Acute Registered Nurse
Company: FRESENIUS
Location: Missoula
Posted on: November 20, 2023
Job Description:
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'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.PRINCIPAL DUTIES AND RESPONSIBILITIES:
- 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.
- 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.
- 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.
- 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 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.
- 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.
- 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.
- 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.
- Employees are required to take the Ishihara's Color Blindness
test as a condition of employment. Note that: Failing theIshihara
Test for Color Blindness does not preclude employment. The Company
will consider whether reasonable accommodation can be
made.SUPERVISION:
- NoneEDUCATION AND REQUIRED CREDENTIALS:
- 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.EXPERIENCE AND SKILLS:
- Minimum of one-year medical-surgical nursing experience
preferred.
- Hemodialysis experience preferred.
- ICU experience preferred.
- Successfully complete a training course in the theory and
practice of hemodialysis.
- Successfully complete CPR Certification.
- Employees have to meet the necessary requirements of Ishihara's
Color Blindness test as a condition of employment.
- 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).ACKNOWLEDGEMENT:I acknowledge that I have read and accepted
this job description. I understand what is expected of me in this
position, and I am able to perform the essential functions as
outlined with or without reasonable accommodation. Furthermore, I
understand that the duties and responsibilities listed in this job
description are intended only as illustrations of the various types
of work that may be performed. The omission of specific statements
of duties does not exclude them from the position if the work is
similar, related, or a logical assignment to the position. If I
have any questions about duties and responsibilities not specified
in this job description that I am asked to perform, I should
discuss them with my immediate supervisor or my Human Resources
representative.ADDENDUM:Infusion Nurse CoordinatorCoordinates and
provides the delivery of patient services and the management of the
POIC by performing the following duties personally or through
subordinates.
- Standards of PracticeUnderstands and conforms to the rules and
regulations affecting the RN's current area of practice including
federal, state and local laws.Know the rationale for and the
effects of medications and treatments and shall correctly
administer the same. Accurately and completely report and
document.The client's status including signs, symptoms and
responses.Care rendered.Physician orders.Administration of
medications and treatments.Client response(s).Contacts other health
care team members concerning significant events regarding client's
status.Respect the client's right to privacy by protecting
confidential information unless obligated or allowed by law to
disclose the information. Obtain instruction and supervision as
necessary when implementing procedures or practices. Notify the
appropriate supervisor when leaving an assignment. Know, recognize
and maintain professional boundaries of the clinician-client
relationship. Report unsafe nursing practice which a clinician has
reasonable cause to suspect has exposed or is likely to expose a
client unnecessarily to risk of harm as a result of failing to
provide client care that conforms to the minimum standards of
acceptable and prevailing professional practice. Be responsible for
one's own continuing competence in clinical practice and individual
professional growth.
- Ensures quality and safe delivery of OIC care service.
- Practice is guided by policies, procedures and standards of
clinical practice.
- Understands and implements current standards of practice for
infusion therapy.
- Adheres to policies related to medication safety, including
documentation of orders, correct administration, double check
procedures and other established policies and practices.
- Understands use of products and equipment.
- Observes and monitors OSHA, infection control and safety
policies.
- Adopts practices to improve work processes, enhance
customer/patient satisfaction and ensure excellence.
- Contributes to a safe and secure environment for patients,
visitors and staff by following established procedures and
protocols.
- Accurately documents, implements and evaluates Physician orders
in a timely manner.
- Initiates teaching using patient teaching protocols and patient
care standards.
- Identifies expected outcomes and nursing interventions to meet
identified diagnosis.
- Implements nursing interventions to meet patient needs and
changing conditions. Monitors patients for compliance with
therapy.
- Completes all documentation accurately and timely.
- Maintains client/family rights and maintains
confidentiality.
- Recognizes the nurse/patient/family relationship impacts the
patient experience. Understands and respects nursing
boundaries.
- Shows kindness and care with patient/family. Displays
sensitivity to the needs and concerns of others.
- Drug Preparation and Management
- Ensures that drugs are ordered, received and stored
properly.
- Maintains optimal drug and supply inventory and reports are
submitted in a timely manner.
- Ensures that proper technique is used in the preparation of
sterile products.
- Ensures that the mixing area is clean, neat and orderly at all
times.
- Responsible for the accuracy of information recorded for proper
patient billing.
- Ensures that all purchasing invoices and inventory records are
completed and submitted in a timely manner.
- Participates in ongoing training and education.
- Referral Management
- Submits referral timely and accurately.
- Notifies appropriate person of referral concerns.
- Roster is reviewed, updated and current.
- General Site Management
- Communicates recommendations and requirements for additional
services to appropriate individuals in a timely manner.
- Consistently addresses and communicates patient concerns to the
Physician and OIC staff.
- Completes job tasks on time by planning and organizing the
schedule of activities.
- Effectively communicates with Pharmacy for collaboration of
protocols, patient care and Physician communication.
- Communicates with OIC staff, Division Managers, Physicians and
Corporate clinical as necessary.
- Nursing calendar/ patient schedules reflects planned visits 2
weeks in advance.
- Delegates responsibilities appropriately.
- Performs nursing functions in staffing situations.
- Uses equipment and supplies effectively and efficiently.
Monitors supplies to maintain appropriate inventory.
- Accurately performs drug and supply inventory.
- Nursing billing is accurate and timely.
- Ensures a RN is available at all times during OIC office
hours.
- Ensures a RN is on call for emergencies involving patients 24
hours, if site not utilizing Healix Call Center
- Professional Growth
- Monitors and maintains professional licensure and qualification
of staff nursing.
- Participates in case conferences and staff meetings.
- Promotes importance of team collaboration and
communications.
- Maintains professional competence, particularly in the areas of
clinical knowledge.
- Leadership
- Presents a positive image of the OIC at all times, and at
professional functions, with patients, physicians, OIC staff,
etc.
- Recognizes the impact of one's behavior of others.
- Deals with others in a pleasant and respectful manner.
- Assumes responsibility for improving care/services.
- Performs as a preceptor to other nurses.
- Monitors staff completion of assignments.
- Clearly defines work assignments.
- Resourceful in handling assignments and solving problems;
flexible in adjusting to a new or changing work
environment/requirement.
- Communicates with staff regarding assignments, as
necessary.
- Performs Additional Assigned Responsibilities as necessary
- Fulfills additional responsibilities accurately and completely
in a timely manner.
- Submits written reports in a timely manner.
- Cooperates with staff members according to OIC philosophy and
objectives.
- Maintains consistent and concise lines of authority and
responsibility.
- Participates in the development of patient education
programs.
- Participates in establishing (written and instructing other
staff) protocols for the initiation of new therapies or new care
related programs.
- Participates in committee meetings.
- Actively participates in the CQI program through meetings and
gathering of information.CORE DUTIES AND RESPONBILITIES
- Include the following basic performance factors all Healix,
Inc. employees are expected to meet.
- Communicates with clients and fellow employees through written
and verbal forms, clearly and timely.
- Interacts professionally with clients and fellow
employees.
- Cooperates with team members to accomplish departmental
goals.
- Accepts and incorporates changes or new ideas into daily
work.
- Provides service in a responsive, timely and accurate manner to
both clients and fellow employees.
- Understands and adheres to policies and procedures.
- Arrives at work as scheduled and notifies supervisors in a
timely manner of any absences.
- Recognizes priorities and takes action; makes productive use of
time.
- Strives to resolve problems and conflicts on his/her own
initiative.
- Attempts to create new ideas or new procedures working as part
of a group or individually.
- As a part of your job, you will receive protected health
information. It is your responsibility to comply with HIPAA in
using and disclosing health information.QUALIFICATIONS
- To perform this job successfully, an individual must be able to
perform each essential duty satisfactorily. The requirements listed
below are representative of the knowledge, skill and/or ability
required. Reasonable accommodations may be made to enable
individuals with disabilities to perform the essential
functions.EDUCATION AND REQUIRED CREDENTIALS:
- BSN or AND or
- College or university program certificate; 2 - 4 years related
experience and/or training; or equivalent combination of education
and experience
- Applicable State License
- CPR certificationOTHER SKILLS AND ABILITIES
- To perform this job successfully, an individual must have a
minimum of two years recent clinical experience to include
excellent IV skills
- One-year experience in Home Health Care or Home IV Therapy
- Management experiencePHYSICAL DEMANDS AND WORKING CONDITIONSThe
physical demands described here are representative of those that
must be met by an employee to successfully perform the essential
functions of this job. Reasonable accommodations may be made to
enable individuals with disabilities to perform the essential
functions.
- While performing the duties of this job, the employee is
required to:
- Regularly use hands to finger, handle, or feel and talk or
hear
- Frequently stand, walk, sit, reach with hands and arms, and
stoop, kneel, crouch, or crawl
- Frequently lift and/or move up to 25 pound and occasionally
lift and/or move up to 50 pounds
- Specific vision abilities required by this job include close
visionWORK ENVIRONMENTThe 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.
- While performing the duties of this job, the employee is:
- Frequently exposed to blood borne pathogens
- Occasionally exposed to outside weather conditions
- The noise level in the work environment is usually
moderateEO/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, Missoula , Acute Registered Nurse, Healthcare , Missoula, Montana
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