Registered Nurse Dialysis - FT

Description

Scope of Work:

The Registered Nurse delivers care and treatment to patients with chronic renal disease. This position performs duties as assigned by the Charge Nurse, including supporting and supervising Certified Hemodialysis Technicians. 

Responsibilities and Expectations:

1. Assist with clinical and operational procedures to improve patient health and minimize hospitalizations and missed treatments

2. Demonstrate effective use of business supplies and efficient utilization of scheduled work hours

3. Perform duties as assigned to meet the patient care and/or operational needs of the facility

4. Document monthly review of patient medication profiles. 

5. Administer in-center medications as ordered by the physician following the 5 rights of medication administration

6. Transcribe orders from medical staff 

7. Assist with the implementation of anemia management and medication protocols per physician order

8. Provide and document patient education and follow up as needed

9. Complete patient admissions process as outlined in the policy and procedure

10. Complete pre and post treatment physical assessments

11. Initiate and terminate patient treatments to include connecting and disconnecting catheters or vascular accesses and cleaning catheter/vascular access sites per policies and procedures

12. Obtain blood samples, centrifuge samples and pack labs as required to complete physician orders

13. Perform duties at all times under the supervision of the Facility Administrator or Charge Nurse and within limits established by and in accordance with company policies and procedures, applicable state and federal laws and regulations

14. Comply with all applicable healthcare regulations, guidelines, and protocols

15. Follow policies and procedures for personal protective equipment (PPE) use

16. Maintain confidentiality of patient protected health information (PHI)

17. Maintain security of medical records

18. Set up hemodialysis machines according to policies and procedures

19. Respond to visual and audio alarms on machines; troubleshoot machine alarms 

20. Remove disposables and clean station after each treatment following policies and procedures

21. Direct and lead the team in emergency response incidents

22. Obtain pre and post treatment weight of patient per policies and procedures

23. Safely initiate and terminate dialysis treatments per facility policies and procedures, and within scope of practice as allowed by state regulations

24. Monitor all patients during dialysis treatments at a minimum of every 30 minutes or per policies and procedures with accurate documentation

25. Assist with patient entry and exit within the facility as needed

26. Review and approve treatment records ensuring accurate documentation of information related to patient treatment by end of shift

27. Maintain supplies in the nurse’s station and medication preparation area. Assist in keeping supply room clean and organized

28. Maintain workspace and unit common areas to ensure cleanliness and organization

29. Supervise and confirm proper procedure of water testing at the beginning of each shift by the assigned staff member per policies and procedures. Document quality control logs throughout the day and after all treatments, as required per policies and procedures

30. Report any significant information or change in patient condition to the patient physician

31. Report machine problems to the Biomedical Technician and Facility Administrator

32. Participate in staff meetings as required. Attend in-services and continuing education sessions in compliance with company policies and procedures.

33. Complete patient rounds with providers

34. Always handle incoming and outgoing calls professionally and courteously, promptly answer calls while identifying oneself and the location

35. Assist with staff training as requested

36. Participate in team concepts and promote a team environment

37. Follow all company policies and procedures Expected to report to work on scheduled day at scheduled time, working entire shift as per attendance policy

38. All other duties as assigned

Physical Demands and Working Conditions:

The physical demands and working conditions described below arise from and are required in the performance of the essential functions of this direct patient-care position. An employee must be able to perform the essential functions of the position safely and effectively, with or without reasonable accommodation. National Renal Care will consider and provide reasonable accommodations to qualified individuals with disabilities as required by applicable law.

For purposes of this job description:

• Occasionally      means up to one-third of the work shift. 
• Frequently      means from one-third to two-thirds of the work shift. 
• Continuously means more than two-thirds of      the work shift. 

The frequency and duration of particular activities may vary based on patient census, patient condition, assigned responsibilities, shift length, emergencies, and facility operational needs.

1. Standing and walking: The position requires frequent to continuous standing and walking throughout the work shift, including prolonged periods of standing while providing and monitoring patient care. The employee must regularly move among patient treatment stations, dialysis machines, medication and supply areas, weighing areas, nursing stations, and emergency equipment. Work is not primarily sedentary, and the employee cannot ordinarily perform the position while remaining seated for a substantial portion of the work shift.

2. Bending and stooping: The position requires frequent bending and stooping at the waist to assess and assist patients, observe and access vascular access sites, operate and inspect dialysis equipment, connect and disconnect treatment lines, access supplies, adjust treatment chairs, obtain patient weights, and clean or disinfect patient-care areas and equipment.

3. Squatting, crouching, and kneeling: The position requires occasional squatting, crouching, or kneeling to access patients, equipment, electrical or machine connections, treatment-chair components, supplies stored at lower levels, spills or areas requiring disinfection, and emergency situations. The employee must be able to move into and out of these positions as necessary to perform patient-care and safety functions.

4. Reaching and positional movement: The position requires frequent to continuous reaching at, below, and above shoulder level; twisting and turning of the torso; and movement between standing, walking, bending, crouching, and seated positions. The employee must be able to reach across or around dialysis machines, treatment chairs, patients, work surfaces, and supply storage areas.

5. Lifting and carrying: The position requires frequent lifting and carrying of clinical supplies and patient-care materials and occasional lifting and carrying of heavier supplies, equipment, chemical solutions, or water solutions weighing up to 50 pounds. Items may need to be lifted from floor level to waist level and from waist level to a height of approximately five feet. Appropriate material-handling equipment or coworker assistance must be used when required by NRC safety procedures or when necessary to perform the task safely.

6. Patient assistance and handling: The position requires frequent to continuous hands-on assistance to patients of varying sizes, weights, mobility levels, and physical conditions. This may include assisting with ambulation; positioning and repositioning patients in treatment chairs; helping patients enter or exit treatment chairs, wheelchairs, or other mobility equipment; steadying patients; and responding when a patient loses balance or becomes unable to bear weight. The employee must be able to support and control an appropriate portion of a patient’s weight during an assisted movement, transfer, repositioning, or unexpected loss of balance. Available mobility aids, transfer equipment, and appropriately trained coworkers must be used when indicated by the patient’s condition and NRC safety procedures.

7. Pushing and pulling: The position requires frequent pushing and pulling of lighter clinical equipment, supply carts, and patient-care materials and occasional pushing, pulling, or positioning of wheelchairs, treatment chairs, dialysis machines, and other rolling equipment. The employee may be required, with assistance, to move machines or equipment having a total weight of up to 200 pounds.

8. Emergency response and BLS: The position requires the ability to respond promptly to patient emergencies, falls, changes in condition, blood loss, needle dislodgement, treatment complications, machine alarms, cardiac or respiratory emergencies, and other urgent situations. The employee must be able to move quickly to the patient, access and move emergency equipment, assume the physical position necessary to assess and treat the patient, and perform the physical components of AHA BLS. This includes repeated and sustained chest compressions, ventilation support, use of an automated external defibrillator, and continuation of emergency-response activities until relieved or until the emergency concludes.

9. Upper-extremity and hand use: The position requires frequent to continuous use of the arms, wrists, hands, and fingers, including repetitive gripping, grasping, pinching, pushing, pulling, and fine motor manipulation. These activities are necessary to operate dialysis machines and computers, handle tubing and connectors, manipulate clamps, prepare and administer medications within the employee’s scope of practice, handle needles and syringes, obtain specimens, perform vascular-access procedures, document patient care, and complete cleaning and disinfection procedures.

10. Observation and response: The position requires the ability to perceive and respond promptly to changes in patient condition, treatment-area activity, machine displays, visual and audible alarms, warning indicators, color-coded components, vascular access sites, bloodlines, labels, medication information, treatment orders, and emergency communications, with corrective devices or reasonable accommodation when applicable.

11. Work pace and sustained activity: The position requires sustained physical activity during patient treatment, treatment initiation and termination, station turnover, emergency response, and other periods of increased clinical activity. The employee must be able to perform required patient-care functions within applicable clinical and operational timeframes while maintaining patient safety and infection-control standards.

12. Computer and documentation work: The position includes occasional periods of sitting and frequent use of computers, electronic medical records, telephones, and other office or clinical technology. Computer and documentation work does not eliminate the requirement for frequent physical presence and activity in the patient-care area.

13. Personal protective equipment: The position requires the ability to wear required personal protective equipment for the duration of the assigned activity. Required equipment may include gloves, gowns, masks, eye or face protection, respirators when applicable, and other protective equipment required by infection-control or safety procedures.

14. Exposure and working conditions: The employee works in a healthcare environment and may be exposed to blood, bodily fluids, bloodborne pathogens, infectious or contagious diseases, contaminated materials, sharps, cleaning agents, disinfectants, chemical solutions, and other materials ordinarily present in a dialysis facility. The work environment is generally climate-controlled and may include moderate or intermittently elevated noise levels, equipment alarms, interruptions, and close physical contact with patients and coworkers.

15. Other locations: The position may require travel to training sites or other NRC facilities. When assigned to work at another facility, the employee is expected to perform the same essential functions and satisfy the physical demands and working conditions applicable to the position.

Requirements

Position Requirements:

1. Current Registered Nurse (RN) license, in good standing, in the state of practice. License must be maintained as current and in good standing 

2. Current American Heart Association (AHA) Basic Life Support (BLS) Provider certification required upon hire and must be maintained without lapse throughout employment.

3. Previous experience working in dialysis preferred

4. Confirmation of ability to differentiate primary colors

5. Demonstrated working knowledge of the English language and ability to communicate in writing as well as verbally

6. Must have basic computer skills, including Microsoft Office (Word, Excel, Outlook); proficiency in all NRC clinical applications required within 30 days of hire

7. Must successfully complete training program approved by the Medical Director, including demonstrated competency, within 30 days of hire

8. Successful completion of clinical skills checklist within 30 days of hire and annually thereafter

9. Knowledge of medical terminology and procedures related to dialysis

10. Strong organizational and multitasking skills

11. Excellent interpersonal and communication skills for effective customer interactions.

12. Proficiency in using electronic medical record (EMR) systems.

13. Ability to work in a fast-paced environment and remain composed under pressure.

14. Attention to detail to ensure accuracy and thoroughness of documentation and correspondences

15. Excellent time management and task prioritization skills