Outpatient Registered Nurse - RN

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Patient Related

Education:

• Assist other health care members in providing patient specific detailed education regarding adequacy measures where appropriate - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM), and regarding disease process/access.

Treatment:

• Welcome assigned patients and inquire as to their wellbeing since their last treatment.

• Evaluate vascular access for patency, perform vascular access cannulation, and perform administration of heparin as delegated or as allowed by state law.

• Obtain necessary pre and post treatment vital signs and weight and perform vascular access evaluation pre- treatment

• Initiate dialysis treatment according to prescribed orders including blood flow (QB) and dialysate flow (QD).         

• Evaluate intradialytic problems and provide intervention as prescribed by physician order or as directed.   

• Monitor patients’ response to dialysis therapy. 

• Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of treatment - document.       

• Discontinue dialysis treatment according to established procedures and evaluate patient prior to termination of venous access - standing & sitting blood pressure

• Obtain Hemostasis and apply appropriate dressings.   

• Evaluate the patient prior to discharge.

• Perform and record Pre and Post dialysis evaluation, weight, and vital signs with initial identification        

• Responsible for calculating and entry of individual patients’ dialysis machine programming for Ultrafiltration (UF) goal; treatment time; and UF modeling as prescribed.          

• Responsible for ensuring appropriate safety alarms are enabled, including Narrow Venous Limits, (NVL) 160.    

• Record accurate and timely information regarding vital signs and treatment parameters onto the Hemodialysis Treatment Sheet with initial identification      

• Responsible for accurate documentation of information related to patient treatment including completion of Hemodialysis Treatment Sheet and, if applicable, progress notes.         

• Report any significant information and/or change in patient condition directly to the registered nurse or supervisor.

• Observe patient and conduct machine safety checks according to facility policy. Report any change or unusual findings to the registered nurse or supervisor.

• Perform and document any intervention for unusual patient status and document patients' response to intervention.

• Evaluate patients’ vascular access during treatment including arterial and venous monitoring pressures, provide appropriate intervention as needed, document and report any unusual findings to the registered nurse or supervisor.

• Obtain all prescribed laboratory testing and prepare specimens for collection.      

• Ensure that all blood spills are immediately cleaned with appropriate disinfectant according to facility policy.       

• Prepare, organize, and efficiently utilize supplies and equipment to prevent wastage.       

• Monitors patients performing self-care under the supervision of RN.

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PURPOSE AND SCOPE:

The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP). This position is accountable and responsible for the provision and coordination of clinically competent care including assessment, planning, intervention and evaluation for an assigned group of patients. This may include delegation of appropriate tasks to direct patient care staff including but not limited to RNs, LVN/LPNs and Patient Care Technicians. As a member of the End Stage Kidney Disease (ESKD) health care team, this position participates in decision-making, teaching, leadership functions, and quality improvement activities that enhance patient care outcomes and facility operations.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

All duties and responsibilities are expected to be performed in accordance with Fresenius Kidney Care policy, procedures, standards of nursing practice, state and federal regulations.

· Performs all essential functions under the direction of the Supervisor and with guidance from the Clinical Educator, Preceptor or in collaboration with other Registered Nurses.

· Performs ongoing, systematic collection and analysis of patient data pre – during – post hemodialysis treatment for assigned patients and documents in the patient medical record, makes adjustments or modifications to treatment plan as indicated and notifies Team Leader, Charge Nurse, Supervisor or Physician as needed.

· Assesses, collaborates, and documents patient/family’s basic learning needs to provide initial and ongoing education to patients and family.

· Directs and provides, in collaboration with direct and ancillary patient care staff, all aspects of the daily provision of safe and effective delivery of hemodialysis therapy to assigned patients.

· Administers medications as prescribed or in accordance with approved algorithm(s), and documents appropriate medical justification and effectiveness.

· Initiates or assists with emergency response measures.

· Serves as a resource for health care team, participates in staff training and orientation of new staff as assigned.

· Ensures correct laboratory collection, processing and shipping procedures are performed and reschedules missed or insufficient laboratory collections.

· Identifies expected outcomes, documents and updates the nursing assessment and plan of care for assigned patients through collaboration with the Interdisciplinary Team.

· Ensures patient awareness related to transplant and treatment modality options.

· Required to complete CAP requirements to advance.

· Performs all other duties as assigned by Supervisor.

PHYSICAL DEMANDS AND WORKING CONDITIONS:

The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

· The position provides direct patient care that regularly involves heavy lifting, moving of patients and assisting with ambulation. Equipment aids and/or coworkers may provide assistance.

· This position requires frequent, prolonged periods of standing and the employee must be able to bend over.

· The employee may occasionally be required to move, with assistance, machines and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. as high as 5 feet.

· The work environment is characteristic of a health care facility with air temperature control and moderate noise levels.

· May be exposed to infectious and contagious diseases/materials.

· Day to day work includes desk work, computer work, interaction with patients, facility/hospital staff and physicians.

· The position may require travel to training sites or other facilities.

· May be asked to provide essential functions of this position in other locations with the same physical demands and working conditions as described above.

SUPERVISION:

Assigned oversight of Patient Care Technicians/LPNs/LVNs/RNs as a Team Leader or designated Nurse in Charge, after meeting all the following:

· Successful completion of all FKC education and training requirements for new employees.

· Must have a minimum of 9 months experience as a RN.

· Must have a minimum of 3 months experience in chronic/acute hemodialysis as a RN.

EDUCATION and LICENSURE:

· Graduate of an accredited School of Nursing.

· Current appropriate state licensure.

· Current or successful completion of CPR BLS Certification.

· Must meet the practice requirements in the state in which he or she is employed.

EXPERIENCE AND REQUIRED SKILLS:

· Entry level for RNs with less than 2 years of Nephrology Nursing experience as a Registered Nurse.

· Chronic/acute hemodialysis experience (preferred).

Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.