Acute Inpatient Registered Nurse - RN - Dialysis

PURPOSE AND SCOPE:

The Inpatient RN provides direct patient care in accordance to company policies and procedures which includes FMCNA compliance programs and contracted hospitals’ policies and procedures.  Areas of practice are diverse, including, but not limited to, hemodialysis, peritoneal dialysis, continuous renal replacement therapies, apheresis, and ultrafiltration. The Inpatient RN will partner with the hospital to provide quality care to the patient and deliver care that provides a positive patient experience. 

PRINCIPAL DUTIES AND RESPONSIBILITIES:

• Under limited supervision, applies considerable knowledge to perform a broad range of tasks which include but are not limited to direct patient care in multiple modalities not limited to hemodialysis, peritoneal dialysis, ultrafiltration, continuous renal replacement therapy, and Apheresis.
• Provides supervision and direction of Patient Care Technicians and clerical staff; provides direction and education to ICU staff for CRRT.
• Responsible for direct patient care of assigned patients in the Inpatient Renal Replacement and Apheresis Services setting and providing the appropriate treatment technique for assigned patients as prescribed in all modality procedures, as appropriately defined – hemodialysis, peritoneal, continuous renal replacement therapies, ultrafiltration, and Apheresis.
• Assesses patients’ responses to treatment therapy making appropriate adjustments and modifications to the treatment plan as indicated by the appropriately credentialed physician.  Communicate problems or concerns to the Inpatient Program Manager, appropriately credentialed physician, patient hospital primary nurse and others as indicated. 
• Delivers safe, effective care in a timely an efficient manner.
• Gives organized, concise shift reports for patients on assigned shifts. Apply high level thinking skills to shift patient schedules to meet needs of more critical patients due to labs, MD order, or patient assessment.
• Responsible for the implementation, administration, monitoring, and documentation of patient’s response to prescribed intradialytic transfusions, including appropriate notification of adverse reactions to physician and appropriate blood supplier. 
• Collaborates and communicates with physicians and other members of the healthcare team to interpret, adjust, and coordinate daily patient care plan to ensure continuity of care.
• Initiates and communicates to FMS facility nursing staff and appropriate hospital personnel as needed.
• Accurately documents all treatment information in the individual patient record (ACES) and the hospital record, as needed.
• Cleans and disinfects dialysis machine surface, chair, equipment, and surrounding areas between treatments according to inpatient renal services policies and procedures.
• Conducts all tasks necessary for preparation for dialysis treatment and documents where appropriate.
• Performs all required pre-treatment dialysis machine alarm testing.
• If applicable, initiates Solution Delivery System.
• Operates all related equipment appropriately and safely and provides minor trouble shooting when necessary; efficiently utilizes supplies to prevent waste.
• Understands, conducts, and documents appropriately Dialysis/Apheresis machine safety tests/alarm tests, equipment calibration, dialysate testing, machine safety tests, functional testing, and internal and external disinfection on all water & dialysis machines, and complies with the documentation/notification standards per FMS policies.
• Completes and documents ongoing participation in QAI activities.
• Participates in staff meetings as scheduled.
• Participates in staff training and orientation as assigned.
• Acts as a subject matter expert to hospital staff for dialysis related patient/equipment complications.
• Responsible for reporting all new or unusual incidents, information, complaints, or problems to the inpatient manager and other parties per the Adverse Event Report requirements. May be assigned to in-center patient care on an as needed basis
• Review and comply with the Code of Business Conduct and all applicable company policies and procedures, local, state and federal laws and regulations.
• Assist with various projects as assigned by direct supervisor.
• Other 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.

• Direct patient care, interaction with patients, outpatient clinicians, hospital staff, and physicians.  The position requires travel between assigned hospitals and facilities; as well as travel to regional meetings/educational events.
• Position requires on call rotation including night, day, weekend, and holidays.
• There is potential for exposure to potentially infectious material and contagious diseases/material. 
• Position provides direct patient care which regularly involves heavy lifting, moving of patient and/or equipment > 200lbs (with assistance); and may lift chemical and water solutions of up to 30lbs up as high as 5 feet. 

SUPERVISION:

• Provides supervision and direction of Patient Care Technicians (Certified Clinical Hemodialysis Technicians (CCHT)) and clerical staff; provides direction and education to ICU staff for CRRT.

EDUCATION:

• Current appropriate state licensure.
• Maintains acquired knowledge and remains current in advancements in nephrology, in particular, relative to inpatient care (hospitalized patients requiring varied treatment modalities, not limited to Renal Replacement, Apheresis, and Ultrafiltration services).
• Must meet the practice requirements in the state in which employed.
• Certification in Nephrology Nursing, Apheresis Nursing, or both is highly encouraged.

EXPERIENCE AND REQUIRED SKILLS:

• One year RN experience required and required nursing skills.
• Minimum 6 months nephrology experience required before working independently with no other Dialysis RNs to provide dialysis and ultrafiltration services.
• Minimum 6 months Nephrology experience required before working independently with no other Apheresis RNs to provide Apheresis services.
• Demonstrated strong assessment skills related to the critically ill patient.
• ICU experience preferred but not required.
• Successful completion of training course in the theory and practice of care of the ESRD patient – Progressive Renal Education Preparation.
• BLS CPR Recognition.
• ACLS CPR Recognition preferred, but not required.
• Demonstrates organizational and time management skills, and a competency toward completing continuing and ongoing Renal/Nephrology education.
• Displays leadership skills and ability to direct and supervise others (such as PCTs, CCHTs, clerical staff).
• Successful completion of Nurses Technical Training.

Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.