-Voted 2021 , 2022 & 2023 America’s Most Loved Workplace (Newsweek)

PURPOSE AND SCOPE:

Functions as part of the dialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal agencies. Responsible for the setup and operation of hemodialysis machines. Assist in the maintenance of a safe and clean working environment. Supports the organization 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 organization Quality Enhancement Goals (QEP).

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Patient Related

Education:

• Assist other health care members in providing patient specific detailed education regarding adequacy measures where appropriate - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM), and regarding disease process/access.

Treatment:

• Welcome assigned patients and inquire as to their wellbeing since their last treatment.

• Evaluate vascular access for patency, perform vascular access cannulation, and perform administration of heparin as delegated or as allowed by state law.

• Obtain necessary pre and post treatment vital signs and weight and perform vascular access evaluation pre- treatment

• Initiate dialysis treatment according to prescribed orders including blood flow (QB) and dialysate flow (QD).         

• Evaluate intradialytic problems and provide intervention as prescribed by physician order or as directed.   

• Monitor patients’ response to dialysis therapy. 

• Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of treatment - document.       

• Discontinue dialysis treatment according to established procedures and evaluate patient prior to termination of venous access - standing & sitting blood pressure

• Obtain Hemostasis and apply appropriate dressings.   

• Evaluate the patient prior to discharge.

• Perform and record Pre and Post dialysis evaluation, weight, and vital signs with initial identification        

• Responsible for calculating and entry of individual patients’ dialysis machine programming for Ultrafiltration (UF) goal; treatment time; and UF modeling as prescribed.          

• Responsible for ensuring appropriate safety alarms are enabled, including Narrow Venous Limits, (NVL) 160.    

• Record accurate and timely information regarding vital signs and treatment parameters onto the Hemodialysis Treatment Sheet with initial identification      

• Responsible for accurate documentation of information related to patient treatment including completion of Hemodialysis Treatment Sheet and, if applicable, progress notes.         

• Report any significant information and/or change in patient condition directly to the registered nurse or supervisor.

• Observe patient and conduct machine safety checks according to facility policy. Report any change or unusual findings to the registered nurse or supervisor.

• Perform and document any intervention for unusual patient status and document patients' response to intervention.

• Evaluate patients’ vascular access during treatment including arterial and venous monitoring pressures, provide appropriate intervention as needed, document and report any unusual findings to the registered nurse or supervisor.

• Obtain all prescribed laboratory testing and prepare specimens for collection.      

• Ensure that all blood spills are immediately cleaned with appropriate disinfectant according to facility policy.       

• Prepare, organize, and efficiently utilize supplies and equipment to prevent wastage.       

• Monitors patients performing self-care under the supervision of RN.

Staff Related

• Assists in training of applicable direct patient care staff on appropriate programs under the supervision of a nurse.

Education/Communication:

• Follows all organization business policies, procedures and systems incorporated into training, including compliance with ethical business practices

• Maintain environmental integrity and aesthetics - ensure all areas are safe and clean.

• Clean and disinfect dialysis machine surface, chair, equipment, and surrounding area between treatments according to facility policy.

• Conduct all tasks necessary for preparation for dialysis treatment and document where appropriate and perform all required pretreatment dialysis machine alarm testing including Pressure Holding (PHT).

• Initiate Solution Delivery System (SDS) system.

RECORD KEEPING:

• Complete and document ongoing participation in Continuous Quality Improvement (CQI) activities.  

• Enters all treatment data into the designated clinical application in an accurate and timely manner.           

• Review treatment sheets for completeness, ensure nursing signatures are documented, and ensure

omitted entries are completed or corrected by appropriate staff.

• Prepare initial patient chart for admission and compile paperwork for appropriate placement in chart.

• Prepare/print lab requisitions for prescribed or stat Lab specimens according to laboratory destination.      

• Collect, label, appropriately prepare and store lab samples according required laboratory specifications.     

• Ensure collection of lab specimens by appropriate lab courier.

INFECTION CONTROL:

• Assists in collecting  information for infection control audits.       

• Supports staff and patient Adherence to infection control practices.         

• Follows infection control Policies and Procedures          

• Participates in and reinforces infection control education of patients and families under the direction of the CM or designee as allowed by state law.

TRANSITIONAL CARE UNIT:

• Follows all newly admitted patients through their first 4 weeks of dialysis and coordinating their transitional dialysis care 

• Reinforces all education and care related matters as it relates to the new patient           as allowed by state law

• Liaisons with appropriate FKC staff members to provide the best patient experience including making sure all disciplines are scheduled to see patient according to plan.      

• Assists in assuring patient understanding or home dialysis products, benefits of home and how home dialysis can work for them.

• Sets and preforms a treatment on all machines used in the transitional care unit.

• Assist in assuring patient understanding of treatment options including demonstration of the peritoneal dialysis set-up.

• Assists with coordination of transition to patient’s modality choice.         

• Assists with supply ordering and inventory for TCU       

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.

• 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

accommodations can be made.

• Day to day work includes desk and personal computer work and interaction with patients, facility staff, and physicians. The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required.       

• 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          

• 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 push and/or pull equipment, exerting up to 15 pounds of force. The employee may be required to lift and to lower solutions on a frequent basis of up to 30 lbs., and on an occasional lift basis up to 40 lbs., as high as 5 feet. There is a two-person assist program and "material assist” devices for the heavier items.

EDUCATION AND LICENSES:

• High School diploma or G.E.D. required.

• Must meet Center for Medicaid/Medicare Services (CMS)-approved state and/or national certification requirements within the required state or CMS timeline.

• All appropriate state licensure, education, and training (if any) required.

• Demonstrated commitment to organization culture, values, and customer service standards

EXPERIENCE AND REQUIRED SKILLS:

• Previous patient care experience in a hospital setting or a related facility preferred.

• Continued employment is dependent on successful completion of the organization dialysis training program and successful completion of CPR certification.

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.

"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 and may fall outside of the range shown.
 
Hourly Rate:  $17.00 - $28.00"

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.

No On-Call or Overnight Shifts! Off most major holidays (Thanksgiving, Christmas and New Year's Day).

-2021 , 2022 & 2023 America’s Most Loved Workplace (Newsweek)

-12 weeks of paid, and structured training with a Dialysis RN Educator & Preceptor

-One-on-one patient care, be a part of their total well-being – not just a part of their day!

- Great work/life balance

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.

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.

"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 and may fall outside of the range shown.
 
Hourly Rate:  $36.00 - $60.00"

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.

PURPOSE AND SCOPE:

The professional registered nurse Outpatient RN CAP 2 may be an entry level designation into the Clinical Advancement Program (CAP) for new employees who meet the RN CAP 2 criteria or attained through advancement from RN CAP 1. 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, 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. 
• 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.
• Participates in education and quality improvement projects at the facility and area level as directed by Supervisor.
• May serve as a Preceptor to new employees.
• Required to complete CAP requirements to maintain or 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 and 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.
• 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:

• Assigned oversight of Patient Care Technicians//LVN/LPNs/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 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 minimum of 2 years of Nephrology Nursing experience

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.

ADDENDUM:

Clinical Advancement Program (CAP) Quality

• Competency demonstrated through fostering a Culture of Patient Safety and quality as evidenced by Improved Patient Health Outcomes
• Promotes, facilitates, and collaborates with all members of the interdisciplinary team (IDT) and patient care team on the application of quality improvement principles, activities in the delivery of care, identification of risk areas and opportunities for improvement, and root cause analysis (RCA)
• Promotes, advances, and assists with implementation of FKC clinical, educational, and quality initiatives.
• Mentors and trains team members to monitor the effectiveness of their daily processes.
• Ensures documentation in eQUIP and utilization of data, benchmarking, and graphical representations in performance improvement activities.
  • Analyzes, manages, and reports data as needed to identify improvement opportunities and measure the progress of improvement projects.
  • Use quality improvement tools to ensure adherence to QAI activities.
• Facilitates program and annual regulatory review audits
• Collaborates with Regulatory to identify and recommend systems and practices that would improve outcomes

Clinical Advancement Program (CAP) Preceptor

• Maintains direct supervision of the new nurse until graduated from new employee training
• Collaborates with team members to identify learning opportunities
• Communicates and collaborates with supervisor and Education Department regarding progress of new nurse
• Continues to mentor and support new nurses once released to work independently
• Mentors new RN Preceptors

Clinical Advancement Program (CAP) Multi-modality Cross Trained

• Cross trained to deliver patient care across multiple modalities
• Responsible for maintaining skill set in each cross-trained modality for the delivery of safe and effective patient care
  • Communicates and collaborates with operational and clinical leaders to support maintenance of skills
• Ensures the provision of safe and comprehensive care of patients within the chosen modalities in accordance with all company policies and procedures
• Embraces a commitment to patient satisfaction and actively seeks opportunities to improve the overall patient experience in alignment with established quality and regulatory standards

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.

"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 and may fall outside of the range shown.
 
Hourly Rate:  $34.00 - $57.00"

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.

• Training Provided
• No dialysis experience neccessary

• Fresenius Medical Care is the nation's largest provider of renal care, meeting the needs of more than 135,000 patients at 1,800 clinics throughout the country.
• Our well-established, trusted organization fosters a spirit of camaraderie, emphasizing friendly collaboration, professional support, and career development.
• Superior training, UltraCare� quality control, and certification procedures ensure your potential to succeed and advance as a professional.
• Competitive compensation and exceptional benefits.
• Outstanding tuition reimbursement program.
• Recognized among Fortune's World's Most Admired Companies� in 2011.
• National Safety Award from CNA insurance companies for 11 consecutive years.
• Opportunities to give back by participating in philanthropy and community outreach programs.

• High School Diploma or equivalent
• Secretarial or Business school preferred. 

• Minimum of 1 year in administrative secretarial work.
• Proficient in the use of computers and related software such as Microsoft Office (Word & Excel)
• Familiar with business and technical vocabulary.
• Knowledge of organizational operations and procedures.
• Ability to employ basic reasoning skills.
• Good communication skills - verbal and written.

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.

"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 and may fall outside of the range shown.
 
Hourly Rate:  $18.00 - $28.00"

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.

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.
• 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:

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:

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.

Employee Name (Please Print):

Employee Signature:

Date:

ADDENDUM:

FTN Group- International RN

EDUCATION and LICENSURE:

• Bachelor’s degree in nursing required and either a CGFNS (Commission on Graduates of Foreign Nursing Schools) Visa Screen Certificate OR an NCLEX (National Council Licensure Examination) pass letter OR a Registered Nursing License in the state of intended employment required.
• 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.

Employee Name (Please Print):

Employee Signature:

Date:

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.

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.

PURPOSE AND SCOPE:

Functions as part of the dialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal agencies. Responsible for the setup and operation of hemodialysis machines. Assist in the maintenance of a safe and clean working environment. Supports the organization 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 organization Quality Enhancement Goals (QEP).

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Patient Related

Education:

• Assist other health care members in providing patient specific detailed education regarding adequacy measures where appropriate - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM), and regarding disease process/access.

Treatment:

• Welcome assigned patients and inquire as to their wellbeing since their last treatment.

• Evaluate vascular access for patency, perform vascular access cannulation, and perform administration of heparin as delegated or as allowed by state law.

• Obtain necessary pre and post treatment vital signs and weight and perform vascular access evaluation pre- treatment

• Initiate dialysis treatment according to prescribed orders including blood flow (QB) and dialysate flow (QD).         

• Evaluate intradialytic problems and provide intervention as prescribed by physician order or as directed.   

• Monitor patients’ response to dialysis therapy. 

• Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of treatment - document.       

• Discontinue dialysis treatment according to established procedures and evaluate patient prior to termination of venous access - standing & sitting blood pressure

• Obtain Hemostasis and apply appropriate dressings.   

• Evaluate the patient prior to discharge.

• Perform and record Pre and Post dialysis evaluation, weight, and vital signs with initial identification        

• Responsible for calculating and entry of individual patients’ dialysis machine programming for Ultrafiltration (UF) goal; treatment time; and UF modeling as prescribed.          

• Responsible for ensuring appropriate safety alarms are enabled, including Narrow Venous Limits, (NVL) 160.    

• Record accurate and timely information regarding vital signs and treatment parameters onto the Hemodialysis Treatment Sheet with initial identification      

• Responsible for accurate documentation of information related to patient treatment including completion of Hemodialysis Treatment Sheet and, if applicable, progress notes.         

• Report any significant information and/or change in patient condition directly to the registered nurse or supervisor.

• Observe patient and conduct machine safety checks according to facility policy. Report any change or unusual findings to the registered nurse or supervisor.

• Perform and document any intervention for unusual patient status and document patients' response to intervention.

• Evaluate patients’ vascular access during treatment including arterial and venous monitoring pressures, provide appropriate intervention as needed, document and report any unusual findings to the registered nurse or supervisor.

• Obtain all prescribed laboratory testing and prepare specimens for collection.      

• Ensure that all blood spills are immediately cleaned with appropriate disinfectant according to facility policy.       

• Prepare, organize, and efficiently utilize supplies and equipment to prevent wastage.       

• Monitors patients performing self-care under the supervision of RN.

Staff Related

• Assists in training of applicable direct patient care staff on appropriate programs under the supervision of a nurse.

Education/Communication:

• Follows all organization business policies, procedures and systems incorporated into training, including compliance with ethical business practices

• Maintain environmental integrity and aesthetics - ensure all areas are safe and clean.

• Clean and disinfect dialysis machine surface, chair, equipment, and surrounding area between treatments according to facility policy.

• Conduct all tasks necessary for preparation for dialysis treatment and document where appropriate and perform all required pretreatment dialysis machine alarm testing including Pressure Holding (PHT).

• Initiate Solution Delivery System (SDS) system.

RECORD KEEPING:

• Complete and document ongoing participation in Continuous Quality Improvement (CQI) activities.  

• Enters all treatment data into the designated clinical application in an accurate and timely manner.           

• Review treatment sheets for completeness, ensure nursing signatures are documented, and ensure

omitted entries are completed or corrected by appropriate staff.

• Prepare initial patient chart for admission and compile paperwork for appropriate placement in chart.

• Prepare/print lab requisitions for prescribed or stat Lab specimens according to laboratory destination.      

• Collect, label, appropriately prepare and store lab samples according required laboratory specifications.     

• Ensure collection of lab specimens by appropriate lab courier.

INFECTION CONTROL:

• Assists in collecting  information for infection control audits.       

• Supports staff and patient Adherence to infection control practices.         

• Follows infection control Policies and Procedures          

• Participates in and reinforces infection control education of patients and families under the direction of the CM or designee as allowed by state law.

TRANSITIONAL CARE UNIT:

• Follows all newly admitted patients through their first 4 weeks of dialysis and coordinating their transitional dialysis care 

• Reinforces all education and care related matters as it relates to the new patient           as allowed by state law

• Liaisons with appropriate FKC staff members to provide the best patient experience including making sure all disciplines are scheduled to see patient according to plan.      

• Assists in assuring patient understanding or home dialysis products, benefits of home and how home dialysis can work for them.

• Sets and preforms a treatment on all machines used in the transitional care unit.

• Assist in assuring patient understanding of treatment options including demonstration of the peritoneal dialysis set-up.

• Assists with coordination of transition to patient’s modality choice.         

• Assists with supply ordering and inventory for TCU       

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.

• 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

accommodations can be made.

• Day to day work includes desk and personal computer work and interaction with patients, facility staff, and physicians. The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required.       

• 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          

• 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 push and/or pull equipment, exerting up to 15 pounds of force. The employee may be required to lift and to lower solutions on a frequent basis of up to 30 lbs., and on an occasional lift basis up to 40 lbs., as high as 5 feet. There is a two-person assist program and "material assist” devices for the heavier items.

EDUCATION AND LICENSES:

• High School diploma or G.E.D. required.

• Must meet Center for Medicaid/Medicare Services (CMS)-approved state and/or national certification requirements within the required state or CMS timeline.

• All appropriate state licensure, education, and training (if any) required.

• Demonstrated commitment to organization culture, values, and customer service standards

EXPERIENCE AND REQUIRED SKILLS:

• Previous patient care experience in a hospital setting or a related facility preferred.

• Continued employment is dependent on successful completion of the organization dialysis training program and successful completion of CPR certification.

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.

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.

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

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.

Share your skills and work with a great team!

PURPOSE AND SCOPE:

Functions as part of the dialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal agencies. Responsible for the setup and operation of hemodialysis machines. Assist in the maintenance of a safe and clean working environment. Supports the organization 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 organization Quality Enhancement Goals (QEP).

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Patient Related

Education:

• Assist other health care members in providing patient specific detailed education regarding adequacy measures where appropriate - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM), and regarding disease process/access.

Treatment:

• Welcome assigned patients and inquire as to their wellbeing since their last treatment.
• Evaluate vascular access for patency, perform vascular access cannulation, and perform administration of heparin as delegated or as allowed by state Law.
• Obtain necessary pre and post treatment vital signs and weight and perform vascular access evaluation pre- treatment
• Initiate dialysis treatment according to prescribed orders including blood flow (QB) and dialysate flow (QD).         
• Evaluate intradialytic problems and provide intervention as prescribed by physician order or as directed.
• Monitor patients’ response to dialysis therapy. 
• Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of treatment - document.
• Discontinue dialysis treatment according to established procedures and evaluate patient prior to termination of venous access - standing & sitting blood pressure
• Obtain Hemostasis and apply appropriate dressings.   
• Evaluate the patient prior to discharge.
• Perform and record Pre and Post dialysis evaluation, weight, and vital signs with initial identification      
• Responsible for calculating and entry of individual patients’ dialysis machine programming for Ultrafiltration (UF) goal; treatment time; and UF modeling as prescribed.      
• Responsible for ensuring appropriate safety alarms are enabled, including Narrow Venous Limits, (NVL) 160.         
• Record accurate and timely information regarding vital signs and treatment parameters onto the Hemodialysis Treatment Sheet with initial identification         
• Responsible for accurate documentation of information related to patient treatment including completion of Hemodialysis Treatment Sheet and, if applicable, progress notes.        
• Report any significant information and/or change in patient condition directly to the registered nurse or supervisor.    
• Observe patient and conduct machine safety checks according to facility policy. Report any change or unusual findings to the registered nurse or supervisor.  
• Perform and document any intervention for unusual patient status and document patients' response to intervention.
• Evaluate patients’ vascular access during treatment including arterial and venous monitoring pressures, provide appropriate intervention as needed, document and report any unusual findings to the registered nurse or supervisor.
• Obtain all prescribed laboratory testing and prepare specimens for collection.   
• Ensure that all blood spills are immediately cleaned with appropriate disinfectant according to facility policy.         
• Prepare, organize, and efficiently utilize supplies and equipment to prevent wastage.     
• Monitors patients performing self-care under the supervision of RN

Staff Related

• Assists in training of applicable direct patient care staff on appropriate programs under the supervision of a nurse.
• Collaborates with the Clinical Manager and Education Coordinator in driving organization quality standards through education regarding all ESRD regulatory and legal requirements and the practice of Continuous Quality Improvement. 
• Provides developmental support to applicable clinical and facility staff. 

Education/Communication:

• Participates in implementing  educational programs for PCT staff including contests and other team-based programs.
• Assists in monitoring processes in the delivery of patient care through regular Continuous Quality Improvement (CQI) activities.
• Follows all organization business policies, procedures and systems incorporated into training, including compliance with ethical business practices

• Maintain environmental integrity and aesthetics - ensure all areas are safe and clean.
• Clean and disinfect dialysis machine surface, chair, equipment, and surrounding area between treatments according to facility policy.
• Conduct all tasks necessary for preparation for dialysis treatment and document where appropriate and perform all required pretreatment dialysis machine alarm testing including Pressure Holding (PHT).
• Initiate Solution Delivery System (SDS) system.

RECORD KEEPING:

• Complete and document ongoing participation in Continuous Quality Improvement (CQI) activities.
• Enters all treatment data into the designated clinical application in an accurate and timely manner.
• Review treatment sheets for completeness, ensure nursing signatures are documented, and ensure

omitted entries are completed or corrected by appropriate staff.

• Prepare initial patient chart for admission and compile paperwork for appropriate placement in chart.        
• Prepare/print lab requisitions for prescribed or stat Lab specimens according to laboratory destination.      
• Collect, label, appropriately prepare and store lab samples according required laboratory specifications.   
• Ensure collection of lab specimens by appropriate lab courier.   

INFECTION CONTROL:

• Assists in collecting  information for infection control audits.
• Acts as a change agent for infection control practices within clinic. Under the direction of the CM or designee monitors staff and patient adherence to infection control practices.         
• Reinforces new hire employee adherence to infection control Policies and Procedures
• Supports ongoing staff and patient engagement on infection control practices under the direction of CM or designee for example participation in patient lobby days and staff meetings to reinforce infection control practice.
• Participates in and reinforces infection control education of patients and families under the direction of the CM or designee as allowed by state law         

TRANSITIONAL CARE UNIT:

• Follows all newly admitted patients through their first 4 weeks of dialysis and coordinating their transitional dialysis care   
• Reinforces all education and care related matters as it relates to the new patient as allowed by state law
• Liaisons with appropriate FKC staff members to provide the best patient experience including making sure all disciplines are scheduled to see patient according to plan.        
• Assists in assuring patient understanding or home dialysis products, benefits of home and how home dialysis can work for them.      
• Sets and preforms a treatment on all machines used in the transitional care unit.
• Assist in assuring patient understanding of treatment options including demonstration of the peritoneal dialysis set-up.
• Assists with coordination of transition to patient’s modality choice.         
• Assists with supply ordering and inventory for TCU       

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.

• 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

accommodations can be made.

• Day to day work includes desk and personal computer work and interaction with patients, facility staff, and physicians. The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required.
• 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  
• 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 push and/or pull equipment, exerting up to 15 pounds of force. The employee may be required to lift and to lower solutions on a frequent basis of up to 30 lbs., and on an occasional lift basis up to 40 lbs., as high as 5 feet. There is a two-person assist program and "material assist” devices for the heavier items.

EDUCATION AND LICENSES:

• High School diploma or G.E.D. required.

• Must have a valid PCT national certification or state specific certification as defined by Center for Medicaid/Medicare Services (CMS)All appropriate state licensure, education, and training (if any) required.
• Demonstrated commitment to organization culture, values, and customer service standards

EXPERIENCE AND REQUIRED SKILLS:

• At least two years previous patient care experience in a hospital setting or a related facility preferred.
• Continued employment is dependent on successful completion of the organization dialysis training program and successful completion of CPR certification.

ADDENDUM:

Home Therapies Program (Not Home Assist)

This list pertains to task performed in the Home Therapies program under the direct supervision of the Home Therapies registered nurse (HT RN)  and in compliance with state law.

• May assist HT RN on Home Visit as directed    
• Reinforces PD/HHD patient education under supervision of HT Registered Nurse as permitted under state law         
• Schedules and contacts patients regarding appointments         
• Weigh patient and obtain vital signs     
• Collect patient’s treatment records and review for completion. Notify RN of incomplete / missing records.
• Cleaning and prepping treatment room; preparing charts prior to clinic visit        
• Preparing lab tubes and requisitions & assisting with lab draw days both pre and post draw (PCT certified phlebotomy or per state regulations)    
• Clerical duties as assigned (faxing, mailing to physician offices etc.)      
• Set-up of the home hemodialysis machine and PD Cycler         
• Assist with exit site care when directed by HT RN         
• Obtain home hemodialysis water and dialysate samples and process for testing as directed by HT RN
• Perform water dialysate collection and processing for testing as directed by the HT RN   
• Creates and sends patient reminders (supply inventory for order, Kt/V collection, bringing meds to clinic visit for review)           
• Prepare initial patient chart for admission. Complies and maintains medical records according to company policy and procedure and in compliance with all appropriate regulatory requirements       
• Maintains logs as directed and applicable
• Support patient registration and use of connected health           
• Provide patient home support as indicated and permissible under state law and applicable regulations

Inventory of Home Program

• Maintains par levels of home department supplies        
• Files home patient packing slips/invoices         

Inventory for Patients

• Assists patient with supply management and contacting customer service

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

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.