New Graduate Nurse

Functions as part of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a Staff Registered Nurse, to ensure provision of quality patient care daily in accordance with FMS policies, procedures, and training. Supports the FMCNA’s mission, vision, values, and customer service philosophy, as well as the Quality Enhancement Program (QEP) and CQI Activities, including those related to patient satisfaction. Actively participates in process improvement activities that enhance patient outcomes and adheres to all requirements of the FMCNA Compliance Program and FMS patient care and administrative policies.

Responsibilities

• Staff Related:
  • Directs Patient Care Technician’s provision of safe and effective delivery of chronic hemodialysis therapy to patients in compliance with facility policy procedure manuals and regulations.
  • Delegates tasks to direct patient care staff, including 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.
  • Attends all required staff meetings as scheduled.
• Patient Related:
  • Education:
    • Ensures educational needs of patients and family are met regarding End Stage Renal Disease (ESRD).
    • Provides ongoing education to patients regarding renal disease, vascular access, dialysis therapy, and related health conditions.
    • Discusses and records education related to diet/fluid and medication compliance.
    • Provides patient-specific education on adequacy measures (e.g., Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM)).
    • Ensures transplant awareness, modality awareness, and drives catheter reduction.
    • Educates patients on laboratory values and their relationship to adequate dialysis therapy, compliance with treatment schedules, medications, and fluid management.
  • Dialysis Treatment:
    • Provides safe and effective delivery of care to patients with ESRD.
    • Accurately implements treatment prescriptions, including Sodium (Na) modeling and Ultrafiltration modeling.
    • Assesses patients’ response to hemodialysis treatment and adjusts the treatment plan as indicated by the prescribing physician.
    • Communicates problems or concerns to the Team Leader or physician.
    • Initiates and documents Initial and Annual Nursing Assessment and ongoing evaluation of patient care needs.
    • Actively participates in pre-evaluation, initiation, monitoring, termination, access homeostasis, and post-evaluation of hemodialysis treatment.
    • Takes appropriate intervention for changes in patient adequacy status and troubleshoots access flow issues.
    • Provides, supervises, and monitors hemodialysis access care according to established procedures.
    • Implements, administers, monitors, and documents patient response to prescribed interdialytic transfusions, including notification of adverse reactions.
    • Ensures accurate and complete documentation by Patient Care Technicians on the Hemodialysis Treatment Sheet.
  • Laboratory-related:
    • Reviews, transcribes, and enters physician lab orders accurately into the Medical Information System.
    • Ensures appropriate preparation of lab requisitions and correct use of lab tubes for prescribed specimens.
    • Identifies and ensures follow-through regarding missed labs and insufficient specimens.
    • Ensures specimens are appropriately packaged and shipped according to DOT policies.
    • Reports alert/panic and abnormal lab results to the appropriate physician.
    • Forwards lab results to physicians as requested.
  • General Duties:
    • Enforces all company-approved policies, procedures, and regulations set forth by state and federal agencies.
    • 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.
    • Collaborates with physicians and healthcare team members to interpret, adjust, and coordinate patient care.
    • Assists patients with prescription refills according to FMCNA policies.
    • Ensures timely transcription and entry of all physician orders into the Medical Information System.
    • Oversees all patient information documentation.
    • Maintains facility drug list for required stock medications.
    • Maintains competency with emergency operational procedures and initiates CPR and emergency measures as needed.
    • Ensures verification and availability of adequate emergency equipment.
    • Ensures provision of appropriate vaccinations, immunizations, and annual Tuberculosis (TB) testing.
    • Administers medications as prescribed and documents medical justification if indicated.
    • Administers PRN medications and completes appropriate documentation of assessment of effectiveness.
    • Maintains appropriate recording of controlled substances as required by law.
    • Assists with the coordination of patient transportation if necessary.
• Maintenance/Technical:
  • Ensures a clean, safe, and sanitary environment in the dialysis facility treatment area.
  • Ensures competency in the operation of all dialysis-related equipment safely and effectively.
  • Ensures all patient stations, including machines and chairs, are clean and free of blood.
  • Ensures immediate addressing of all blood spills according to FMCNA Bloodborne Pathogen Control Policies.
• Medical Records & Documentation:
  • General:
    • Ensures all relevant data, including physician orders, lab results, vital signs, and treatment parameters, are documented appropriately in the Medical Information System.
    • Ensures all appropriate patient-related treatment data is entered into the Medical Information System.
    • Ensures implementation of FMCNA policies regarding patient admission, transfer, and discharge.
    • Verifies accuracy of Patient Care Technician documentation.
  • Daily:
    • Reviews and ensures appropriate daily completion of Hemodialysis Treatment Sheets by all patient care staff.
    • Ensures all appropriate procedures are followed regarding opening and closing procedures.
  • Monthly:
    • Initiates, documents, and completes ongoing Continuous Quality Improvement (CQI) activities, including monthly reports.
    • Completes monthly nurses' progress notes.
    • Ensures patient medical records are complete with appropriate information and identification.
    • Reviews transplant status and follows established procedures for appropriate action.
    • Completes patient care plans for new patients within the initial 30 days or for any unstable patients requiring monthly plans.
    • Completes any long-term programs that are due.
  • Annually:
    • Completes initial and annual Nursing History and Assessment physical.
    • Ensures completion of Annual Standing Order Review with each physician as required.
• Other:
  • Obtains and maintains any required credentials or certifications necessary for the position in an active and valid status.
  • Capable of working in a challenging environment requiring multitasking and flexibility to changing needs.
  • Maintains regular and punctual attendance.
  • Performs other related duties as assigned.

Requirements

• Graduated from an accredited nursing program within the past 12 months.
• Required to obtain nursing license and registration within the timeline defined by state regulations, or within 90 days of hire, whichever occurs first.
• Current appropriate state Temporary Permit.
• Must meet the practice requirements in the state of employment.

Physical Demands and Working Conditions

• Provides direct patient care involving heavy lifting and moving of patients, with assistance from equipment or coworkers.
• Requires frequent, prolonged periods of standing and bending over.
• May occasionally move machines and equipment of up to 200 lbs with assistance.
• May lift chemical and water solutions of up to 30 lbs as high as 5 feet.
• Work environment is characteristic of a healthcare facility with air temperature control and moderate noise levels.
• May be exposed to infectious and contagious diseases/materials.
• Employees are required to take the Ishihara’s Color Blindness test; reasonable accommodation may be considered if failed.