Registered Nurse - RN - Dialysis

Overview

Must be able to float to the different clinics on Hawaii Island (Kona, Kamuela, Hilo). Float differential eligible. Functions as part of the hemodialysis health care team as a Staff Registered Nurse to ensure provision of quality patient care daily in accordance with FMCNA policies, procedures, and training. Supports the FMCNA mission, vision, values, and customer service philosophy. Supports the Quality Enhancement Program (QEP) and CQI activities related to patient satisfaction and process improvement.

Adheres to all requirements of the FMCNA Compliance Program, and FMS patient care and administrative policies.

• Direct patient care supervision by directing Patient Care Technicians to ensure safe and effective delivery of chronic hemodialysis therapy in compliance with facility policy and procedures, and applicable regulations.
• Delegate tasks to direct patient care staff including LVN/LPNs, Patient Care Technicians, and Dialysis Assistants.
• Assess daily patient care needs and develop appropriate patient care assignments; monitor staff techniques and adherence to procedures.
• Participate in staff training and orientation of new staff; participate in required staff meetings.
• Provide educational guidance to patients and families about End Stage Renal Disease (ESRD), renal disease, vascular access, dialysis therapy, and related health conditions; educate on diet/fluid and medication compliance.
• Provide patient-specific education on adequacy measures where applicable (Online Clearance Monitoring, Adequacy Monitoring Program, Urea Kinetic Modeling).
• Promote transplant awareness and modality awareness; facilitate catheter reduction.
• Educate patients on laboratory values and their relation to dialysis adequacy, treatment compliance, medications, and fluid management.
• Deliver safe and effective care for patients with ESRD; implement treatment prescriptions (including sodium modeling and ultrafiltration modeling) to ensure stable therapy as indicated.
• Assess patient response to hemodialysis, adjust treatment plans as prescribed; communicate problems or concerns to the Team Leader or physician; identify and report patient-related issues.
• Initiate Initial and Annual Nursing Assessments and ongoing evaluation/documentation of patient care needs per FMC policies.
• Participate in pre-evaluation, initiation, monitoring, termination, access homeostasis, and post-evaluation of hemodialysis treatment per FMC procedures; intervene for changes in adequacy status and troubleshoot access flow issues identified by OLC/AMP yellow lights.
• Provide, supervise (if applicable), and monitor hemodialysis access care per established procedures; document patient responses to treatments.
• Manage transfusions as prescribed and notify appropriate physician and blood supplier of adverse reactions; ensure accurate documentation of Hemodialysis Treatment Sheets and lab orders; prepare lab requisitions and ensure correct lab tubes and processing.
• Ensure specimens are properly packaged for DOT shipments and directed to appropriate labs; report abnormal labs to the physician and forward results as requested.
• Enforce FMCNA policies and applicable state/federal regulations; maintain safe, efficient shift operations; act as a resource for staff; engage with Clinical Manager regarding personnel and patient care status.
• Collaborate with physicians and the healthcare team to interpret, adjust, and coordinate patient care; assist with prescription refills per FMCNA policies; ensure timely transcription of orders into the Medical Information System.
• Oversee documentation of patient information, maintain facility drug lists, and ensure competency in emergency procedures including CPR; ensure availability of emergency equipment; provide vaccinations and annual TB testing as required.
• Administer medications as prescribed or per approved algorithms; document assessments of effectiveness; manage PRN medications and controlled substances as required by law.
• Coordinate patient transportation if necessary; maintain a clean, safe dialysis environment; ensure proper operation of dialysis equipment and cleanliness of patient stations.
• Address blood spills per FMCNA Bloodborne Pathogen policies; ensure all treatment data, physician orders, and patient status are accurately recorded in the Medical Information System.
• Ensure adherence to admission, transfer, and discharge policies; verify accuracy of PCT documentation; complete daily Hemodialysis Treatment Sheets; manage opening/closing procedures per safety standards.
• Initiate, document, and complete CQI activities including monthly reports; complete monthly nurses' progress notes; ensure complete patient medical records with proper identification on each page.
• Review transplant status and follow procedures; complete care plans for new patients within 30 days or for unstable patients as required; perform annual Nursing History and Assessment; complete Standing Order Reviews with physicians as required.
• Perform additional…