Fresenius Medical Care

Outpatient Registered Nurse - RN

PURPOSE AND SCOPE:

The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP). This position is accountable and responsible for the provision and coordination of clinically competent care including assessment, planning, intervention and evaluation for an assigned group of patients. This may include delegation of appropriate tasks to direct patient care staff including but not limited to RNs, LVN/LPNs and Patient Care Technicians. As a member of the End Stage Kidney Disease (ESKD) health care team, this position 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 Supervisor and with guidance from the Clinical Educator, Preceptor or in collaboration with other Registered Nurses.

· Performs ongoing, systematic collection and analysis of patient data pre – during – post hemodialysis treatment for assigned patients and documents in the patient medical record, makes adjustments or modifications to treatment plan as indicated and notifies Team Leader, Charge Nurse, Supervisor or Physician as needed.

· Assesses, collaborates, and documents patient/family’s basic learning needs to provide initial and ongoing education to patients and family.

· Directs and provides, in collaboration with direct and ancillary patient care staff, all aspects of the daily provision of safe and effective delivery of hemodialysis therapy to assigned patients.

· Administers medications as prescribed or in accordance with approved algorithm(s), and documents appropriate medical justification and effectiveness.

· Initiates or assists with emergency response measures.

· Serves as a resource for health care team, participates in staff training and orientation of new staff as assigned.

· Ensures correct laboratory collection, processing and shipping procedures are performed and reschedules missed or insufficient laboratory collections.

· Identifies expected outcomes, documents and updates the nursing assessment and plan of care for assigned patients through collaboration with the Interdisciplinary Team.

· Ensures patient awareness related to transplant and treatment modality options.

· Required to complete CAP requirements to advance.

· 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, 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.

· Day to day work includes desk work, computer work, interaction with patients, facility/hospital staff and physicians.

· The position may require travel to training sites or other facilities.

· May be asked to provide essential functions of this position in other locations with the same physical demands and working conditions as described above.

SUPERVISION:

Assigned oversight of Patient Care Technicians/LPNs/LVNs/RNs as a Team Leader or designated Nurse in Charge, after meeting all the following:

· Successful completion of all FKC education and training requirements for new employees.

· Must have a minimum of 9 months experience as a RN.

· Must have a minimum of 3 months experience in chronic/acute hemodialysis as a RN.

EDUCATION and LICENSURE:

· Graduate of an accredited School of Nursing.

· Current appropriate state licensure.

· Current or successful completion of CPR BLS Certification.

· Must meet the practice requirements in the state in which he or she is employed.

EXPERIENCE AND REQUIRED SKILLS:

· Entry level for RNs with less than 2 years of Nephrology Nursing experience as a Registered Nurse.

· Chronic/acute hemodialysis experience (preferred).

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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Such activities may include: identifying clinical problems, participating in data collection, participating in the research committee, sharing research activities/finding with others, conducting research, analyzing data and trends of nursing practice to develop changes in nursing practice and utilizes evidence based practice in the development of policies, procedures and standards of practice in patient care. • The registered nurse considers factors related to safety, effectiveness, cost and impact on practice in the planning and delivery of nursing services. o Assigns or delegates tasks based on the needs and condition of the patient, potential for harm, complexity of the nursing activity, required problem solving and innovation, predictability of outcome, extent of patient interaction o Assists the patient and family in becoming informed consumers about the options, costs, risks and benefits of treatments and care. • The registered nurse provides leadership in the professional practice setting and the profession. o Participated in nursing councils, hospital and unit based committees as appropriate. o Attends at least 50% of unit staff meetings o Works to create and maintain professional, healthy work environment when representing Bronson in all settings (local, regional or nationally) • Responsibilities related to the Scrub RN o Interprets procedure card, assesses case cart for supplies prior to the scheduled procedure time. Identifies missing equipment and/or supplies and makes arrangements to acquire those supplies. o Applies knowledge of operative procedure and physician preferences by anticipating physicians' needs. o Observant of overt changes in patient's condition that indicates a problem has emerged. o Evaluates and updates case information, i.e., preference cards, broken or misplaced equipment, back-ordered supplies, and recommended changes in procedure. o Remains aware of the proper use of equipment and instruments, and discourages improper use and handling by co-workers & physicians. o Is observant of the changing needs of the operative field and the surgical team, anticipates potential needs, and takes appropriate actions. o Acts as the specialist and resource for circulators who may be unfamiliar with positioning devices, specialty equipment, and/or implants needed. o Assigned and responsible for after-hour call on a rotational basis. o Ability to perform scrub duties in multiple services; ie: neuro and ortho STII able to perform spinal fusions in bother services. For HDU Department Only: Additional on call requirements above and beyond regular scheduled hours For Bronson Lakeview Hospital and Bronson South Haven Hospital: The RN is responsible for completing the Workday CBL –“Swing beds”. This is an annual CBL that describes the difference in a swing bed patient versus an in-patient or observation patient. The RN will understand the documentation differences and the specific care required for each individual swing bed patient. Bronson South Haven Hospital and Bronson Lakeview Hospital employees who are approved to work in a Swing Bed Facility only: Employees may be expected to cover shifts at Bronson Lakeview Hospital and/or Bronson South Haven Hospital depending on patient acuity and staffing needs. Shift Time Type Full time Scheduled Weekly Hours 0 Cost Center 4300 Trauma Emergency Center (BLH) Agency Use Policy and Agency Submittal Disclaimer Bronson Healthcare Group and its affiliates (“Bronson”) strictly prohibit the acceptance of unsolicited resumes from individual recruiters or third-party recruiting agencies ("Recruiters") in response to job postings or word of mouth. Unsolicited resumes sent to any employee of Bronson by Recruiters, without both a valid written agreement with Bronson and a direct written request from the Bronson Talent Acquisition Department for a specific job position, will be considered the property of Bronson. Furthermore, no fees will be owed or paid to Recruiters who submit resumes for unsolicited candidates, even if those candidates are hired. This policy applies regardless of whether the Recruiter has a pre-existing agreement with Bronson. Only candidates submitted through a specific written agreement with the Bronson Talent Acquisition Department for a named position are eligible for fee consideration. Please take a moment to watch a brief video highlighting employment with Bronson!
MountainStar Healthcare

Registered Nurse ( RN ) - Inpatient Acute Care - Bronson Lakeview Hospital

CURRENT BRONSON EMPLOYEES - Please apply using the career worklet in Workday. This career site is for external applicants only. Love Where You Work! Team Bronson is compassionate, resilient and strong. We are driven by Positivity which inspires us to be our best and to go above and beyond for our patients, for one another, and for our community. If you’re ready for a rewarding new career, join Team Bronson and be part of the experience. Location BLH Bronson LakeView Hospital Title Registered Nurse ( RN ) - Inpatient Acute Care - Bronson Lakeview Hospital Registered Nurse (RN) – Acute Care Unit Bronson LakeView Hospital - Paw Paw, MI Up to $20,000 Sign-On Bonus Up to $10/hour Night Shift Differential Position Overview Join Bronson LakeView Hospital's Acute Care team and provide exceptional, patient-centered care to adults with a variety of medical, surgical, and chronic health conditions. As an Acute Care RN, you'll work collaboratively with an interdisciplinary team to deliver high-quality care while developing strong clinical assessment, critical thinking, and care coordination skills. What You'll Do Assess, plan, implement, and evaluate patient care using the nursing process Monitor patient conditions and respond appropriately to changes in status Administer medications and treatments in accordance with clinical standards Coordinate care with physicians and interdisciplinary team members Delegate appropriate tasks within scope of practice Educate patients and families regarding treatment plans, medications, and discharge needs Accurately document patient care, interventions, and outcomes Support quality, safety, and patient experience initiatives Minimum Qualifications Education Associate Degree in Nursing required Bachelor of Science in Nursing (BSN) preferred BSN required within eight (8) years of hire Licensure Current Michigan Registered Nurse (RN) license in good standing Certifications BLS required upon completion of orientation Additional certifications, including critical care or advanced life support certifications, may be required based on department needs Additional Qualifications Strong critical thinking and clinical decision-making skills Ability to interpret clinical data and develop appropriate plans of care Effective verbal, written, and electronic communication skills Ability to work effectively in a fast-paced patient care environment Commitment to compassionate, patient-centered care Physical Requirements Frequent standing, walking, lifting, and patient handling Ability to lift up to 50 pounds Ability to maintain concentration and attention to detail throughout the workday Join Bronson LakeView Hospital and help deliver exceptional acute care to the patients and communities we serve. Under general supervision and in accordance with the policies, procedures and guidelines established within the organization, the unit, and the Michigan Public Health Code, the registered nurse manages the care delivery for patients in the organization throughout the length of stay to achieve quality outcomes and timely discharge by the following: utilizing the nursing process of assessment, planning, diagnosing, implementation and evaluation; coordinating the care provided by other professionals; delegating selected acts, tasks or functions that fall within the scope of professional nursing practice and the abilities of patient care assistants and universal service assistants; providing selected aspects of physical care within the scope of professional nursing practice as appropriate given the patient's level of acuity and complexity of care required; and documenting and communicating during each tour of duty the patient's response to care provided, consumption of resources and anticipated needs. Employees providing direct patient care must demonstrate competencies specific to the population served. Associate's degree in Nursing required Bachelor's degree in Nursing preferred, must obtain within 8 years of hire Licensed Registered Nurse in good standing for the state of Michigan As of December 29, 2013, any nurse hired by Bronson who does not hold a BSN (or higher nursing degree) will be given 8 years from date of hire date to obtain. If, after 8 years, the nurse has not met this requirement, employment will be terminated. BLS certification required by completion of core orientation Critical care or ALS as well as other certifications may be required for some RNs, unit specific Bronson South Haven Specific - Effective July 1, 2017 all new hires are expected to successfully obtain their BSN within 8 years of hire date. Bronson South Haven Specific : Emergency Department: SALT triage, ESI Triage, and NIH Stroke Scale to be completed within 90 days of hire date. Advanced Cardiac Life Support, Pediatric Advanced Life Support, and Trauma Nursing Core Course (TNCC only required for FT and part -time nurses) within 6 months of hire date. Special Care Unit: All nurses in department will need to have Pediatric Advance Life Support certification within 6 months of hire. RNs in Labor & Delivery and Mother/Baby/Antepartum at BMH & BBC Specific : The Electronic Fetal Monitoring Certification through PQF or NCC is required within 6 months of completing intermediate fetal monitoring Current driver's license in the state of Michigan and proof of insurance required for BAH • Ability to read, interpret, and analyze data from various computer systems and equipment in order to set an appropriate plan of action • Must be able to constantly communicate both verbally, in writing and electronically Work which produces high levels of mental/visual fatigue, e.g., interactive and repetitive or small detailed work requiring alertness and concentration for sustained periods of time, the operation of and full attention to a personal computer or CRT between 40 and 70 percent of the time. Involves regularly lifting of bulky or moderately heavy weights (i.e., up to 50 pounds), and occasionally assisting with heavier tasks or expending the equivalent effort in pushing, pulling, or otherwise handling material, equipment, and other objects. Standards of Practice: • The registered nurse collects comprehensive data pertinent to the patients’ health or the situation. o Assesses the patient’s physical and developmental needs o Analyzes assessment data to identify appropriate patient needs o Documents nursing history and age appropriate physical/emotional needs/strengths for assigned patients o Reviews vital signs to assess condition of patient and detect deviations from normal. • The registered nurse analyzes the assessment data to determine patient problems or issues o Uses the assessment data to identify patient problems o Confirms problems with patient and family when appropriate o Documents the expected outcomes and plan of care related to the problems through use of the clinical pathway and outcome teaching record • The registered nurse identified expected outcomes for a plan individualized to the patient o Utilizes the patient/family input when defining outcomes. Incorporates the patient values, ethical and cultural considerations. o Coordinates discharge planning for outcomes not achieved utilizing the continuum of care available. • The registered nurse develops a plan that prescribes interventions to attain expected outcomes. o Incorporates clinical pathways into the plan when appropriate o Develops individualized interventions with patient input when appropriate o Considers data from other members of the healthcare team when developing the plan of care • The registered nurse implements the identified plan. o Implements appropriate interventions. o Administers prescribed medication and treatment in accordance with approved nursing techniques and polices. o Utilizes evidence-based interventions specific to the patients plan o Maintains awareness of comfort and safety needs of the patient. o Initiates a patient education plan according to the individualized needs of the patient, and coordinates the implementation of the plan. o Manages the care plan for patients by organizing and delegation patient care interventions to be implemented. Evaluates the effectiveness of care given by self and others. • The registered nurse evaluates progress toward attainment of the expected outcomes o Evaluates the effectiveness of the planned interventions and the patient response toward achievement of the expected outcomes. o Documents the patient response toward the expected outcomes. Standards of Professional Performance: • The registered nurse systematically evaluates the quality and effectiveness of nursing practice. o Participates in quality improvement activities o Uses the results of quality improvement activities to initiate changes in nursing practice. • The registered nurse attains knowledge and competency that reflects current nursing practice. o Participates in ongoing educational activities related to appropriate knowledge and professional issues. o Maintains professional records that provide evidence of competency and continued ongoing educational activities. • The registered nurse evaluates one’s own nursing practice in relation to professional practice standards and guidelines, relevant statues, rules and regulations. o Provides age appropriate care in a culturally and ethnically sensitive manner. o Participates in self-evaluation, identifying areas of strengths as well as areas benefiting from professional development. o Participates in systematic peer review as appropriate. • The registered nurse interacts with and contributes to the professional development of peers and colleagues. o Shares knowledge and skills with peers and colleagues o Maintains compassionate and caring relationships with peers and colleagues o Contributes to a supportive and healthy work environment. • The registered nurse collaborates with patient, family, and others in the conduct of nursing practice. o Partners with the multiple health disciplines to effect change and generate positive outcomes for the patient and family, based on the plan of care. • The registered nurse integrates ethical provisions in all areas of practice. o Delivers care in a manner that preserves and protects patient autonomy, dignity, confidentiality and rights. o Demonstrates a commitment to connecting with self and others through relationship centered care giving. o Serves as a patient advocate • The registered nurse integrates research finding into practice. o Uses research to improve the health of patients and the practice environment. o Participates in the various levels of research based on their level of education. Such activities may include: identifying clinical problems, participating in data collection, participating in the research committee, sharing research activities/finding with others, conducting research, analyzing data and trends of nursing practice to develop changes in nursing practice and utilizes evidence based practice in the development of policies, procedures and standards of practice in patient care. • The registered nurse considers factors related to safety, effectiveness, cost and impact on practice in the planning and delivery of nursing services. o Assigns or delegates tasks based on the needs and condition of the patient, potential for harm, complexity of the nursing activity, required problem solving and innovation, predictability of outcome, extent of patient interaction o Assists the patient and family in becoming informed consumers about the options, costs, risks and benefits of treatments and care. • The registered nurse provides leadership in the professional practice setting and the profession. o Participated in nursing councils, hospital and unit based committees as appropriate. o Attends at least 50% of unit staff meetings o Works to create and maintain professional, healthy work environment when representing Bronson in all settings (local, regional or nationally) • Responsibilities related to the Scrub RN o Interprets procedure card, assesses case cart for supplies prior to the scheduled procedure time. Identifies missing equipment and/or supplies and makes arrangements to acquire those supplies. o Applies knowledge of operative procedure and physician preferences by anticipating physicians' needs. o Observant of overt changes in patient's condition that indicates a problem has emerged. o Evaluates and updates case information, i.e., preference cards, broken or misplaced equipment, back-ordered supplies, and recommended changes in procedure. o Remains aware of the proper use of equipment and instruments, and discourages improper use and handling by co-workers & physicians. o Is observant of the changing needs of the operative field and the surgical team, anticipates potential needs, and takes appropriate actions. o Acts as the specialist and resource for circulators who may be unfamiliar with positioning devices, specialty equipment, and/or implants needed. o Assigned and responsible for after-hour call on a rotational basis. o Ability to perform scrub duties in multiple services; ie: neuro and ortho STII able to perform spinal fusions in bother services. For HDU Department Only: Additional on call requirements above and beyond regular scheduled hours For Bronson Lakeview Hospital and Bronson South Haven Hospital: The RN is responsible for completing the Workday CBL –“Swing beds”. This is an annual CBL that describes the difference in a swing bed patient versus an in-patient or observation patient. The RN will understand the documentation differences and the specific care required for each individual swing bed patient. Bronson South Haven Hospital and Bronson Lakeview Hospital employees who are approved to work in a Swing Bed Facility only: Employees may be expected to cover shifts at Bronson Lakeview Hospital and/or Bronson South Haven Hospital depending on patient acuity and staffing needs. Shift Time Type Full time Scheduled Weekly Hours 0 Cost Center 6400 General Care Unit (BLH) Agency Use Policy and Agency Submittal Disclaimer Bronson Healthcare Group and its affiliates (“Bronson”) strictly prohibit the acceptance of unsolicited resumes from individual recruiters or third-party recruiting agencies ("Recruiters") in response to job postings or word of mouth. Unsolicited resumes sent to any employee of Bronson by Recruiters, without both a valid written agreement with Bronson and a direct written request from the Bronson Talent Acquisition Department for a specific job position, will be considered the property of Bronson. Furthermore, no fees will be owed or paid to Recruiters who submit resumes for unsolicited candidates, even if those candidates are hired. This policy applies regardless of whether the Recruiter has a pre-existing agreement with Bronson. Only candidates submitted through a specific written agreement with the Bronson Talent Acquisition Department for a named position are eligible for fee consideration. Please take a moment to watch a brief video highlighting employment with Bronson!