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 Technicians in the safe and effective delivery of chronic hemodialysis therapy, ensuring compliance with facility policies, procedures, and regulatory standards.
  • Delegates tasks to direct patient care staff, including LVN/LPNs, Patient Care Technicians, and Dialysis Assistants.
  • Assesses daily patient care needs and develops appropriate assignments for staff.
  • Monitors patient care staff for adherence to techniques and facility policies.
  • Participates in staff training and orientation of new employees.
  • Attends all required staff meetings.
• Patient Related:
  • Education:
    • Ensures educational needs of patients and families regarding End Stage Renal Disease (ESRD) are met.
    • Provides ongoing education on renal disease, vascular access, dialysis therapy, and related health conditions.
    • Discusses and records education on diet, fluid, and medication compliance.
    • Provides detailed education on adequacy measures such as Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), and Urea Kinetic Modeling (UKM).
    • Promotes transplant awareness, modality awareness, and catheter reduction.
    • Educates patients on laboratory values and their relationship to dialysis therapy, treatment compliance, medications, and fluid management.
  • Dialysis Treatment:
    • Provides safe and effective delivery of hemodialysis care to patients with ESRD.
    • Accurately implements treatment prescriptions, including Sodium (Na) modeling and Ultrafiltration modeling.
    • Assesses patient response to treatment and adjusts plans as indicated by the prescribing physician.
    • Communicates concerns or issues to the Team Leader or physician.
    • Initiates and documents Initial and Annual Nursing Assessments and ongoing evaluations.
    • Participates in pre-evaluation, initiation, monitoring, termination, access homeostasis, and post-evaluation of hemodialysis treatments.
    • Intervenes for changes in patient adequacy status and troubleshoots access flow issues.
    • Supervises and monitors hemodialysis access care.
    • Implements, administers, and documents patient response to prescribed interdialytic transfusions, including adverse reactions.
    • Ensures accurate documentation by Patient Care Technicians on Hemodialysis Treatment Sheets.
  • Laboratory-related:
    • Reviews, transcribes, and enters physician lab orders into the Medical Information System.
    • Ensures appropriate preparation of lab requisitions and correct use of lab tubes.
    • Performs lab draw and processing procedures for all samples.
    • Follows up on missed or insufficient lab specimens according to company policies.
    • Ensures proper packaging and shipment of lab specimens in compliance with DOT policies.
    • Directs and delivers labs to appropriate facilities.
    • Reports alert, panic, and abnormal lab results to physicians.
    • Forwards lab results to physicians as requested.
  • General Duties:
    • Enforces company policies, procedures, and regulatory standards.
    • Maintains safe, efficient, and effective shift operations.
    • 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 coordinate patient care.
    • Assists patients with prescription refills according to FMCNA policies.
    • Transcribes and enters physician orders into the Medical Information System in a timely manner.
    • Oversees all patient information documentation.
    • Maintains facility drug list for required stock medications.
    • Maintains competency in emergency procedures and initiates CPR as needed.
    • Ensures availability and verification of emergency equipment.
    • Provides appropriate vaccinations, immunizations, and annual TB testing.
    • Administers medications as prescribed and documents medical justification if indicated.
    • Administers PRN medications and documents assessment of effectiveness.
    • Maintains appropriate recording of controlled substances.
    • Assists with patient transportation coordination if necessary.
• Maintenance/Technical:
  • Ensures a clean, safe, and sanitary environment in the dialysis facility treatment area.
  • Demonstrates competency in operating all dialysis-related equipment safely and effectively.
  • Ensures patient stations, machines, and chairs are clean and appropriately placed.
  • Immediately addresses 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 patient status, are documented and entered into the Medical Information System.
    • Ensures all patient-related treatment data is accurately entered into the system.
    • Implements FMCNA policies regarding patient admission, transfer, and discharge.
    • Verifies accuracy of Patient Care Technician documentation.
  • Daily:
    • Reviews and ensures completion of Hemodialysis Treatment Sheets by all patient care staff.
    • Follows opening and closing procedures, ensuring all staff and patients safely leave the premises.
  • Monthly:
    • Initiates, documents, and completes Continuous Quality Improvement (CQI) activities, including monthly reports.
    • Completes monthly nurses' progress notes.
    • Ensures patient medical records are complete with appropriate documentation and identification.
    • Reviews transplant status and follows established procedures for appropriate action.
    • Completes patient care plans for new or unstable patients within the required timeframe.
    • 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.
• Other:
  • Obtains and maintains all required credentials or certifications in an active and valid status.
  • Capable of working in a challenging environment requiring multitasking, flexibility, and handling demanding situations.
  • 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 regular 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 controlled air temperature 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 needed.