Registered Nurse - RN - Dialysis

Fresenius Medical Care•Hilo, HI

14d•$42 - $60•Onsite

About The Position

The Registered Nurse functions as part of the hemodialysis health care team, providing quality daily patient care in accordance with Fresenius Medical Care policies, procedures, training, and applicable regulations. The role supports the company’s mission, values, customer service philosophy, Quality Enhancement Program, and continuous quality improvement activities. The nurse must be able to provide coverage at clinics on Hawaii Island, including Kona, Kamuela, and Hilo; a float differential is eligible. The nurse directs and delegates patient-care staff, assesses patient needs, assigns care, monitors staff practices, and contributes to staff training. The position provides and oversees chronic hemodialysis care, assesses patient responses, implements prescribed treatments, coordinates with physicians and other healthcare professionals, and educates patients and families about renal disease, dialysis, vascular access, medications, diet, fluid, laboratory values, and treatment options. The position also oversees clinical documentation, physician orders, laboratory processes and results, medications, emergency readiness, infection control, equipment competency, patient records, and facility operations. The nurse participates in patient assessments and care planning, transplant and modality awareness, and ongoing quality improvement. Direct patient care involves physical demands, including frequent and prolonged standing, bending, assisting with ambulation, and lifting or moving patients and equipment, sometimes with assistance. The work takes place in a healthcare facility and may involve exposure to infectious or contagious materials.

Requirements

Graduate of an accredited School of Nursing.
Current appropriate state licensure and compliance with practice requirements in the state of employment.
At least one year of nursing experience is required.
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 automatically 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

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

Responsibilities

Direct Patient Care Technicians and delegate tasks to direct 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 adherence to facility policies and procedures.
Participate in staff training and orientation, required staff meetings, and act as a resource for other staff members.
Educate patients and families about ESRD, renal disease, vascular access, dialysis therapy, diet and fluid compliance, medications, laboratory values, adequacy measures, transplant awareness, and treatment modalities.
Provide and oversee safe and effective hemodialysis care, accurately implement prescriptions, assess patient responses, adjust treatment plans as indicated, and communicate issues to the Team Leader or physician.
Initiate initial and annual nursing assessments and ongoing evaluation and documentation of patient-care needs.
Participate in pre-evaluation, initiation, monitoring, termination, access homeostasis, and post-evaluation of hemodialysis treatment.
Intervene for changes in patient adequacy status and troubleshoot access-flow issues; provide, supervise, and monitor hemodialysis access care.
Implement, monitor, and document prescribed interdialytic transfusions and patient responses, reporting adverse reactions appropriately.
Ensure accurate and complete patient-care documentation, including treatment sheets, physician orders, treatment data, and patient records in the Medical Information System.
Review and enter physician laboratory orders; prepare requisitions, ensure correct specimen handling and shipment, follow up on missed or insufficient specimens, and report abnormal or alert results to physicians.
Enforce company policies and applicable state and federal regulations and maintain safe, efficient, and effective shift operations.
Meet routinely with the Clinical Manager regarding personnel and patient-care matters; collaborate with physicians and other healthcare professionals to coordinate care.
Assist patients with prescription refills and coordinate transportation when needed.
Maintain the facility drug list, administer prescribed and PRN medications, document administration and effectiveness, and maintain controlled-substance records.
Maintain competency in emergency procedures, initiate CPR and emergency measures when necessary, and ensure emergency equipment is available and verified.
Ensure appropriate vaccinations, immunizations, and annual TB testing.
Maintain a clean, safe, and sanitary treatment area; ensure stations and equipment are clean and properly placed, and address blood spills according to policy.
Ensure competency in operating dialysis equipment and ensure appropriate implementation of patient admission, transfer, and discharge policies.
Verify Patient Care Technician documentation and ensure daily completion of Hemodialysis Treatment Sheets.
Ensure opening and closing procedures are followed, including confirmation 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 and properly identified patient medical records; review transplant status and follow established procedures.
Complete patient care plans for new patients within 30 days and for unstable patients as required, complete due long-term programs, and conduct initial and annual Nursing History and Assessment physicals.
Ensure annual Standing Order Reviews are completed with each physician.
Perform additional duties as assigned.