Outpatient Registered Nurse - RN

Fresenius Medical Care • Tacoma, WA

21d • $35 - $59

About The Position

Functions as part of the hemodialysis health care team as a Staff Registered Nurse, providing quality daily patient care in accordance with Fresenius Medical Care policies, procedures, training, applicable regulations, and the company’s mission, values, and customer service philosophy. Supports the Quality Enhancement Program and continuous quality improvement activities, including patient satisfaction and process improvement. Adheres to the Compliance Program and patient-care and administrative policies.

The nurse directs and delegates work to patient-care staff, assesses patient needs, assigns care, and monitors staff practices. The role provides and coordinates hemodialysis care for patients with end-stage renal disease, evaluates responses to treatment, implements prescribed treatment plans, manages access care, administers medications and transfusions, and communicates concerns with physicians and other members of the healthcare team. It also includes patient and family education about renal disease, dialysis, vascular access, treatment adequacy, laboratory results, diet, fluids, medications, transplant and modality options, and treatment compliance.

The nurse oversees clinical documentation, physician orders, laboratory processes and results, patient records, care plans, assessments, and required reporting. The position maintains safe facility operations, emergency readiness, equipment competency, infection-control practices, and a clean treatment area; participates in staff training and meetings; and completes ongoing quality improvement and other assigned duties. Coverage at area facilities may be required by management.

This position provides direct patient care in a healthcare facility. Work may involve heavy lifting and moving patients, assisting with ambulation, frequent and prolonged standing, bending, and occasionally moving equipment with assistance. The work environment has controlled air temperature and moderate noise and may involve exposure to infectious or contagious diseases and materials. An Ishihara color vision test is a condition of employment; failure does not preclude employment, and reasonable accommodation may be considered.

The hourly pay range is $35.00–$59.00, depending on work location and qualifications. The benefits overview lists medical, dental, and vision insurance, a 401(k) with company match, paid time off, parental leave, and, for bonus-eligible positions, potential performance-based bonuses depending on company and individual performance.

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 any applicable state requirements.
• Meet the necessary 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.
• Provide coverage at any or all area facilities as required by management.
• Complete Icd-9 coding Training.
• Complete Nurses Technical Training.

Nice To Haves

• Minimum of one year of medical-surgical nursing experience preferred.
• Hemodialysis experience preferred.
• ICU experience preferred.

Responsibilities

• Direct patient-care staff and delegate tasks to LVN/LPNs, Patient Care Technicians, and Dialysis Assistants.
• Assess daily patient-care needs, make appropriate assignments, and monitor staff techniques and adherence to facility procedures.
• Participate in staff training, new-staff orientation, and required staff meetings.
• Educate patients and families about ESRD, renal disease, vascular access, dialysis therapy, adequacy measures, laboratory values, diet and fluid guidance, medications, transplant and modality awareness, and treatment compliance.
• Provide safe hemodialysis care, implement treatment prescriptions, assess patient response, adjust or modify care as indicated, and communicate issues to the Team Leader or physician.
• Initiate and complete initial, annual, and ongoing nursing assessments and documentation.
• Participate in pre-evaluation, treatment initiation, monitoring, termination, access homeostasis, and post-evaluation for hemodialysis patients.
• Intervene when adequacy status changes or access-flow issues are identified; provide, supervise when applicable, and monitor dialysis access care.
• Administer, monitor, and document prescribed interdialytic transfusions and patient responses, and report adverse reactions appropriately.
• Review and enter physician orders and laboratory orders into the Medical Information System; prepare and process laboratory requisitions and specimens according to company and Department of Transportation procedures.
• Follow up on missed or insufficient specimens, report abnormal or critical laboratory results to physicians, and forward results as requested.
• Maintain safe, efficient, and effective shift operations; act as a resource to other staff and meet 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 company policies; ensure physician orders are entered in a timely manner.
• Oversee patient information documentation, verify Patient Care Technician documentation, and ensure daily completion of Hemodialysis Treatment Sheets and appropriate data entry.
• Maintain the facility drug list and appropriate controlled-substance records; administer prescribed or algorithm-authorized medications and document required assessments and justifications.
• Maintain competency in emergency procedures, initiate CPR and emergency measures when needed, and verify availability of emergency equipment.
• Ensure appropriate vaccinations, immunizations, and annual TB testing.
• Coordinate patient transportation when necessary.
• Maintain a clean, safe, and sanitary dialysis treatment area; ensure equipment and patient stations are clean and appropriately arranged; address blood spills under company policies.
• Implement patient admission, transfer, and discharge procedures and follow opening and closing procedures, including confirming staff and patients have safely left the premises.
• Initiate, document, and complete ongoing CQI activities, including monthly reports; complete monthly nurses’ progress notes, patient care plans, long-term programs, nursing histories and assessments, and annual standing-order reviews.
• Review transplant status and follow established procedures for appropriate action.
• Perform additional duties as assigned.

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• 401(k) with company match
• Paid time off
• Parental leave
• Potential performance-based bonuses for bonus-eligible positions, depending on company and individual performance

What This Job Offers

• Job Type: Full-time