Outpatient Registered Nurse - RN

Fresenius Medical Care•Gig Harbor, WA

27d

About The Position

The Outpatient Registered Nurse works as a Staff Registered Nurse on a hemodialysis health care team, providing quality daily care to patients with end-stage renal disease (ESRD) in accordance with Fresenius Medical Care policies, procedures, training, and applicable regulations. The nurse supports the company’s mission, values, quality initiatives, compliance program, and patient-service philosophy, and participates in continuous quality improvement activities. The role includes directing and delegating work to patient-care staff; assessing patient needs and assigning care; providing and overseeing hemodialysis treatment and access care; educating patients and families about renal disease, treatment, diet, medications, laboratory values, transplant and modality options; and coordinating care with physicians and other healthcare professionals. The nurse monitors patient responses, implements prescribed treatment plans and medications, responds to changes or emergencies, and communicates patient concerns to the appropriate clinical lead or physician. The nurse also oversees clinical documentation, physician orders, laboratory processes and results, patient records, treatment sheets, and required assessments and care plans. Additional duties include supporting staff training, maintaining emergency readiness and medication records, ensuring a clean and safe treatment environment, and completing quality-improvement and other assigned work. The position may require coverage at area facilities as directed by management. This position involves direct patient care and regular heavy lifting and moving of patients, assisting with ambulation, frequent and prolonged standing, and bending. With assistance, the employee may occasionally move 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 is in a healthcare facility with controlled air temperature and moderate noise, with possible exposure to infectious or contagious diseases and materials. The Ishihara color-vision test is a condition of employment; failing the test does not preclude employment, and reasonable accommodation may be considered. The role requires graduation from an accredited School of Nursing, current appropriate state licensure, and meeting applicable state practice requirements. Candidates must successfully complete hemodialysis training and CPR certification. Medical-surgical nursing experience, hemodialysis experience, and ICU experience are preferred. The stated hourly pay range is $45.00–$59.00, depending on work location and the candidate’s qualifications. The benefits package includes medical, dental, and vision insurance, a 401(k) with company match, paid time off, and parental leave.

Requirements

Graduate of an accredited School of Nursing.
Current appropriate state licensure and compliance with practice requirements in the state of employment.
Successfully complete a training course in the theory and practice of hemodialysis.
Successfully complete CPR certification.
Meet the applicable requirements of the Ishihara color-vision test as a condition of employment; failing the test does not preclude employment, and reasonable accommodation may be considered.
Complete ICD-9 coding training and Nurses Technical Training.
Ability to perform the stated physical demands of direct patient care, with reasonable accommodations as applicable.

Nice To Haves

At least one year of medical-surgical nursing experience is preferred.
Hemodialysis experience is preferred.
ICU experience is preferred.

Responsibilities

Direct and delegate work to patient-care staff, including LVNs/LPNs, Patient Care Technicians, and Dialysis Assistants; assess daily care needs, assign work, and monitor staff techniques and adherence to policies.
Provide, supervise, and monitor safe and effective hemodialysis treatment and access care in accordance with prescriptions, procedures, and applicable standards.
Assess patient responses to treatment and adjust or modify the treatment plan as indicated by the prescribing physician; communicate patient concerns and problems to the Team Leader or physician.
Conduct initial, annual, and ongoing nursing assessments and document patient care needs and status.
Educate patients and families about ESRD, renal disease, vascular access, dialysis therapy, diet and fluids, medications, laboratory values, treatment compliance, adequacy measures, transplant awareness, and treatment modalities.
Participate in patient pre-evaluation, treatment initiation, monitoring, termination, access homeostasis, and post-evaluation; intervene when adequacy or access-flow concerns are identified.
Implement, administer, monitor, and document prescribed medications and transfusions, including assessment of responses and reporting adverse reactions as appropriate.
Review and enter physician orders and laboratory orders into the Medical Information System; coordinate lab requisitions, specimen collection, processing, packaging, delivery, and follow-up; report abnormal or alert results to physicians.
Ensure accurate and complete patient records, treatment sheets, vital signs, treatment parameters, physician orders, lab results, and other required documentation.
Maintain shift operations safely and effectively; act as a resource for staff; participate in staff training, orientation, and required meetings; communicate with the Clinical Manager about personnel and patient-care matters.
Maintain competency in emergency procedures, initiate CPR and emergency measures when needed, and verify availability of emergency equipment.
Ensure appropriate vaccinations, immunizations, and annual tuberculosis testing; maintain the facility drug list and controlled-substance records as required.
Assist with prescription refills and patient transportation coordination when necessary.
Ensure the dialysis treatment area is clean, safe, and sanitary; oversee cleaning and placement of patient stations, machines, and chairs, and ensure blood spills are addressed according to policy.
Implement patient admission, transfer, and discharge policies and follow opening and closing procedures, including verifying that staff and patients have safely left the premises.
Initiate, document, and complete ongoing CQI activities, including monthly reports; complete nurses’ progress notes, patient care plans, nursing histories and assessments, long-term programs, and annual standing-order reviews.
Provide coverage at area facilities as required by management and perform additional duties as assigned.