care matters.
Collaborate and communicate with physicians and other healthcare-team members to interpret, adjust, and coordinate patient care.
Assist patients with prescription refills in accordance with company policies and ensure physician orders are transcribed and entered into the Medical Information System in a timely manner.
Oversee patient information documentation and maintain the facility drug list for required stock medications.
Maintain competency in emergency procedures, initiate CPR and emergency measures when indicated, and verify adequate emergency equipment availability.
Ensure appropriate vaccinations, immunizations, and annual TB testing; administer prescribed or approved-algorithm medications and document required justification, assessments, effectiveness, and controlled-substance records.
Assist with patient transportation coordination when necessary.
Maintain a clean, safe, and sanitary dialysis treatment area; operate dialysis-related equipment safely; ensure patient stations, machines, and chairs are clean and appropriately placed; and address blood spills according to company policy.
Ensure relevant patient-care data, physician orders, laboratory results, vital signs, treatment parameters, and patient status are appropriately documented in the Medical Information System.
Implement patient admission, transfer, and discharge policies and verify Patient Care Technician documentation.
Review daily completion of Hemodialysis Treatment Sheets and ensure opening and closing procedures are followed, including confirming staff and patients have safely left the premises.
Initiate, document, and complete monthly Continuous Quality Improvement activities and reports; complete monthly nurses’ progress notes; and ensure medical records are complete and properly identified.
Review transplant status and follow established procedures; complete care plans for new patients within 30 days and for unstable patients as required; and complete due long-term programs.
Complete initial and annual Nursing History and Assessment physicals and annual Standing Order Reviews with physicians as required.
Maintain required credentials and certifications in active, valid status, notify the supervisor of changes, maintain regular and punctual attendance, and perform other related duties as assigned.