Outpatient Registered Nurse - RN

Fresenius Medical Care; New York (NY); On-site; Full time

Job summary

A leading healthcare provider is seeking a Staff Registered Nurse to join their hemodialysis team in New York. The role involves ensuring quality patient care, supervising staff, and providing education to patients with End Stage Renal Disease. Candidates should have nursing credentials and experience in hemodialysis. This position offers a dynamic work environment with opportunities for professional growth.

Qualifications

• Minimum one-year medical-surgical nursing experience preferred.
• Successful completion of hemodialysis training course.

Responsibilities

• Directs Patient Care Technician’s provision of safe and effective delivery of chronic hemodialysis therapy.
• Educates patients regarding laboratory values and their relationship to adequate dialysis therapy.
• Participates in all required staff meetings as scheduled.

Skills

Patient Care

Communication

Team Collaboration

Education

Graduate of an accredited School of Nursing

Current appropriate state licensure

Job description

PURPOSE AND SCOPE:

Functions as part of the hemodialysis health care team as a Staff Registered Nurse to ensure provision of quality patient care on a daily basis in accordance with FMS policies, procedures, and training. Supports the FMCNA’s mission, vision, values, and customer service philosophy. Supports the FMCNA commitment to the Quality Enhancement Program (QEP) and CQI activities, including those related to patient satisfaction and actively participates in process improvement activities that enhance the likelihood that patients will achieve the FMCNA Quality Enhancement Goals (QEP). Adheres to all requirements of the FMCNA Compliance Program, and FMS patient care and administrative policies.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

• Directs Patient Care Technician’s provision of safe and effective delivery of chronic hemodialysis therapy to patients in compliance with standards outlined in the facility policy procedure manuals, as well as regulations set forth by the corporation, state, and federal agencies.
• Delegates tasks to all direct patient care staff including but not limited to LVN/LPNs, Patient Care Technicians, and Dialysis Assistants.
• Assesses daily patient care needs and develops appropriate patient care assignments.
• Routinely monitors patient care staff for appropriate techniques and adherence to facility policy and procedures.
• Participates in staff training and orientation of new staff as assigned.
• Participates in all required staff meetings as scheduled.
• Ensures educational needs of patients and family are met regarding End Stage Renal Disease (ESRD).
• Provides ongoing education to patients regarding their renal disease, vascular access, dialysis therapy, and related health conditions.
• Discusses with patient, and records education related to diet/fluid and medication compliance.
• Provides patient-specific detailed education regarding adequacy measures where applicable—Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM).
• Ensures transplant awareness, modality awareness, and drive catheter reduction.
• Educates patients regarding laboratory values and their relationship to adequate dialysis therapy, treatment schedule, medications, and fluid intake.
• Provides safe and effective delivery of care to patients with ESRD.
• Accurately implements treatment prescriptions including Sodium (Na) modeling prescription, and Ultrafiltration modeling (where appropriate) to ensure stable treatment therapy as indicated.
• Assesses patients’ response to hemodialysis treatment therapy, making appropriate adjustments and modifications to the treatment plan as indicated by the prescribing physician. Communicates problems or concerns to the Team Leader or physician.
• Identifies and communicates patient-related issues to Team Leader or physician.
• Initiates initial and annual nursing assessments, and ongoing evaluation and documentation of patient care needs according to FMC policies and procedures.
• Participates in pre-evaluation, initiation, monitoring, termination, access homeostasis, and post-evaluation of patients receiving hemodialysis treatment therapy according to established FMC procedures.
• Takes appropriate interventions for changes in patient adequacy status and troubleshooting access flow issues as identified by OLC/AMP yellow lights.
• Provides, supervises (if applicable), and monitors hemodialysis access care according to established procedures.
• Implements, administers, monitors, and documents patient's response to prescribed interdialytic transfusions, including appropriate notification of adverse reactions to physician and blood supplier.
• Ensures accurate and complete documentation by Patient Care Technician on the Hemodialysis Treatment Sheet.
• Reviews, transcribes, and enters physician lab orders accurately into the Medical Information System.
• Ensures appropriate preparation of lab requisitions for Spectra or alternate lab.
• Ensures correct lab tubes are utilized for prescribed lab specimens and that lab draw and processing procedures are performed appropriately for all lab samples.
• Identifies and ensures appropriate follow-through regarding missed labs and specimens reported to be insufficient according to company policies and procedures.
• Ensures all specimens are appropriately packaged according to Department of Transportation (DOT) policies and procedures relating to shipment of blood or body fluid specimens and potentially hazardous material.
• Ensures that all labs are directed and delivered to appropriate labs.
• Reports alert/panic and abnormal labs results to appropriate physician.
• Ensures lab results are forwarded to physicians as requested.
• Enforces all company approved policies and procedures, as well as regulations set forth by state and federal agencies and departments.
• Maintains overall shift operation in a safe, efficient, and effective manner.
• Acts as a resource for other staff members.
• Routinely meets with the Clinical Manager to discuss personnel and patient care status, issues, and information.
• Collaborates and communicates with physicians and other healthcare team members to interpret, adjust, and coordinate care provided to the patient.
• Provides assistance as needed to patients regarding prescription refills according to FMCNA Policies.
• Ensures all physician orders are transcribed and entered into the Medical Information system in a timely manner.
• Oversees all documentation of patient information.
• Maintains facility drug list for all required stock medications.
• Maintains competency with all emergency operational procedures, and initiates CPR and emergency measures in case of cardiac and/or respiratory arrest.
• Ensures verification and availability of adequate emergency equipment.
• Ensures provision of appropriate vaccinations, immunizations, and annual Tuberculosis (TB) testing.
• Administers medications as prescribed or in accordance with approved algorithms, and documents appropriate medical justification if indicated.
• Administers PRN medications as prescribed and completes appropriate documentation of assessment of effectiveness.
• Maintains appropriate recording of controlled substances as required by law.
• Assists with patient transportation coordination if necessary.
• Ensures a clean, safe, and sanitary environment in the dialysis facility treatment area.
• Ensures competency in operation of all dialysis-related equipment safely and effectively.
• Ensures all patient stations, including machines and chairs, are clean and properly maintained.
• Ensures all blood spills are immediately addressed per FMCNA Bloodborne Pathogen Control Policies.
• Ensures all relevant data including physician orders, lab results, vital signs, treatment parameters, and patient status are documented appropriately and entered into Medical Information System.
• Ensures all patient-related treatment data is accurately entered into the system.
• Ensures all policies regarding patient admission, transfer, and discharge are followed.
• Verifies the accuracy of Patient Care Technician documentation.
• Reviews and ensures completion of Hemodialysis Treatment Sheets by all staff.
• Ensures procedures for opening and closing the facility are followed, including monitoring that all staff and patients have safely left.
• Initiates and documents ongoing CQI activities, including monthly reports.
• Completes monthly nurses' progress notes.
• Ensures patient medical records are complete and properly labeled.
• Reviews transplant status and follows procedures for appropriate action.
• Completes initial and annual Nursing History and Assessment physicals.
• Completes patient care plans for new or unstable patients within 30 days or as needed.
• Completes scheduled long-term programs and assessments.
• Completes initial and annual Nursing History and Assessment physicals.
• Ensures completion of Annual Standing Order Review with each physician.
• Performs any additional duties as assigned.

PHYSICAL DEMANDS AND WORKING CONDITIONS

The physical demands and work environment characteristics are representative of those encountered while performing this role. Reasonable accommodations may be made for individuals with disabilities.

• The position involves heavy lifting, moving patients, assisting with ambulation, and operating equipment of up to 200 lbs., with assistance. Frequent standing and bending are required. Chemical and water solutions of up to 30 lbs. may be lifted up to 5 feet.
• The environment is typical of a healthcare facility with controlled temperature and moderate noise. Exposure to infectious materials is possible.
• Employees are required to pass the Ishihara Color Blindness test; failing does not preclude employment if accommodations are possible.

SUPERVISION:

• None

EDUCATION AND CREDENTIALS:

• Graduate of an accredited School of Nursing.
• Current appropriate state licensure.
• Must meet state practice requirements.

EXPERIENCE AND SKILLS:

• Minimum one-year medical-surgical nursing experience preferred.
• Hemodialysis experience preferred.
• ICU experience preferred.
• Successful completion of hemodialysis training course.
• CPR certification required.
• Must meet Ishihara's Color Blindness test requirements.
• Availability to cover all area facilities as needed.
• Icd-9 coding and Nurses Technical Training preferred.

The pay rate varies by location and qualifications: Hourly Rate: $43.00 - $62.00

EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity

Fresenius Medical Care North America maintains a drug-free workplace.

Clinic Hours: 4:30 AM - 9:30 PM, Monday - Saturday