Acute Inpatient Registered Nurse - RN

PURPOSE AND SCOPE:

The professional registered nurse Inpatient Services 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 kidney disease health care team, this position participates in decision-making, teaching, leadership functions, and quality improvement activities that enhance patient care outcomes and program 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, applicable contractual service agreements, state and federal regulations.

· Performs all essential functions under the direction of the Supervisor and with guidance from the Educator, Preceptor or in collaboration with another Registered Nurse.

· Performs ongoing, systematic collection and analysis of patient data pre – during – post treatment for assigned patients and documents in the patient medical record, makes adjustments and modifications to treatment plan as indicated and notifies Supervisor, Physician, patient’s primary nurse and others as may be indicated.

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

· Recognizes aspects and implications of patient status that vary from normal and reports to or collaborates with appropriate health team members for input including but not limited to Supervisor, appropriate physician, and the contracted facility primary Nurse.

· Directs and provides safe effective patient care for assigned patients as prescribed for all modality specific treatment procedures.

· Assesses daily assigned patient care needs and collaborates with direct and ancillary patient care staff as needed.

· Initiates and coordinates communication with FKC and Non-FKC dialysis providers and appropriate contracted facility personnel as needed to provide continuity of patient care.

· Performs the implementation, administration, monitoring, and documentation of patient's response to prescribed intradialytic transfusions, including appropriate notification of adverse reactions to physician and appropriate blood supplier.

· Administers medications as prescribed and documents appropriate medical justification and effectiveness.

· Initiates and assists with emergency response measures.

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

· May be asked to provide specialized nursing care instruction to hospital/facility staff as stipulated contractually.

· May be assigned to assist in an Outpatient facility on an as needed basis.

· 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.

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

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

· The position requires travel to training/meeting sites and between assigned facilities.

· Position requires participation in on-call rotation, night, weekend, holiday or as defined by individual program needs.

SUPERVISION:

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

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

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

· 6 months experience in acute dialysis 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 all states 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 an RN

· Minimum 9 months experience as a Registered Nurse, 12 months (preferred).

· 6 months acute dialysis experience (preferred)

· Hemodialysis and/or ICU experience (preferred).

ACKNOWLEDGEMENT:

I acknowledge that I have read and accepted this job description. I understand what is expected of me in this position, and I am able to perform the essential functions as outlined with or without reasonable accommodation. Furthermore, I understand that the duties and responsibilities listed in this job description are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position. If I have any questions about duties and responsibilities not specified in this job description that I am asked to perform, I should discuss them with my immediate Supervisor or my Human Resources representative

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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AVALA Covington, LA

Summary Provides direct patient care to all patient populations. Addresses the psychosocial, physical and general aspects of care related to the surgical environment. Assists with the maintenance of PACU equipment and inventory. Participates in performance improvement activities. Responsible for monitoring patient’s physiological status in the immediate postoperative environment. Communicates with surgeon and anesthesiologist continuously, and as needed, about patient conditions; receives direction for patient management. Intercedes to maintain optimum homeostasis. Can respond quickly and accurately to changes in condition or response to treatment. May be required to perform in the charge nurse role. Essential Duties and Responsibilities Able to perform a head-to-toe assessment on all patient populations and reassessments per facility policy. Provides care appropriate to disease condition and age of the patient. Demonstrates knowledge of perioperative factors that alter immediate postoperative phase. Identifies physical symptoms and changes and takes appropriate action in a timely manner. Demonstrates knowledge of airway management and procedures and the ability to use the equipment. Demonstrates ability to assess cardio-respiratory systems for changes and provides appropriate treatment. Observes behavioral and physiologic changes due to medications, takes appropriate actions and documents. Ability to adequately assess and reassess pain. Utilizes appropriate pain management techniques. Educates the patient and family regarding pain management. Demonstrates an ability to assist physicians with procedures. Carries out medical/surgical asepsis during treatments and special procedures. Knowledge of medications and their correct administration based on age of patient and clinical condition. Follows the five medication rights and reduces the potential for medication errors. Carries out safety measures to prevent patient from harming him/herself or others. Assesses level of consciousness and promotes activity. Encourages turn, cough, and deep breathe by exercises and position changes. Demonstrates knowledge of anesthetic drugs, actions and side effects. Demonstrates knowledge of arterial lines, spinal and epidural catheters and documents pertinent clinical information per policy. Has knowledge of emergency medications. Demonstrates knowledge of peripheral nerve block procedures and catheters; able to document pertinent clinical information per policy. Ability to formulate an individualized plan of care. Ability to revise plan of care as indicated by the patient’s response to treatment and evaluate overall plan for effectiveness. Formulates a teaching plan with patient and family based upon identified learning needs and evaluates effectiveness of learning. Interacts professionally with patient/family. Responds appropriately to patient in an emergency or per ACLS or PALS protocol. Communicates effectively and thoroughly the patient’s condition upon transfer from PACU to the receiving unit Registered Nurse. Establishes and maintains effective communication and good working relationships with co-workers and health care team members for the patient’s benefit. Consults other departments as appropriate to provide an interdisciplinary approach to the patient’s needs. Orients new staff as needed. Maintains regulatory agency requirements, hospital and nursing policies, procedures and standards. Demonstrates knowledge of cardiac monitoring, identifies dysrhythmias, and treats appropriately based upon facility protocol. Able to perform 12 lead EKG as indicated. Able to perform waived testing (point-of-care testing) or moderate complexity testing per clinical laboratory guidelines and unit policy and procedure. Able to interpret results of laboratory tests and take appropriate action on test results. Notifies physician of any abnormal lab/test results. Completes specially assigned duties consistently and as schedule allows. Documentation meets current standards and policies. Manages and operates equipment safely and correctly. Treats patients and their families with respect and dignity. Identifies and addresses psychological, cultural, ethnic and religious/spiritual needs of patients and their families. Functions as a liaison between patients, their families and other departments and other healthcare providers. Utilizes initiative; strives to maintain steady level of productivity; self-motivated. Organizes and manages activities reflecting due consideration for the needs of the department and staff . Charge Nurse Responsibilities: Makes daily patient assignments, monitors the daily surgery schedule and daily unit progress, reports changes to involved departments. Supports/oversees unit staff and monitors staffing efficiency. Monitors late and on call schedule. Staff’s unit according to nursing standards. Supervises staff to ensure quality of nursing care, delegates’ specific duties and tasks. Monitors daily time sheets. Provides and controls supplies, and equipment needed for successful operation of the department. Directs and delegates control of inventories to ensure proper amounts available. Supervises care and cleanliness of equipment and supplies to ensure good working conditions. Effectively communicates pertinent issues to OR Director. Provides orientation to new staff members. Assists in the evaluation process. Promotes the hospital’s mission, values, and goals. Utilizes initiative, strives to maintain a steady level of productivity, completes assigned projects by due date. Knowledgeable of lab procedures and lab equipment. Participates in QA/PI activities, communicates results to staff. Completes other duties as assigned by Director. Communicates with OR Director regarding issues, conflicts, or operational occurrences in the department and participates with problem solving. Promotes professional growth of subordinates by sharing knowledge and/or directing them to sources if information appropriate to given situation. Utilizes journals, books, etc. to learn and/or improve new techniques and equipment. Core Competencies Action Orientation - Targets and achieves results, overcomes obstacles, accepts responsibility, establishes standards and responsibilities, creates a results-oriented environment, and follows through on actions. Communications - Communicates well both verbally and in writing. Effectively conveys and shares information and ideas with others. Listens carefully and understands various viewpoints. Presents ideas clearly and concisely and understands relevant detail in presented information. Creativity/Innovation - Generates novel ideas and develops or improves existing and new systems that challenge the status quo, takes risks, and encourages innovation. Critical Judgment - Possesses the ability to define issues and focus on achieving workable solutions. Consistently does the right thing by performing with reliability. Customer Orientation - Listens to customers, builds customer confidence, increases customer satisfaction, sets appropriate customer expectations, and responds to customer needs. Interpersonal Skills - Effectively and productively engages with others and establishes trust, credibility, and confidence with others. Leadership - Motivates, empowers, inspires, collaborates with, and encourages others. Builds consensus when appropriate. Focuses team members on common goals. Teamwork - Knows when and how to attract, develop, reward, and utilize teams to optimize results. Acts to build trust, inspire enthusiasm, encourage others, and help resolve conflicts and develop consensus in creating high-performance teams. Professional Requirements Meets dress code standards; adheres to policy dress code policy. Completes annual education requirements. Maintains regulatory requirements. Always maintains patient confidentiality. Reports to work on time and as scheduled, completes work within designated time. Wears identification while on duty, uses computerized punch time system correctly. Attends annual review and department in-services, as scheduled. Attends monthly staff meetings or reads staff meeting minutes. Represents the organization in a positive and professional manner. Actively participates in performance improvement and continuous quality improvement (CQI) activities. Complies with all organizational policies regarding ethical business practices. Communicates the mission, ethics and goals of the hospital, as well as the focus statement of the department. Assists other staff members in performing any duty that enhances the delivery of patient care. Advanced Orthopedic and Spine Certification Requirements (CR.1c) As part of the Advanced Orthopedic and Spine Certification, at a minimum, the Program direct-care staff, must have four (4) hours of education specific to the Program scope, initially, and at least annually thereafter. (CR.1e) As part of the Advanced Orthopedic and Spine Certification, staff possess adaptability to processes as related to up-to-date best practices, collaboration between departments, compliance with protocols/processes, communication, cooperation and exceptional customer service. Within 90 days of hire or, if currently employed, within 90 days of signing the job description, must adhere to: Orientation of Advanced Orthopedic and Spine Certification In compliance with the Program education requirements Completed department specific competencies Regulatory Requirements Graduate of an accredited school of nursing Current state Registered Nurse licensure in the state of Louisiana Current BLS, ACLS, and PALS certification Skills Ability to communicate effectively in English, both verbally and in writing. Basic computer knowledge. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk and hear. This position is very active and requires repetitive motions, standing, walking, bending, kneeling and stooping all day. The employee must frequently lift or move items weighing over 100 pounds.