Registered Nurse-RN-Dialysis

POSITION FEATURES:

• Paid one on one training and education provided.
• Empower, engage and train dialysis patients on peritoneal and home hemodialysis using state of the art training programs and equipment.
• Primarily works in the clinic setting and conducts initial home visits with another staff member present.
• Position functions as an onsite Patient Educator and Case Manager for patients with various shifts and work hours.

PURPOSE AND SCOPE:
The professional registered nurse (Home Therapy CAP RN 2) position may be an entry level CAP designation for new employees that meet the CAP RN 2 criteria or attained through advancement from CAP RN 1. The CAP RN 2 is accountable and responsible for the provision and coordination of clinically competent care including assessment, planning, intervention and evaluation for an assigned group of home therapy patients.
As a member of the Chronic Kidney Disease (CKD) health care team, the CAP RN 2 participates in decision-making, teaching, leadership functions, and quality improvement activities that enhance patient care outcomes and facility operations.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
All duties and responsibilities are expected to be performed in accordance with Fresenius Kidney Care policy, procedures, standards of nursing practice, state and federal regulations.

• Performs all essential functions under the direction of the Program Manager and with guidance from the Educator, Preceptor or a Home Therapy CAP RN 2,3, 4 or 5 for the first 3 months of employment.
• Required to complete CAP program requirements to either maintain the CAP RN 2 level or advance to CAP RN 3.
• Performs ongoing, systematic review and analysis of dialysis data for Home Therapy patients and documents in the patient medical record, adjusts or modifies the treatment plan as indicated and notifies Supervisor/ Manager or physician as needed.
• Recognizes aspects and implications of patient status that vary from normal and reports to or collaborates with appropriate health team members for input.
• Assesses assigned patient care needs and collaborates with direct and ancillary patient care staff as needed.
• Directs and provides, in collaboration with the patient, home care partner, direct and ancillary patient care staff, all aspects of the provision of safe and effective delivery of dialysis therapy to assigned patients.
• Administers medications as prescribed or in accordance with approved algorithm(s), and documents appropriate medical justification and effectiveness
• Ensures correct patient laboratory collection, processing and shipping procedures are performed and reschedules missed or insufficient laboratory collections.
• Ensures physician orders for assigned patients are entered and acknowledged in the Medical Record
• Initiates or assists with emergency response measures.
• Delegates appropriate tasks to direct patient care staff including but not limited to RNs, LVN/LPNs and Patient Care Technicians.
• Monitors patient care staff for appropriate techniques and adherence to FKC policy and procedures.
• Promotes infection control, equipment and environmental safety.
• Assesses, collaborates and documents patient/family's basic learning needs to provide initial and ongoing education to patients and family
• Assists in the identification, evaluation, selection and education of Home Dialysis candidates and Home Partners.
• Performs assessment and identifies barriers of the Home Dialysis candidate's home environment and partner/ family readiness and ability to perform dialysis treatments in the home.
• Admits new Home Therapy patients using the appropriate processes per Fresenius Kidney Care policy and procedure.
• Trains Home Dialysis patients and / or Home Partners on the safe, effective operation and maintenance of all Home Dialysis equipment and treatment supplies through a formal standardized Home Dialysis Training Program.
• Identifies expected outcomes, documents and updates the nursing assessment and plan of care for assigned patients through collaboration with the Interdisciplinary Team.
• Assesses and manages patients' response to home dialysis training and treatment therapy by following prescribed predetermined protocols. Communicates patient related issues to the physician as needed .
• Serves as a leader, coach, mentor and role model for new and incumbent employees by setting examples of appropriate behavior, work habits and attitudes towards patients, co-workers, supervisors and the company at the facility and area level. May serve as a Preceptor to new employees.
• As a Preceptor fulfills the following:
  • Demonstrates, reinforces, and encourages attitudes and actions which are consistent with FKC Mission and Core Values.
  • Follows schedule established by the Education Department to ensure that information presented in class is applied in the clinical setting.
  • Seeks opportunities for new employees and communicates progress to Program Manager. Provides feedback about new employee's progress to the PM and the Education Department using evaluation tools and direct communication.
  • Completes all documentation in a timely manner.
  • Maintains direct supervision of the new employee until the employee is released to work independently by the Education Department and PM.
  • Encourages the new employee to function independently within the constraints of the training schedule and supplies positive feedback as well as suggestions to improve knowledge and skills
• Performs essential functions of a designated Nurse in charge as assigned by Supervisor.
• Collaborates with the interdisciplinary team in the assessment and development of patient plans of care.
• Ensures patient awareness related to transplant and treatment modality options.
• Makes referrals to Social Worker and Registered Dietitian as appropriate.
• Checks availability of adequate emergency equipment and supplies daily as assigned.
• Assists with medication tracking and inventory as assigned.
• Serves as a resource for health care team, participates in staff training and orientation of new staff as assigned.
• Participates in all required staff meetings as scheduled.
• Supports and promotes the Fresenius Kidney Care mission, vision, values, and customer service philosophy.
• Provides education to staff members regarding updates to policy and procedures as directed by Supervisor/ Manager.
• Participates in education and quality improvement projects at the facility and area level as directed by Supervisor.
• Performs all other duties as assigned by Supervisor.

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. 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.
• Rotates coverage with other licensed home therapy staff as assigned to ensure reliable and adequate coverage.
• Position requires participation in on-call rotation. (Night, Weekend or as defined by individual program needs).
• May be asked to provide essential functions of this position at other locations with the same physical demands and working conditions as described above including travel to patient's homes.

SUPERVISION:

• Assigned oversight of patient care technicians/LPNs as a Team Leader or designated Nurse in charge, after the following:
  • Successful completion of all FKC education and training requirements for new employees plus
  • Must have a minimum of 3 months experience in chronic home dialysis and/ or home hemodialysis plus
  • Achieve and maintain all CAP RN 2 level criteria.

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:

• Entry level for RNs with 2 years or more of nephrology nursing experience within the last two years or BSN plus 1 year of nephrology nursing experience within the last two years.
• Chronic home dialysis or hemodialysis experience (preferred).
• Successful completion of FKC Education and Training requirements for new employees.
• Successful completion and maintenance of CPR BLS Certification.
• Meet all conditions of employment including Ishihara's Color Blindness Test.
• Successful completion of all annual required education/training/competencies.
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