Registered Nurse

Jamboor Medical Corporation•Victorville, CA

6d•$42 - $46

About The Position

The In Center Hemodialysis Registered Nurse provides safe, individualized nursing care to patients receiving maintenance hemodialysis. The RN assesses patients before, during, and after treatment; implements prescribed care; administers medications; responds to changes in condition and emergencies; documents care; educates patients and caregivers; and collaborates with the interdisciplinary team. This is a direct-care staff RN position. The RN provides required clinical oversight of assigned patient-care activities but does not have routine personnel-management authority. The RN conducts patient assessments and contributes to individualized care planning, education, and follow-up. The role includes initiating, monitoring, and terminating hemodialysis treatments; assessing vascular access and treatment response; administering ordered medications; reviewing laboratory results and orders; responding to complications; and supporting continuity of care. The RN also follows infection-prevention and equipment-safety requirements, maintains timely and accurate documentation, protects patient rights and confidentiality, and participates in quality improvement and required professional development activities. The employee works in a clinical environment and may encounter blood, body fluids, infectious diseases, chemicals, sharps, and moderate equipment noise. Travel between DCD locations may be required based on operational need. Required personal protective equipment and safety precautions must be used.

Requirements

Current, active, and unrestricted California Registered Nurse license in good standing.
Graduate of an accredited or state-approved registered nursing education program.
Current Basic Life Support certification, maintained as required by facility policy and before independent patient-care assignment.
Successful completion of DCD orientation, dialysis training, and initial and ongoing competency validation before independent assignment.
Ability to maintain all licenses, certifications, health screenings, and documentation required by law and facility policy.
Knowledge of dialysis principles, vascular access, infection prevention, medication safety, emergency response, patient education, and clinical documentation.
Knowledge of the California Nursing Practice Act and ability to practice within applicable federal and state requirements, professional standards, facility policies, and individual competency.
Ability to apply clinical judgment, recognize changes in patient condition, prioritize care, communicate clearly, and escalate concerns promptly.
Ability to provide required clinical direction to Certified Hemodialysis Technicians and assigned care-team members without assuming personnel-management authority.
Ability to use electronic health records, dialysis equipment, emergency equipment, and required clinical systems after training.
Ability to work effectively in routine and emergency situations and communicate respectfully with patients, families, caregivers, practitioners, and interdisciplinary team members.
Commitment to patient rights, confidentiality, professional conduct, dependable attendance, teamwork, and a safe care environment.
Ability, with or without reasonable accommodation, to stand, sit, and walk for extended periods; bend, stoop, kneel, crouch, reach, push, pull, and lift up to 30 pounds; communicate effectively; and observe patients, vascular access sites, equipment displays, alarms, and color-based safety indicators.
Ability to work in a clinical environment with potential exposure to blood, body fluids, infectious diseases, chemicals, sharps, and moderate equipment noise, using required personal protective equipment and safety precautions.

Nice To Haves

Previous dialysis experience is preferred but is not required if the RN successfully completes the facility-approved dialysis orientation training and competency validation program.

Responsibilities

Establish and maintain professional therapeutic relationships and communicate respectfully with patients, families, caregivers, practitioners, and interdisciplinary team members.
Complete RN components of initial comprehensive assessments and reassessments within required timeframes.
Continually assess patient needs and contribute to the development, implementation, evaluation, and revision of individualized plans of care.
Participate in comprehensive assessments, care-planning conferences, follow-up reassessments, and applicable annual or monthly reassessments.
Include patients and, when appropriate, families or caregivers in care planning and education regarding dialysis, medications, vascular access care, infection prevention, treatment adherence, emergency preparedness, modality options, and transplantation.
Establish measurable patient goals with the interdisciplinary team and evaluate progress toward expected outcomes.
Provide direct nursing care according to the dialysis prescription, practitioner orders, California Nursing Practice Act, facility policies, and demonstrated competencies.
Initiate, monitor, and terminate hemodialysis treatments safely within training and demonstrated competency.
Perform and document pre-treatment, intradialytic, post-treatment, and discharge nursing assessments.
Verify patient identity, allergies, prescription, orders, machine settings, dialyzer, dialysate, anticoagulation, vascular access, medications, and precautions.
Assess vascular access and promptly address or report signs of infection, infiltration, bleeding, stenosis, thrombosis, or dysfunction.
Monitor vital signs, fluid removal, treatment tolerance, machine parameters, and patient response; evaluate abnormal findings and intervene within scope and policy.
Recognize and respond to dialysis complications and medical emergencies, initiate emergency procedures, notify the appropriate practitioner, and arrange a higher level of care when indicated.
Provide immediate clinical supervision of assigned Certified Hemodialysis Technician functions as required by California law and facility policy, without personnel-management authority.
Administer and document medications and treatments according to valid orders, law, policy, and demonstrated competency.
Review, clarify when necessary, implement, and document medical orders accurately and within required timeframes.
Complete medication reconciliation at admission, at least monthly, after hospitalization or transition of care, and whenever medication changes are identified.
Review relevant laboratory results and trends, implement authorized interventions, and notify the practitioner of significant or critical findings.
Participate in practitioner rounds and patient-care conferences as assigned and communicate significant findings, condition changes, and unresolved concerns promptly.
Complete or support follow-up related to missed or shortened treatments, hospitalizations, emergency department visits, and transitions of care according to facility workflow.
Coordinate referrals, appointments, and continuity-of-care needs related to the dialysis plan as assigned.
Follow infection-prevention requirements, including hand hygiene, personal protective equipment, aseptic technique, medication preparation, injection safety, vascular access care, station disinfection, bloodborne pathogen precautions, and hepatitis B isolation practices.
Confirm required machine, water, dialysate, and environmental safety checks are completed and within acceptable limits before treatment; report and respond to abnormal results.
Review required clinical, treatment, medication-safety, water, and equipment logs and address or escalate incomplete documentation and abnormal findings.
Promptly report equipment concerns, unsafe conditions, occupational exposures, and other safety events.
Review patient records for diagnoses, allergies, prescriptions, orders, vascular access information, precautions, and pertinent clinical history.
Complete nursing notes, treatment records, assessments, summaries, care-plan documentation, and other required records accurately and within established timeframes.
Maintain current nursing documentation and contribute to timely interdisciplinary plan-of-care updates.
Report and document adverse events, medication errors, suspected abuse or neglect, and other reportable incidents according to law and facility policy.
Participate as assigned in the facility Quality Assessment and Performance Improvement program, including review of clinical outcomes and corrective actions.
Protect patient rights, privacy, and confidentiality and comply with DCD policies, professional standards, and applicable federal and state requirements.
Attend required staff meetings, in-services, emergency drills, continuing education, and competency activities.
Follow the established reporting and escalation process, using the DCD Escalation Flow Map when management is not present in the building.
Participate in orientation, training, and competency support for staff when assigned and within scope, training, and demonstrated competency.
Provide coverage at other DCD facilities when assigned based on operational needs and after required site orientation, training, and competency validation.
Maintain required licenses, certifications, health clearances, competencies, and continuing education.
Perform other duties within lawful scope of practice, training, and demonstrated competency as assigned.