New Graduate Nurse

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 daily in accordance with FMS policies, procedures, and training. Supports the FMCNA mission, vision, values, and customer service philosophy, and the commitment to the Quality Enhancement Program (QEP) and CQI activities.

Staff Related Responsibilities

• Directs Patient Care Technician's provision of safe and effective delivery of chronic hemodialysis therapy in compliance with facility policy and state/federal regulations
• Delegates tasks to direct patient care staff including 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 policy and procedures
• Participates in staff training and orientation of new staff as assigned
• Participates in all required staff meetings as scheduled

Patient Education

• Ensures educational needs of patients and family are met regarding End Stage Renal Disease (ESRD)
• Provides ongoing education regarding renal disease, vascular access, dialysis therapy, and related health conditions
• Discusses and records education related to diet/fluid and medication compliance
• Provides patient-specific education regarding adequacy measures including OLC, AMP, and UKM
• Ensures transplant awareness, modality awareness, and drive catheter reduction
• Educates patients regarding laboratory values and their relationship to adequate dialysis therapy

Dialysis Treatment

• Provides safe and effective delivery of care to patients with ESRD
• Accurately implements treatment prescriptions including Sodium modeling and Ultrafiltration modeling
• Assesses patients' response to hemodialysis treatment therapy and makes appropriate adjustments
• Communicates problems or concerns to the Team Leader or physician
• Initiates Initial and Annual Nursing Assessment and ongoing evaluation and documentation of patient care needs
• Participates in pre-evaluation, initiation, monitoring, termination, access homeostasis, and post evaluation of patients receiving hemodialysis
• Takes appropriate intervention for changes in patient adequacy status and troubleshoots access flow issues
• Provides, supervises, and monitors hemodialysis access care
• Implements, administers, monitors, and documents patient's response to prescribed interdialytic transfusions
• Ensures accurate and complete documentation by Patient Care Technician on the Hemodialysis Treatment Sheet

Laboratory-Related Responsibilities

• Reviews, transcribes, and enters physician lab orders accurately into the Medical Information System
• Ensures appropriate preparation of lab requisitions
• Ensures correct lab tubes are utilized and lab draw and processing procedures are performed appropriately
• Identifies and ensures appropriate follow-through regarding missed labs and insufficient specimens
• Ensures all specimens are appropriately packaged according to DOT policies
• Ensures labs are directed and delivered to appropriate labs
• Reports alert/panic and abnormal lab results to appropriate physician
• Ensures lab results are forwarded to physicians as requested

General Duties

• Enforces all company approved policies and procedures and state/federal regulations
• Maintains overall shift operation in a safe, efficient, and effective manner
• Acts as a resource for other staff members
• Routinely meets with the Clinical Manager to discuss personnel and patient care status
• Collaborates and communicates with physicians and other healthcare team members
• Provides assistance to patients regarding prescription refills according to policy
• Ensures all physician orders are transcribed and entered into the Medical Information System in a timely manner
• Oversees all patient information documentation
• Maintains facility drug list for all required stock medications
• Maintains competency with emergency operational procedures and initiates CPR and emergency measures
• Ensures verification and availability of adequate emergency equipment
• Ensures provision of appropriate vaccinations, immunizations, and annual TB testing
• Administers medications as prescribed and documents appropriate medical justification
• Administers PRN medications and completes documentation of assessment of effectiveness
• Maintains appropriate recording of controlled substances as required by law
• Assists with coordination of patient transportation if necessary

Maintenance and Technical

• Ensures a clean, safe, and sanitary environment in the dialysis facility treatment area
• Ensures competency in the operation of all dialysis-related equipment
• Ensures all patient stations, including machines and chairs, are clean and free of blood
• Ensures all blood spills are immediately addressed according to Bloodborne Pathogen Control Policies

Medical Records and Documentation

• Ensures all relevant data including physician orders, lab results, vital signs, treatment parameters, and patient status are documented and entered into the Medical Information System
• Ensures all policies regarding patient admission, transfer, and discharge are appropriately implemented
• Verifies accuracy of Patient Care Technician documentation
• Reviews and ensures appropriate daily completion of Hemodialysis Treatment Sheets
• Ensures appropriate procedures are followed regarding opening and closing procedures
• Initiates, documents, and completes ongoing Continuous Quality Improvement (CQI) activities including monthly reports
• Completes monthly nurses' progress notes
• Ensures patient medical records are complete with appropriate information and documentation
• Reviews transplant status and follows established procedures
• Completes patient care plans for new patients within the initial 30 days or for unstable patients requiring monthly plans
• Completes initial and annual Nursing History and Assessment physical
• Ensures completion of Annual Standing Order Review with each physician

Physical Demands and Working Conditions

The position provides direct patient care that regularly involves heavy lifting and moving of patients and assisting with ambulation. Requires frequent, prolonged periods of standing and the ability to bend over. May occasionally be required to move machines and equipment of up to 200 lbs. with assistance, and lift chemical and water solutions of up to 30 lbs. up to 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.