Nurse Graduate Nurse Resident

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 timeframe 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 effec.