Registered Nurse - RN - Dialysis

Fresenius Medical Care•Honolulu, HI

17d

About The Position

The Registered Nurse functions as part of the hemodialysis health care team and is responsible for providing quality daily patient care in accordance with Fresenius Medical Care policies, procedures, training, and applicable state and federal regulations. The role supports the company’s mission, vision, values, customer service philosophy, Quality Enhancement Program, and continuous quality improvement activities. The nurse directs and delegates work to patient-care staff, assesses daily patient needs, develops assignments, monitors care practices, and supports staff training. The nurse provides and coordinates hemodialysis care, assesses patient responses, implements prescribed treatment plans, manages dialysis access care, administers medications and transfusions, and communicates patient issues to physicians and the clinical team. The position also involves educating patients and families about ESRD, dialysis, vascular access, treatment adequacy, laboratory results, diet, fluids, medications, transplantation, and treatment modalities. The nurse maintains accurate clinical records and orders, oversees laboratory processes and documentation, supports emergency readiness, and ensures a safe, clean treatment environment. The role participates in facility operations, staff meetings, and ongoing quality-improvement work, and may provide coverage at area facilities as required by management.

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.
Complete the Ishihara Color Blindness 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

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

Responsibilities

Direct and delegate patient-care work to Patient Care Technicians, LVN/LPNs, Dialysis Assistants, and other direct-care staff.
Assess daily patient-care needs, develop appropriate assignments, and monitor staff techniques and compliance with 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, diet and fluid management, medications, laboratory values, treatment adequacy, transplantation, and treatment modalities.
Provide safe hemodialysis care and accurately implement prescribed treatment plans, including sodium and ultrafiltration modeling when appropriate.
Assess patient responses to hemodialysis and adjust or modify care as indicated by the prescribing physician.
Communicate patient concerns and treatment issues to the Team Leader, physician, and other members of the health care team.
Initiate and complete initial and annual nursing assessments and ongoing evaluations and documentation of patient-care needs.
Participate in pre-evaluation, treatment initiation, monitoring, termination, access homeostasis, and post-evaluation for hemodialysis patients.
Intervene when patient adequacy status changes and troubleshoot access-flow issues identified through OLC or AMP.
Provide, supervise when applicable, and monitor hemodialysis access care.
Administer and monitor prescribed interdialytic transfusions, document patient responses, and report adverse reactions appropriately.
Review, transcribe, and enter physician orders and laboratory orders into the Medical Information System in a timely and accurate manner.
Oversee laboratory requisitions, specimen collection and processing, follow-up on missed or insufficient specimens, packaging, and delivery; report abnormal results and forward results to physicians as requested.
Enforce company policies and applicable regulations, and maintain safe, efficient, and effective shift operations.
Act as a resource for staff and meet routinely with the Clinical Manager regarding personnel and patient-care matters.
Assist patients with prescription refills in accordance with company policies.
Maintain facility drug lists and appropriate records of controlled substances.
Maintain competency in emergency procedures, initiate CPR and emergency measures when needed, and verify emergency equipment availability.
Ensure appropriate vaccinations, immunizations, and annual tuberculosis testing.
Administer prescribed or protocol-approved medications, including PRN medications, and document administration and effectiveness.
Coordinate patient transportation when necessary.
Maintain a clean, safe, and sanitary dialysis treatment area; ensure stations and equipment are clean and properly placed, and address blood spills according to policy.
Ensure dialysis equipment is operated safely and effectively.
Ensure patient-care information and treatment data are accurately documented in the Medical Information System and patient records.
Implement patient admission, transfer, and discharge procedures and verify Patient Care Technician documentation and completion of treatment sheets.
Follow opening and closing procedures and ensure 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 assessments, and annual standing-order reviews as required.
Review patient transplant status and follow established procedures.
Perform additional duties as assigned and provide coverage at area facilities as required by management.