New Graduate Registered Nurse

Fresenius Medical Care•Bethesda, MD

About The Position

The New Graduate Registered Nurse works as part of a hemodialysis health care team 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. The role supports FMCNA’s mission, vision, values, customer service philosophy, and Quality Enhancement Program (QEP), including continuous quality improvement and patient satisfaction activities. The employee must obtain a nursing license and registration within the timeframe specified by state regulations or within 90 days of hire, whichever comes first. The nurse provides and coordinates care for patients with end-stage renal disease (ESRD), including education, hemodialysis treatment, access care, medication administration, laboratory coordination, documentation, and emergency response. The position also guides and monitors direct patient care staff, maintains a safe and sanitary treatment environment, and ensures compliance with company policies and applicable state and federal regulations. The job involves direct patient care and regular heavy lifting and moving of patients, assistance with ambulation, frequent and prolonged standing, and bending. With assistance, the employee may occasionally move machines or equipment weighing up to 200 pounds and lift chemical or water solutions weighing up to 30 pounds to a height of five feet. The work takes place in a healthcare facility with controlled air temperature and moderate noise, with possible exposure to infectious and contagious diseases or materials. An Ishihara color blindness test is required as a condition of employment; failing the test does not preclude employment, and reasonable accommodation may be considered.

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 the practice requirements of the state in which employed.
Maintain any credentials or certifications required for the position in active and valid status, including timely renewal.
Ability to handle demanding situations, multitask, and remain flexible as needs change.
Maintain regular and punctual attendance.
Ability to perform the described physical duties, including frequent prolonged standing, bending, patient lifting and movement, and occasional movement of equipment and lifting of solutions, with assistance or equipment aids as applicable.

Responsibilities

Direct and monitor Patient Care Technicians and other direct patient care staff, delegate tasks, assess daily care needs, and develop patient care assignments.
Participate in staff training, new staff orientation as assigned, and required staff meetings.
Educate patients and families about ESRD, renal disease, vascular access, dialysis therapy, diet and fluid, medication compliance, adequacy measures, transplant and modality awareness, laboratory values, and treatment adherence.
Provide safe and effective hemodialysis care and implement prescribed treatments, including sodium and ultrafiltration modeling when appropriate.
Assess patients’ responses to treatment, adjust or modify care plans as indicated by the prescribing physician, and communicate patient issues to the Team Leader or physician.
Initiate and complete nursing assessments and ongoing evaluations and documentation of patient care needs.
Participate in pre-evaluation, treatment initiation and monitoring, termination, access homeostasis, and post-evaluation for hemodialysis patients.
Intervene when patient adequacy status changes or access-flow issues are identified; provide, supervise when applicable, and monitor hemodialysis access care.
Administer and monitor prescribed interdialytic transfusions and report adverse reactions to the physician and blood supplier as appropriate.
Ensure complete and accurate Hemodialysis Treatment Sheet documentation by Patient Care Technicians.
Review, transcribe, and enter physician orders and laboratory orders and results into the Medical Information System; prepare requisitions and ensure appropriate specimen collection, processing, packaging, routing, and follow-up.
Report alert, panic, and abnormal laboratory results to the appropriate physician and forward laboratory results as requested.
Enforce company policies and applicable state and federal regulations; maintain safe and effective shift operations and serve as a resource for staff.
Meet with the Clinical Manager about personnel and patient-care matters and collaborate with physicians and other healthcare team members to coordinate care.
Assist patients with prescription refills and coordinate transportation when necessary.
Oversee patient information and medical-record documentation, including treatment data, orders, results, vital signs, and patient status; verify Patient Care Technician documentation.
Maintain the facility drug list for required stock medications; administer prescribed or protocol-approved medications, document required assessments and justifications, and maintain controlled-substance records.
Maintain competency in emergency procedures, initiate CPR and other emergency measures as needed, and verify availability of emergency equipment.
Ensure appropriate vaccinations, immunizations, and annual tuberculosis testing.
Maintain a clean, safe, and sanitary dialysis treatment area; operate dialysis equipment safely; ensure stations, machines, and chairs are clean and properly placed; and address blood spills according to policy.
Complete required opening and closing procedures and ensure staff and patients have safely left the premises.
Initiate, document, and complete ongoing Continuous Quality Improvement activities, including monthly reports.
Complete monthly nurses’ progress notes, patient care plans when required, long-term programs when due, and annual nursing history and assessment physicals.
Review transplant status and take appropriate action under established procedures; complete annual standing-order reviews with physicians as required.
Maintain required credentials and certifications in active, valid status, report changes to a supervisor, maintain punctual attendance, and perform other related duties as assigned.