Fresenius Medical Center Full Time Dialysis RN - Rotating Shifts - 40 Hours in La Mesa, California
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 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).
Supports the FMCNA’s mission, vision, values, and customer service philosophy. Adheres to all requirements of the FMCNA Compliance Program, and FMS patient care and administrative policies.
DUTIES / ACTIVITIES:
Responsible for driving the FMS culture through values and customer service standards.
Accountable for outstanding customer service to all external and internal customers.
Develops and maintains effective relationships through effective and timely communication.
Takes initiative and action to respond, resolve and follow up regarding customer service issues with all customers in a timely manner.
PRINCIPAL RESPONSIBILITIES AND DUTIES
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
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 and dialysis therapy, and other 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 the relationship to adequate dialysis therapy, compliance with treatment schedule, medications, and fluid
Provides safe and effective delivery of care to patients with ESRD
Implements accurate 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 Assessment, and ongoing evaluation and documentation of patient care needs according to FMC Policies and Procedures
Participates in the pre evaluation, initiation, monitoring, termination, access homeostasis, and post evaluation of patients receiving hemodialysis treatment therapy according to established FMC procedures
Identifies and implements appropriate intervention 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 intradialytic transfusions, including appropriate notification of adverse reactions to physician and appropriate 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 labs 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 polices 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
Act as a resource for other staff members
Routinely meets with the Clinical Manager to discuss personnel and patient care status, issues, and information
Collaborate and communicate with physicians and other members of the healthcare team 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 the event of a 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 algorithm(s), 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 the coordination of patient transportation if necessary
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 and placed appropriately
Ensures that all blood spills are immediately addressed according to FMCNA Blood-borne Pathogen Control Policies
MEDICAL RECORDS & DOCUMENTATION:
Ensures all relevant data including physician orders, lab results, vital signs and treatment parameters, and patient status are documented appropriately and entered into Medical Information System
Ensures all appropriate patient related treatment data is entered into the Medical Information System
Ensures all FMCNA policies regarding patient admission, transfer, and discharge are appropriately implemented
Ensures and verify accuracy of Patient Care Technician documentation
Reviews and ensures appropriate daily completion of Hemodialysis Treatment Sheets by all patient care staff
Ensures that all appropriate procedures are followed regarding opening and closing procedures, inclusive of monitoring that all staff and patients have safely left the premises
Initiates, documents, and completes ongoing Continuous Quality Improvement (CQI) activities including monthly reports
Completes monthly nurses' progress note
Ensures patient medical records are complete with appropriate information, documentation, and identification on each page (Addressograph label is on all chart forms)
Reviews transplant status and follows established procedure regarding appropriate action to be taken
Completes patient care plans for new patients within the initial 30 days or any patients deemed unstable requiring monthly patient care plans
Completes any long-term programs that are due
Completes initial and annual Nursing History and Assessment physical
Ensures completion of Annual Standing Order Review with each physician as required
- Performs additional duties as assigned.
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.
Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodations can be made.
The position provides direct patient care that regularly involves heavy lifting and 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. up 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.
Graduate of an accredited School of Nursing.
Current appropriate state licensure
Must meet the practice requirements in the state in which he or she is employed
Education and Training qualifications per UltraCare CAP program requirements.
EXPERIENCE AND REQUIRED SKILLS
Minimum of one-year medical-surgical nursing experience preferred
Hemodialysis experience preferred
ICU experience preferred
Experience and skill requirements as delineated for the appropriate level in the UltraCare CAP program.
Successfully complete a training course in the theory and practice of hemodialysis
Successfully complete CPR Certification
Provide coverage at any or all area facilities as required by management
ICD - 9 coding Training
Nurses Technical Training
Must meet appropriate state requirements (if any)
EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity