New Graduate Nurse
Company: Fresenius
Location: Chesapeake
Posted on: November 18, 2023
Job Description:
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 time frame
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 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:
- As a condition of continued employment you are required to
obtain and maintain any required credentials or certifications
necessary for your position in an active and valid status
(including renewal of such credentials or certifications prior to
any expiration date). In the event that your credential or
certified status changes you must notify your supervisor
immediately.
- Capable of working in a challenging environment which requires
the ability to handle demanding situations multitasking and
remaining flexible to changing needs.
- Maintain regular and punctual attendance.
- Perform other related duties as assigned.Additional
responsibilities may include focus on one or more departments or
locations.-- See applicable addendum for department or location
specific functions.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.
- 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.SUPERVISION:
- NoneEDUCATION:
- Graduate of an accredited School of Nursing.
- Current appropriate state Temporary Permit.
- Must meet the practice requirements in the state in which he or
she is employed.EXPERIENCE AND REQUIRED SKILLS:--
- 0 - 1 year's related experience.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.
Keywords: Fresenius, Chesapeake , New Graduate Nurse, Healthcare , Chesapeake, Virginia
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