New Graduate Registered Nurse

Fresenius Medical Care•Boston, MA

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, to provide quality patient care in accordance with Fresenius Medical Services (FMS) policies, procedures, and training. Supports FMCNA’s mission, vision, values, customer service philosophy, Quality Enhancement Program (QEP), and continuous quality improvement activities, and complies with the FMCNA Compliance Program and patient care and administrative policies. Employees must obtain their nursing license and registration within the timeframe specified by state regulations or within 90 days of hire, whichever occurs first. The role directs and supports patient care staff, helps coordinate assignments, monitors adherence to procedures, and participates in staff training and meetings. It provides and monitors hemodialysis care, evaluates patient responses, coordinates with physicians and the health care team, and educates patients and families about end-stage renal disease, dialysis, vascular access, treatment adequacy, medications, diet, fluids, transplantation, and treatment options. The nurse also handles laboratory orders and specimens, medication administration, emergency readiness, patient transportation coordination, facility safety and equipment readiness, and accurate patient records. Responsibilities include daily, monthly, and annual documentation and quality activities. The work involves direct patient care in a healthcare facility and may include exposure to infectious or contagious diseases and materials. The position requires physical activity including lifting and moving patients, prolonged standing, bending, and occasionally moving equipment or lifting supplies with stated weight limits.

Requirements

Graduated from an accredited nursing program within the past 12 months.
Obtain a nursing license and registration within the timeframe defined by state regulations or within 90 days of hire, whichever occurs first.
Hold a current appropriate state Temporary Permit.
Meet practice requirements in the state of employment.
Maintain any required credentials or certifications in active and valid status, including timely renewal.
Be able to handle demanding situations, multitask, and remain flexible as needs change.
Maintain regular and punctual attendance.
Take the Ishihara Color Blindness test as a condition of employment; failure does not automatically preclude employment, and reasonable accommodation may be considered.
Meet the physical demands of direct patient care, including frequent prolonged standing, bending, assisting with patient ambulation, and heavy lifting or moving of patients; machines or equipment weighing up to 200 pounds may occasionally be moved with assistance, and chemical or water solutions weighing up to 30 pounds may need to be lifted as high as 5 feet.

Responsibilities

Direct Patient Care Technicians and 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, orientation of new staff as assigned, and required staff meetings.
Educate patients and families about end-stage renal disease, renal disease, vascular access, dialysis therapy, diet and fluid management, medications, laboratory values, treatment compliance, adequacy measures, transplantation, and treatment modalities.
Provide safe and effective hemodialysis care and implement prescribed treatment parameters, including sodium and ultrafiltration modeling where appropriate.
Assess patient responses to hemodialysis, adjust or modify the care plan as indicated, and communicate patient issues or concerns to the Team Leader or physician.
Initiate initial and annual nursing assessments and ongoing evaluation and documentation of patient care needs.
Participate in pre-evaluation, treatment initiation and monitoring, termination, access homeostasis, and post-evaluation for hemodialysis patients.
Intervene appropriately for changes in patient adequacy status and troubleshoot access flow issues identified through OLC or AMP.
Provide, supervise when applicable, and monitor hemodialysis access care.
Implement and monitor prescribed interdialytic transfusions, document patient responses, and notify the physician and blood supplier of adverse reactions as appropriate.
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 requisitions, ensure appropriate specimen collection and processing, follow up on missed or insufficient specimens, and report abnormal results to physicians.
Package and route specimens according to applicable Department of Transportation procedures and ensure results are forwarded to physicians as requested.
Enforce company policies and applicable state and federal regulations and maintain safe, efficient, and effective shift operations.
Serve as a resource for 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 coordinate and adjust patient care.
Assist patients with prescription refills according to FMCNA policies and ensure physician orders are entered into the Medical Information System promptly.
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 needed, and verify that adequate emergency equipment is available.
Ensure appropriate vaccinations, immunizations, and annual tuberculosis testing; administer prescribed or protocol-authorized medications and document required assessments and justifications.
Maintain controlled-substance records as required by law and assist with patient transportation coordination when necessary.
Maintain a clean, safe, and sanitary dialysis treatment area; operate dialysis-related equipment safely; and ensure patient stations, machines, and chairs are clean and properly positioned.
Address blood spills immediately according to FMCNA Bloodborne Pathogen Control Policies.
Document physician orders, lab results, vital signs, treatment parameters, patient status, and other relevant treatment data in the Medical Information System.
Implement patient admission, transfer, and discharge policies and verify the accuracy of Patient Care Technician documentation.
Review daily Hemodialysis Treatment Sheets and follow opening and closing procedures, including monitoring that staff and patients have safely left the premises.
Initiate, document, and complete ongoing monthly CQI activities and reports; complete monthly nurses' progress notes; and maintain complete, properly identified medical records.
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 physical assessments and annual standing-order reviews with physicians as required.
Maintain required credentials and certifications, notify a supervisor promptly of a change in credential status, maintain regular and punctual attendance, and perform other related duties as assigned.