New Graduate Registered Nurse

Fresenius Medical Care is seeking a New Graduate Registered Nurse to join the hemodialysis healthcare team. In this role, you will provide direct patient care to individuals with End Stage Renal Disease (ESRD) under the supervision of a Staff Registered Nurse. You will work in a dialysis facility setting, delivering safe and effective hemodialysis therapy while supporting the organization's commitment to quality enhancement and continuous improvement.

Clinical Setting

You will work in a hemodialysis facility providing chronic dialysis therapy to patients with ESRD. The environment is characteristic of a healthcare facility with air temperature control and moderate noise levels. You may be exposed to infectious and contagious diseases and materials. The position requires frequent, prolonged periods of standing, bending, and the ability to assist with patient lifting and movement. You may occasionally move machines and equipment up to 200 lbs. with assistance and lift chemical and water solutions up to 30 lbs. as high as 5 feet.

Responsibilities

Patient Care and Treatment

• Provide safe and effective delivery of hemodialysis therapy to patients with ESRD
• Accurately implement treatment prescriptions including sodium modeling and ultrafiltration modeling as appropriate
• Assess patients' response to hemodialysis treatment and make appropriate adjustments to the treatment plan as indicated by the prescribing physician
• Initiate and complete initial and annual nursing assessments and ongoing evaluation of patient care needs
• Actively participate in pre-evaluation, initiation, monitoring, termination, access homeostasis, and post-evaluation of patients receiving hemodialysis
• Provide, supervise if applicable, and monitor hemodialysis access care
• Implement, administer, monitor, and document patient response to prescribed interdialytic transfusions
• Identify and communicate patient-related issues to the Team Leader or physician
• Take appropriate intervention for changes in patient adequacy status and troubleshoot access flow issues

Patient Education

• Ensure educational needs of patients and families are met regarding ESRD
• Provide ongoing education regarding renal disease, vascular access, dialysis therapy, and related health conditions
• Discuss and record education related to diet, fluid, and medication compliance
• Provide patient-specific education regarding adequacy measures including Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), and Urea Kinetic Modeling (UKM)
• Educate patients regarding transplant awareness, modality awareness, and drive catheter reduction
• Educate patients regarding laboratory values and their relationship to adequate dialysis therapy, treatment compliance, medications, and fluid management

Staff Supervision and Training

• Direct Patient Care Technicians' provision of safe and effective hemodialysis therapy
• Delegate tasks to all direct patient care staff including LVN/LPNs, Patient Care Technicians, and Dialysis Assistants
• Assess daily patient care needs and develop appropriate patient care assignments
• Routinely monitor patient care staff for appropriate techniques and adherence to facility policies and procedures
• Participate in staff training and orientation of new staff as assigned
• Participate in all required staff meetings

Laboratory Management

• Review, transcribe, and enter physician lab orders accurately into the Medical Information System
• Ensure appropriate preparation of lab requisitions
• Ensure correct lab tubes are utilized for prescribed specimens and that lab draw and processing procedures are performed appropriately
• Identify and ensure appropriate follow-through regarding missed labs and insufficient specimens
• Ensure all specimens are appropriately packaged according to Department of Transportation (DOT) policies
• Ensure labs are directed and delivered to appropriate laboratories
• Report alert, panic, and abnormal lab results to the appropriate physician
• Ensure lab results are forwarded to physicians as requested

Documentation and Medical Records

• Ensure all relevant data including physician orders, lab results, vital signs, treatment parameters, and patient status are documented appropriately and entered into the Medical Information System
• Ensure all appropriate patient-related treatment data is entered into the Medical Information System
• Review and ensure appropriate daily completion of Hemodialysis Treatment Sheets by all patient care staff
• Ensure accuracy of Patient Care Technician documentation
• Ensure all FMCNA policies regarding patient admission, transfer, and discharge are appropriately implemented
• Complete monthly nurses' progress notes
• Ensure patient medical records are complete with appropriate information, documentation, and identification on each page
• Review transplant status and follow established procedures
• Complete patient care plans for new patients within the initial 30 days or for patients deemed unstable requiring monthly patient care plans
• Complete any long-term programs that are due
• Complete initial and annual Nursing History and Assessment physical
• Ensure completion of Annual Standing Order Review with each physician

Medication and Emergency Management

• Administer medications as prescribed or in accordance with approved algorithms
• Administer PRN medications as prescribed and complete appropriate documentation of assessment of effectiveness
• Maintain appropriate recording of controlled substances as required by law
• Maintain competency with all emergency operational procedures
• Initiate CPR and emergency measures in the event of cardiac and/or respiratory arrest
• Ensure verification and availability of adequate emergency equipment

Facility Operations

• Enforce all company-approved policies and procedures and regulations set forth by state and federal agencies
• Maintain overall shift operation in a safe, efficient, and effective manner
• Ensure a clean, safe, and sanitary environment in the dialysis facility treatment area
• Ensure all patient stations, including machines and chairs, are clean and free of blood and placed appropriately
• Ensure that all blood spills are immediately addressed according to FMCNA Bloodborne Pathogen Control Policies
• Ensure competency in the operation of all dialysis-related equipment safely and effectively
• Act as a resource for other staff members
• Routinely meet 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
• Provide assistance as needed to patients regarding prescription refills according to FMCNA policies
• Ensure all physician orders are transcribed and entered into the Medical Information System in a timely manner
• Oversee all patient information documentation
• Maintain facility drug list for all required stock medications
• Ensure provision of appropriate vaccinations, immunizations, and annual Tuberculosis (TB) testing
• Assist with coordination of patient transportation if necessary
• Initiate and document ongoing Continuous Quality Improvement (CQI) activities including monthly reports
• Maintain regular and punctual attendance
• Perform other related duties as assigned

Required Qualifications

• Graduation from an accredited nursing program within the past 12 months
• Current appropriate state Temporary Permit
• Required to obtain nursing license and registration within the timeline defined by state regulations, or within 90 days of hire, whichever occurs first
• Must meet the practice requirements in the state in which you are employed
• Capable of working in a challenging environment which requires the ability to handle demanding situations, multitasking, and remaining flexible to changing needs

Additional Requirements

• As a condition of continued employment, you are required to obtain and maintain any required credentials or certifications necessary for your position in an active and valid status, including renewal of such credentials or certifications prior to any expiration date. If your credential or certified status changes, you must notify your supervisor immediately.
• Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodation can be made.
• Physical demands include the ability to regularly lift and move patients, assist with ambulation, frequently stand for prolonged periods, and bend over. Equipment aids and/or coworkers may provide assistance. You may occasionally be required to move machines and equipment up to 200 lbs. with assistance and lift chemical and water solutions up to 30 lbs. as high as 5 feet.