Registered Nurse

The In Center Hemodialysis Registered Nurse provides safe individualized nursing care to patients receiving maintenance hemodialysis. The RN assesses patients before during and after treatment implements prescribed care administers medications responds to changes in condition and emergencies documents care educates patients and caregivers and collaborates with the interdisciplinary team. This is a direct care staff RN position. The RN provides required clinical oversight of assigned patient care activities but does not have routine personnel management authority.

• Establish and maintain professional therapeutic relationships with patients and communicate respectfully with families caregivers practitioners and interdisciplinary team members.
• Complete the RN components of the initial comprehensive assessment within the later of 30 calendar days or 13 outpatient hemodialysis sessions and complete reassessments within required time frames.
• Continually assess patient needs and contribute to the development implementation evaluation and revision of the individualized plan of care.
• Participate with the patient and interdisciplinary team in comprehensive assessments care planning conferences follow up reassessments and annual or monthly reassessments as applicable.
• Include patients and when appropriate families or caregivers in care planning and education regarding dialysis medications vascular access care infection prevention treatment adherence emergency preparedness modality options and transplantation.
• Establish measurable patient goals with the interdisciplinary team and evaluate progress toward expected outcomes.

• Provide direct nursing care to assigned patients in accordance with the dialysis prescription practitioner orders the California Nursing Practice Act facility policies and demonstrated competencies.
• Initiate monitor and terminate hemodialysis treatments safely within the RN's training and demonstrated competency.
• Perform and document pre treatment intradialytic post treatment and discharge nursing assessments.
• Verify patient identity allergies dialysis prescription practitioner orders machine settings dialyzer dialysate anticoagulation vascular access ordered medications and applicable precautions before and during treatment.
• Assess vascular access before during and after treatment and promptly address or report signs of infection infiltration bleeding stenosis thrombosis or access dysfunction.
• Monitor vital signs fluid removal treatment tolerance machine parameters and patient response throughout treatment. Evaluate abnormal findings and intervene within scope and policy.
• Recognize and respond to dialysis complications and medical emergencies. Initiate emergency procedures notify the appropriate practitioner and arrange a higher level of care when indicated.
• Provide immediate clinical supervision of assigned Certified Hemodialysis Technician functions as required by California law and facility policy. This responsibility does not include hiring discipline performance evaluations scheduling or other personnel management authority.

• Administer and document medications and treatments according to valid orders the California Nursing Practice Act facility policy and demonstrated competency.
• Review clarify when necessary implement and document medical orders accurately and within required time frames.
• Complete medication reconciliation at admission at least monthly after hospitalization or a transition of care and whenever medication changes are identified.
• Review relevant laboratory results and trends implement authorized interventions and notify the practitioner of significant or critical findings according to policy.
• Participate in practitioner rounds and patient care conferences as assigned and promptly communicate significant findings changes in condition and unresolved clinical concerns.
• Complete or support follow up related to missed or shortened treatments hospitalizations emergency department visits and transitions of care according to facility workflow.
• Coordinate referrals appointments and continuity of care needs related to the dialysis plan as assigned.

• Follow infection prevention requirements including hand hygiene personal protective equipment aseptic technique medication preparation injection safety vascular access care…