Outpatient Registered Nurse - RN

Fresenius Medical Care•Orlando, FL

3d•Onsite

About The Position

Functions as a Staff Registered Nurse on the hemodialysis health care team, providing quality daily patient care in accordance with company policies, procedures, training, and applicable regulations. Supports the company’s mission, values, quality-improvement goals, compliance program, and customer service philosophy. Provides and coordinates hemodialysis care for patients with end-stage renal disease, assesses patient needs and treatment responses, delegates and monitors work performed by direct-care staff, and communicates with physicians and other members of the health care team. The role also includes patient and family education, accurate clinical documentation and laboratory coordination, medication administration, emergency readiness, and maintaining a safe dialysis treatment environment. The position requires graduation from an accredited School of Nursing and current appropriate state licensure. Candidates must successfully complete training in hemodialysis theory and practice and hold CPR certification. Medical-surgical nursing experience is preferred; hemodialysis and ICU experience are also preferred. The role may require coverage at area facilities as directed by management. The work is performed in a health care facility with controlled air temperature and moderate noise. Direct patient care regularly involves heavy lifting and moving patients, assisting with ambulation, and frequent, 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. Exposure to infectious or contagious diseases and materials may occur. Employees must take the Ishihara Color Blindness test as a condition of employment; failing the test does not automatically preclude employment, and reasonable accommodation may be considered.

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.
Current CPR certification.
Meet applicable state requirements, if any.
Successfully complete the Ishihara Color Blindness test as a condition of employment; failing the test does not automatically preclude employment, and reasonable accommodation may be considered.
Provide coverage at any or all area facilities as required by management.

Nice To Haves

At least one year of medical-surgical nursing experience.
Hemodialysis experience.
ICU experience.
ICD-9 coding training.
Nurses Technical Training.

Responsibilities

Direct and delegate patient-care tasks to Patient Care Technicians, LVN/LPNs, Dialysis Assistants, and other direct-care staff; assess daily care needs and make appropriate assignments.
Monitor patient-care staff for appropriate techniques and compliance with facility policies and procedures; assist with training and orientation of new staff and attend required staff meetings.
Educate patients and families about ESRD, renal disease, vascular access, dialysis therapy, diet and fluid management, medications, laboratory values, treatment compliance, adequacy measures, transplant and modality options, and catheter reduction.
Deliver safe hemodialysis care, implement prescribed treatment parameters and modeling, assess patients’ responses, adjust or modify treatment plans as indicated by the prescribing physician, and communicate concerns or changes to the Team Leader or physician.
Complete 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.
Intervene when patient adequacy status changes or access-flow issues are identified, and provide, supervise when applicable, and monitor hemodialysis access care.
Implement, administer, monitor, and document prescribed interdialytic transfusions and notify the physician and blood supplier of adverse reactions as appropriate.
Ensure complete and accurate patient-care documentation, including Hemodialysis Treatment Sheets, treatment data, patient status, physician orders, laboratory results, vital signs, and treatment parameters; review and verify Patient Care Technician documentation.
Review, transcribe, and enter physician orders into the Medical Information System; coordinate laboratory requisitions, specimen collection and processing, packaging, delivery, and follow-up on missed or insufficient specimens; report abnormal, alert, or panic results to physicians.
Enforce company policies and applicable regulations; maintain safe and effective shift operations and serve as a resource for other staff.
Meet routinely with the Clinical Manager about personnel and patient-care matters, and collaborate with physicians and other health care team members to coordinate care.
Assist patients with prescription refills as needed under company policies, and ensure physician orders are entered into the Medical Information System promptly.
Maintain the facility drug list and appropriate controlled-substance records; administer prescribed and PRN medications, document administration and effectiveness, and provide medical justification when indicated.
Maintain competency in emergency procedures; initiate CPR and emergency measures for cardiac or respiratory arrest and verify the availability of emergency equipment.
Ensure appropriate vaccinations, immunizations, and annual tuberculosis testing are provided.
Coordinate patient transportation when necessary and maintain a clean, safe, and sanitary treatment area; ensure equipment is operated safely, patient stations are clean and properly arranged, and blood spills are addressed under policy.
Implement patient admission, transfer, and discharge procedures; ensure opening and closing procedures are followed and that staff and patients leave the premises safely.
Initiate, document, and complete ongoing Continuous Quality Improvement activities, including monthly reports; complete monthly nurses’ progress notes, patient care plans, long-term programs, nursing histories and physical assessments, and annual standing-order reviews.
Review transplant status and follow established procedures for appropriate action.
Perform additional duties as assigned.