RN Full-time
Fresenius Medical Care

Registered Nurse - RN - Dialysis

Fresenius Medical Care New York, NY, US

Fulltime position, no part time or per diem available.

Located in the Mink Bldg.

Must be able to work flexible shifts between

5:00 AM - 9:00 PM, Monday - Saturday, (3) 12+ hour Rotating Shifts a week

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.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • Completes initial and annual Nursing History and Assessment physical.
  • Ensures completion of Annual Standing Order Review with each physician as required.
  • 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.

  • 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.
  • Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the

Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodation can be made.

SUPERVISION:

  • None

EDUCATION AND REQUIRED CREDENTIALS:

  • 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 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.
  • Employees have to meet the necessary requirements of Ishihara's Color Blindness test as a condition of employment.
  • 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).

The rate of pay for this position will depend on the successful candidate’s work location and qualifications, including relevant education, work experience, skills, and competencies.
 
Hourly Rate: $37.00 - $63.00

Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.

Fresenius Medical Care is an equal opportunity employer and does not discriminate on the basis of race, color, religion, sexual orientation, gender identity, parental status, national origin, age, disability, military service, or other non-merit-based factors

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All newly hired nurses to the NICU, L&D, Mother-Baby, and 5I unit must receive this certification within 6 months. All registered nurses and advanced practice nurses providing direct oncology care must demonstrate one of the following: Current cancer-specific certification in the nurse’s specialty by an accredited certification program. Oncology nursing certifications that qualify include, but are not limited to: AOCNP®, AOCNS®, AOCN®, BMTCN®, CPHON®, CPON®, CBCN® OCN® or Ongoing education by earning 36 cancer-related continuing education nursing contact hours every 3 years (maintained by department manager) Registered Nurses in the Emergency Department must complete de-escalation training within 1 year of hire to transfer to the Emergency Department. Successful completion of Department and Unit Orientation Program. Core Competencies Teamwork & Adaptability Acts as a Professional Role Model Assessment Skills Excellent Communication Skills (both verbal and written) Attention to Detail Planning & Organizing Sound Problem-Solving, Judgment and Decision-Making Skills Stress Tolerance Physical/Mental Demands/Requirements & Work Environment May be exposed to chemicals necessary to perform required tasks. Any hazardous chemicals the employee may be exposed to are listed in the hospital’s SDS (Safety Data Sheet) data base and accessed through the hospital’s Intranet site (Employee Tools/SDS Access). A copy of the SDS data base can also be found at the hospital switchboard, saved on a disc. Position requires ability to move about freely at least 85 per cent of the time. Must be able to remain stationary for extended/prolonged periods Frequently moves/transports objects up to fifty (50) pounds and must be able to move patients of all weights with a minimum of one (1) assist or assistive device/equipment Must be able to work in environment with continuous interruptions Must be able to assess and respond to rapidly changing situational needs of patients, department and hospital Must be able to adapt in a high stress and fast-paced environment with multiple interruptions Must be able to detect sounds and respond to emergency sounds/signals at all times Must be able to constantly operate computer, equipment and other devices Position requires ability to concentrate on fine detail with interruptions and attend to tasks for more than sixty (60) minutes at a time. Individual must be able to understand and relate to theories behind several related concepts and remember multiple tasks given during the course of a day. Primary Population Served Check Appropriate Box(s) Below Neonatal (birth – 28 days) Patients with exceptional communication needs Infant (29 days – less than 1 year) Patients with developmental delays Pediatric (1 – 12 years) Patients at end of life Adolescent (13 – 17 years) Patients under isolation precautions Adult (18 – 64 years) Patients with cultural needs Geriatric (> 65 years) X All populations Bariatric Patients with weight related comorbidities Non-patient care population The responsibilities and tasks outlined in this job description are not exhaustive and may change as determined by the needs of White Plains Hospital. Salary Range: $116,663 - $151,724 (Based on FT employment)
RN Outpatient Full-time
Northwell Health

Registered Nurse - Ambulatory

Northwell Health White Plains, NY
$68,000 - $115,000 / year
182954 Job Description Performs an age specific plan of care for designated group of patients using the nursing process of assessment, diagnosis, outcome identification, planning, implementation, and evaluation of patient care. Collaborates with physicians and other health team members in coordinating and implementing procedures and treatments. Uses leadership skills/clinical judgment in coordinating patient care and directing/delegating activities of the patient care unit team. Job Responsibility Conducts patient interview, explains policies and procedures to patient/ significant others, reviews patient’s chart and answers questions correctly and courteously; assesses gastrointestinal, cardiovascular, respiratory, renal and neurological health status; determines mobility, sensory deficits, prostheses use, and skin condition and adjusts plan of care, as appropriate, assesses level of pain and pain management; communicates/documents patient’s physiologic health status and plan of care; Assesses patient’s psychosocial health status; elicits perception of medical/nursing care and the expectation of care; determines coping mechanism, knowledge level, and ability to comprehend; identifies cultural/ethnic requirements to reduce anxiety and ensure patient satisfaction; communicates and documents psychological status and care plan of support groups, counseling services, and social services; Identifies patient outcome; develops criteria for measurement of patient outcomes; identifies actual/potential patient problems; identifies patient’s need for teaching based on psychosocial and developmental assessment. Develops patient outcome statement (s) and establishes individualized patient goals; Identifies care activities and establishes the priorities necessary to achieve expected outcome; coordinates the cost-effective use of supplies, equipment and medication to achieve expected outcome; documents the plan of care and collaborates with physicians and other health team members; Implements the plan of care; maintains constant vigilance over patients care to ensure that safety precautions/needs are followed (side rails up, call lights and bedside stand within reach, etc.; exercises professional skills related to the plan of care; reassesses patients as needed and appropriately revises plan of care; correctly administers prescribed treatments; correctly uses equipment necessary for patient care; provides emotional support to patient and significant other; applies scientific principles in performing procedures; carries them out safely, timely and efficiently; makes accurate observations of patient’s conditions during treatments/procedures; reports and records same as appropriate; keeps accurate documentation of patient’s treatment, activity and condition, as well as patient’s responses to medical and nursing interventions; uses appropriate methods of documentation according to departmental policy; acts rapidly and effectively during any emergency situation, managing self, patients and other employees; provides a calm, quiet, restful atmosphere; communicates effectively with the patient’s family or caretakers; participates in planning for discharge and coordinates referrals, as appropriate; provides discharge instructions to patient and significant other; evaluates care provided for patient outcome. Demonstrates ability to measure effectiveness of care provided and documents same; performs variance analysis related to outcome data for performance improvement; designs, implements, and evaluates systems to improve care in unit; keeps accurate documentation of patient’s treatment, activity and condition; uses appropriate methods of documentation according to departmental policy. Collaborates with other care team members in planning and carrying out treatment regimen; provides direction to other members of the care team; collaborates with the appropriate physician on patient’s plan of care. Accurately interprets and implements treatment regimen as prescribed by the Physician; assists the Physician during treatments and/or diagnostic procedures; keeps Patient Care Manager/designee and/or physician, abreast of changes in patient’s condition and/or treatments, as appropriate; uses clinical judgment in delegating assignments in providing patient care, and ensures that assignments are completed in a timely fashion. Performs grade I-IV Decubitus Care; performs preventive skin care measures; applies simple dressings, maintaining principles of aseptic technique; applies warm and cold compresses, consistent with facility procedure; performs irrigations, consistent with Facility procedure; performs other procedures related to skin care, as necessary. Administers medications correctly and safely; correctly identifies medication in terms of action, dosage, side effects, and implications for the patient; meets standard on medication administration examination; demonstrates preparation of local solutions. Administers and documents medication correctly; educates patients and significant others related to drug and food interactions; educates patients and significant others related to drug and food interactions. Participates in patient and family education; provides patient with an explanation of his/her condition as indicated; communicates assessment data in an orderly fashion by recording, updating and verbalizing pertinent information to care team members and to appropriate agencies; recognizes and utilizes health teaching opportunities and resources /materials available for this teaching; provides for early discharge planning and appropriate referrals for post-hospital care; evaluates the effectiveness of teaching by feedback from patient/ family and documents same. Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions. Job Qualification Graduate from an accredited School of Nursing. Bachelor’s Degree in Nursing, preferred. Must be enrolled in an accredited BSN program within two (2) years and obtain a BSN Degree within five (5) years of job entry date. Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed. OBGYN/L&D Experience, Preferred. Additional Salary Detail The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).