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Registered Nurse

Reports to (position): Dialysis Clinic Manager 

Primary purpose of the role: 

Responsible to deliver patient centred care within the hemodialysis setting in accordance with organisational core values / standards of practice and codes and guidelines as set out by APHRA. To provide support to the Management Team by participating in the clinical, management, education and quality activities of staff and patients within the clinic. 

Key Responsibilities:

• Participates in the design, planning, delivery and evaluation of patient care within the hemodialysis clinical setting.
• Protects the rights of patients by adhering to Privacy Principles and providing an excellent standard of care.
• Responsible for own professional development and provides education to colleagues, patients and visitors.
• Ensures/promotes a safe, secure and healthy working environment to staff and a comfortable, safe environment for visitors and patients as detailed in the Workplace Health and Safety policy (FMEAU-28).
• Actively participates in the quality improvement process by reporting all incidents, hazards and opportunities for improvement.
• Completes clinical and mandatory competencies annually
• Performs defined management functions when required. 
• Maintains accurate patient information in medical records, including Therapy Data Management System (TDMS) and abides by confidentiality and Privacy Policy. Competencies (attitude, skills, typical qualifications & experience) 

Essential: 

• Registered as a general nurse with AHPRA (Australian Health Practitioner Regulation Agency).
• Current practicing certificate.
• Understanding of the Quality improvement process and risk management obligations
• Demonstrated clinical competence and expertise (or working towards) in nephrology nursing.
• Ability to continuously reflect on nursing practice and apply learning as appropriate.
• Effective communication and interpersonal skills including the ability to operate within multidisciplinary team.
• Demonstrated organisational, decision-making and problem solving skills, combined with the ability to be self-directed.
• Demonstrated ability to effectively perform staff and patient education.
•  Knowledge of nursing, nephrology and other professional issues which impact on nursing practice within the specialty. 

Desirable: 

• Nephrology nursing theory and practice.
• Computer literacy.
• Demonstrated commitment to quality improvement initiatives. 

Description
Lend direction as well as a caring attitude. Bring a smile and your vital knowledge to everyone every day. Brighten prospects for patients and your career.

Connect with your goals and change lives

with Fresenius Medical Care North America.

Here is your opportunity to make profound connections that make all the difference. As the global leader in dialysis healthcare we know what it takes to create strong bonds among patients their families and our team members-and why it matters. Within this positive environment those in our care can achieve better outcomes-and professionals can achieve their most important objectives.

 
Why Join the Fresenius Team?

Passion. Dedication. Knowledge. Motivation. Experience. These are the impressive qualities you'll find in the Fresenius Leadership Team. Our strength in the North American market and extensive global network provide our employees with the best of both worlds-the friendliness of a local organization and the stability of a worldwide organization-for diverse experiences and challenging career opportunities. When you join the Fresenius Medical Care team you'll be welcomed into a company that is built on the philosophy that our employees are our most important asset. Our career advantages include the following: 

• Fresenius Medical Care is the nation's largest provider of renal care meeting the needs of more than 135 000 patients at 1 800 clinics throughout the country.
• Our well-established trusted organization fosters a spirit of camaraderie emphasizing friendly collaboration professional support and career development.
• Superior training UltraCare® quality control and certification procedures ensure your potential to succeed and advance as a professional.
• Competitive compensation and exceptional benefits.
• Outstanding tuition reimbursement program.
• Recognized among Fortune's World's Most Admired Companies in 2011.
• National Safety Award from CNA insurance companies for 11 consecutive years.

Opportunities to give back by participating in philanthropy and community outreach programs.
 

Staff Registered Nurse

This is an exceptional opportunity to succeed with a premier healthcare organization. As a key member of our hemodialysis team this professional will manage our Patient Care Technicians in providing safe effective delivery of chronic hemodialysis therapy. Delegating tasks training and monitoring all direct-patient staff including LVNs/LPNs and Dialysis Assistants this individual will assess care needs and develop assignments.

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.

DUTIES / ACTIVITIES:

CUSTOMER SERVICE:

• Responsible for driving the FMS culture though values and customer service standards.
• Accountable for outstanding customer service to all external and internal customers.
• Develops and maintains effective relationships through effective and timely communication.
• Takes initiative and action to respond resolve and follow up regarding customer service issues with all customers in a timely manner. 

PRINCIPAL RESPONSIBILITIES AND DUTIES

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 polices 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:

• 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.

Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test Blindness does not preclude employment. The Company will consider whether reasonable accommodations can be made.

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.

EDUCATION:

• 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 REQUIRED 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.
• 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).

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.