Outpatient Registered Nurse - Fresenius Medical Care
Company: Fresenius Medical Care
Location: Bellaire
Posted on: April 24, 2024
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Job Description:
PURPOSE AND SCOPE: 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 on a daily basis in accordance with FMS
policies procedures and training. Supports the FMCNA's mission
vision values and customer service philosophy. 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). Adheres to all requirements of the FMCNA
Compliance Program and FMS patient care and administrative
policies. Employees hired into this position will be required to
obtain their nursing license and registration within the time frame
outlined in state specific regulations or within 90 days from hire
date whichever comes sooner. PRINCIPAL DUTIES AND RESPONSIBILITIES:
STAFF RELATED: 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. 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 Participates in 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 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. Dialysis Treatment: Provides safe and
effective delivery of care to patients with ESRD. Accurately
implements 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.
Actively participates in the pre evaluation initiation monitoring
termination access homeostasis and post evaluation of patients
receiving hemodialysis treatment therapy according to established
FMC procedures. Takes 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 interdialytic
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. Laboratory-related: 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. General duties: Enforces all company
approved policies 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. 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 and placed
appropriately. Ensures that all blood spills are immediately
addressed 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 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. Daily 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. Monthly
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. Annually Completes initial and
annual Nursing History and Assessment physical. Ensures completion
of Annual Standing Order Review with each physician as required.
OTHER: 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). In the event that your credential or
certified status changes you must notify your supervisor
immediately. Capable of working in a challenging environment which
requires the ability to handle demanding situations multitasking
and remaining flexible to changing needs. Maintain regular and
punctual attendance. Perform other related duties as assigned.
Additional responsibilities may include focus on one or more
departments or locations. See applicable addendum for department or
location specific functions. 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.
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. SUPERVISION: None EDUCATION: Graduate of an
accredited School of Nursing. Current appropriate state Temporary
Permit. Must meet the practice requirements in the state in which
he or she is employed. EXPERIENCE AND REQUIRED SKILLS: 0 - 1 year's
related experience. EO/AA Employer:
Minorities/Females/Veterans/Disability/Sexual Orientation/Gender
Identity Fresenius Medical Care North America maintains a drug-free
workplace in accordance with applicable federal and state laws.
Keywords: Fresenius Medical Care, Houston , Outpatient Registered Nurse - Fresenius Medical Care, Healthcare , Bellaire, Texas
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