Outpatient Registered Nurse - RN

Fresenius Medical Care•Ashland, KY

9d•Onsite

About The Position

This float-position Staff Registered Nurse works as part of the hemodialysis health care team to provide quality daily care to patients in accordance with Fresenius Medical Care policies, procedures, training, and applicable regulations. The role supports the company’s mission, values, quality programs, compliance requirements, and continuous improvement activities. The nurse oversees and delegates work to direct patient care staff, assesses patient needs, assigns care, monitors staff practices, and helps train and orient staff. The nurse provides and coordinates hemodialysis care; assesses patients’ responses to treatment; implements prescribed treatment plans; monitors vascular access; administers medications and transfusions; responds to emergencies; and communicates patient concerns to physicians and team leaders. The role includes educating patients and families about ESRD, dialysis, vascular access, treatment adequacy, medications, diet, fluids, laboratory results, transplant and treatment modalities. The nurse also manages clinical orders and laboratory processes, ensures accurate documentation and medical records, supports patient admission, transfer, and discharge, completes assessments and care plans, and participates in monthly continuous quality improvement activities. The position requires coverage at any or all area facilities as directed by management. It involves direct patient care in a health care facility and may include exposure to infectious or contagious materials. Physical duties include regularly lifting and moving patients and assisting with ambulation; prolonged standing and bending; occasionally moving equipment weighing up to 200 pounds with assistance; and lifting chemical or water solutions weighing up to 30 pounds to heights of up to five feet. Equipment or coworkers may assist with patient handling. Reasonable accommodations may be made for individuals with disabilities. Ishihara color-vision testing is a condition of employment, but a failed test does not preclude employment; reasonable accommodation will 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.
Successfully complete CPR certification.
Meet applicable state requirements, if any.
Meet the necessary requirements of the Ishihara Color Blindness test as a condition of employment; failing the test does not preclude employment, and reasonable accommodation may be considered.
Ability to perform direct patient care that regularly involves heavy lifting and moving patients and assisting with ambulation; frequent prolonged standing and bending; occasional movement, with assistance, of equipment weighing up to 200 pounds; and lifting chemical and water solutions weighing up to 30 pounds to heights of up to five feet.

Nice To Haves

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

Responsibilities

Direct and delegate the work of patient care staff, including LVNs/LPNs, Patient Care Technicians, and Dialysis Assistants.
Assess daily patient care needs, develop appropriate assignments, and monitor staff techniques and compliance with policies and procedures.
Participate in staff training, new-employee orientation, and required staff meetings.
Educate patients and families about ESRD, renal disease, vascular access, dialysis therapy, adequacy measures, diet and fluid management, medications, laboratory values, transplant awareness, treatment modalities, and catheter reduction.
Provide safe and effective hemodialysis care, implement treatment prescriptions, assess patient responses, adjust care as indicated, and communicate concerns to the Team Leader or physician.
Complete initial, annual, and ongoing nursing assessments and document patient care needs and treatment.
Participate in the evaluation, initiation, monitoring, termination, access homeostasis, and post-evaluation of hemodialysis treatments.
Intervene when patient adequacy status changes and troubleshoot access-flow issues identified through OLC or AMP.
Provide, supervise where applicable, and monitor hemodialysis access care.
Administer and monitor prescribed transfusions and medications, document patient responses and medical justifications as appropriate, and report adverse reactions.
Review, transcribe, and enter physician orders and laboratory orders into the Medical Information System; maintain the facility drug list and assist patients with prescription refills according to policy.
Coordinate laboratory requisitions, specimen collection, processing, packaging, and delivery; follow up on missed or insufficient specimens; and report abnormal, alert, or panic results to physicians.
Maintain safe, efficient, and effective shift operations and serve as a resource to other staff.
Collaborate and communicate with physicians and other members of the health care team to coordinate and adjust patient care.
Maintain competency in emergency procedures, initiate CPR and other emergency measures when needed, and verify the availability of emergency equipment.
Ensure appropriate vaccinations, immunizations, and annual tuberculosis testing.
Ensure the treatment area is clean, safe, and sanitary; verify that stations, machines, and chairs are clean and correctly placed; and address blood spills according to policy.
Ensure safe and competent operation of dialysis equipment and accurate, complete entry of patient, treatment, order, laboratory, and vital-sign information into the Medical Information System.
Implement patient admission, transfer, and discharge procedures; verify Patient Care Technician documentation; and ensure daily completion of Hemodialysis Treatment Sheets.
Follow opening and closing procedures, including confirming that staff and patients have safely left the premises.
Initiate, document, and complete ongoing CQI activities, including monthly reports, and complete monthly nurses’ progress notes.
Maintain complete patient medical records and complete patient care plans, long-term programs, nursing histories and physical assessments, and annual standing-order reviews as required.
Review transplant status and follow established procedures for appropriate action.
Provide coverage at any or all area facilities as required by management.
Perform additional duties as assigned.