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
PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory requirements and programs. Adheres to all requirements of the FMCNA Compliance Program, and FMS patient care and administrative policies as the clinical leader, has the authority to make daily decisions to ensure continuity of care and patient and staff safety PRINCIPAL DUTIES AND RESPONSIBILITIES: Manages the tactical execution of short- and long-term objectives through the coordination of activities with a direct responsibility for results, including costs, methods, and staffing. Provides leadership, coaching and development plans for all direct reports to maintain an engaged and productive workforce; partnering with Human Resources on employee matters. Technically proficient in the specific department and knowledge of industry practice and business principles. Works on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends. Has a larger range within the department. Responsible for supporting and driving FMS quality standards through meeting all ESRD regulatory requirements and the practice of Quality Assessment and Improvement (QAI), including use of FMS QAI tools. Responsible for addressing and acting on adverse events and action thresholds. Oversees facility’s Home Therapies Program if applicable. Accountable for compliance with all applicable federal, state and local laws and regulations. Ensures all FMS Clinical Quality policies and procedures are communicated to and implemented by the facility staff. Maintains integrity of medical records and other FMS administrative and operational records. Complies with all data collections and auditing activities. Maintains facility environmental integrity, including safety. Experienced leadership required for multi-faceted environment; role primarily focuses on tactical execution. Receives assignments in the form of objectives and determines how to use resources to meet schedules and goals. An individual contributor will have significant project/process responsibilities. Program or project responsibility generally within the function. Follows processes and operational policies in selecting methods and techniques for obtaining solutions. Interprets and recommends change to policies and establishes procedures that effect immediate organization(s). Decisions have an impact on work processes and outcomes. Erroneous decisions or failure to achieve results will add costs and may impact the short-term goals of the organization. Frequently interacts with subordinate supervisors, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers. Participates and presents at meetings with internal and external representatives. Often leading a cooperative effort among members of a project team. Interacts with internal departments and external customers; particularly in problem resolution. Acts as an advisor to subordinate(s) to meet schedules and/or resolve technical problems. Responsible for hiring, coaching and counseling employees, including performance reviews, disciplinary action and terminations. Provides technical guidance. Performs other related duties as assigned. PATIENT CARE: Coordinates all aspects of patient care with the appropriate staff members, from admission through discharge of the patient. Ensure education of the patient regarding quality measures, transplant options, modality awareness, and access care, including catheter reduction and adherence to treatment regime. Acts as a resource for the patient to address patient concerns and questions. Accountable for timely completion of patient care assessments and care plans by organizing meetings of the facility’s Interdisciplinary Team to discuss patient care plans and to resolve patient problems. Directs initiation, maintenance and communication of efficient and timely patient schedules to ensure maximization of the facility station efficiency. Is aware of and develops a mechanism or process for knowing the specific situation of each patient, including hospitalizations, no- shows, catheter use, and any significant change in patient care status. Develops action plans for unexcused and missed treatments in collaboration with the Director. Plans, coordinates and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely workup of patients for access management, dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination of care with the multidisciplinary renal team. Communicates changes in patient status regarding clinical, insurance, travel and transportation issues to the disease management company. Maintains current knowledge of disease management software and systems as pertinent. STAFF: Responsible for implementation of FMS staffing, and medical supply models, to provide quality patient care, and makes recommendations. Participates in the recruitment and interview process, and decision to hire new personnel. Ensures completion of new hiring orientation and training including mandatory in-services and ICD code training when applicable. Ensures documentation completed for annual in service training, and policy and procedure in service updates. Responsible for all patient care employees receiving appropriate training according to FMS policy, including training to ensure ongoing compliance with all FMS risk management initiatives. Provides opportunities for professional growth, and training to ensure clinical competence and the ability for licensed staff to assume Team Leader responsibilities Responsible for overseeing performance of all licensed personnel, direct patient care staff, reporting indirect patient care personnel as assigned, and when necessary, technical staff. Provides employee education and guidance, and feedback related to performance. Maintains current knowledge regarding FMCNA benefits, Human Resources policies, procedures, and processes, and acts as a resource to facility staff. Provides counseling for all clinical staff members at regular intervals offering support and encouraging professional growth. Completes timely employee evaluations and establishes annual goals for staff. Provides written documentation of all disciplinary conferences in accordance with the established personnel policies, and confers with the Director and Human Resources regarding the nature of the disciplinary decisions. Participates in Corporate and Business Unit specific employee recognition and satisfaction programs. Creates, maintains, and communicates efficient and timely employee schedules according to the needs of the facility. Creates and implements a Continuous Quality Improvement (CQI) Process Improvement Team that involves staff in problem solving. PHYSICIANS: Facilitates the application process for physician privileges and compliance with FMS Medical Staff By-Laws. Responsible for strong Director and physician relationships and facilitating staff relationships with physicians. Ensures regular and effective communication with all physicians, through regular meetings with Directors. Participates in Governing Body. Schedules and coordinates CQI meetings with physicians. MAINTENANCE/TECHNICAL: Responsible for the integrity and safety of the facility water system. Must be knowledgeable in the operation of all facility equipment and technology. ADMINISTRATIVE: Responsible for maintaining and updating all FMS manuals. Accountable for completion of the Annual Standing Order Review and ICD coding. Checks correspondence whether electronic, paper or voice mail, and responds as appropriate. Directs information gathering as required supporting billing and collection activities. Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve supply cost goals following all guidelines established in FMS formularies Participates in the completion and interpretation of the Pl-17 inventory supply use analysis. Reviews and approves facility payroll. Reviews profit and loss statements with Director Responsible for participating in all required Network reporting and on-site state or federal surveys. Participates in the completion of the FMS Administrative Clinical Review. 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 Position may require 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. SUPERVISION: Responsible for the direct supervision of various levels of staff as designated by region. EDUCATION AND REQUIRED CREDENTIALS: Bachelor’s Degree; Advanced Degree desirable or an equivalent combination of education and experience Graduate of an accredited School of Nursing (RN). Current appropriate state licensure. EXPERIENCE AND SKILLS: 6 – 8 years’ related experience or an equivalent combination of education and experience. 3+ years’ supervisory or project/program management experience preferred. Minimum of 12 months experience in clinical nursing is required. Experience in med/surg or ICU/CCU is preferred. Minimum of 6 months chronic or acute dialysis nursing experience is required. Must be available as a full-time employee and provide on-call coverage when necessary. Demonstrated leadership competencies and skills for the position, including excellent communication, customer service, continuous quality improvement, relationship development, results orientation, team building, motivating employees, performance management, and decision making. Demonstrated management skills necessary to provide leadership in the supervision of dialysis personnel and to ensure the delivery of maximum quality care to all patients. Must complete Clinical Manager training modules and ongoing developmental programs within the specified time line. 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
PURPOSE AND SCOPE: Functions as part of the Home Therapies dialysis health care team. Ensures provision of quality home patient care in accordance with company policies, procedures and training. Supports the company’s commitment to the Quality Enhancement Program (QEP) and CQI activities, including those related to patient satisfaction. Actively participates in process improvement activities that enhance the likelihood that patients will achieve the company’s Quality Enhancement Goals (QEP). PRINCIPAL DUTIES AND RESPONSIBILITIES: Staff Related: Provides safe and effective training and oversight of the delivery of home dialysis therapies to patients in compliance with standards outlined in the facility policy and procedure manuals, as well as regulations set forth by the Corporation, state and federal agencies. Rotates with other licensed staff to ensure adequate coverage. Participates in staff training and orientation of new staff as assigned. Participates in all required staff meetings as scheduled. Quality: Provides outstanding quality of patient care, as defined by company quality goals and standards. Submits CQI information to Clinical Manager for completion of HT QAI Template for inclusion in facility CQI packet. Participates in all monthly CQI meetings. Education: Assists in the identification and evaluation of candidates for the company Home Therapies Program, including assessment of patients’ home environment. Trains home patients and their families/significant others on the safe and effective operation and maintenance (as appropriate), of all home therapies equipment through a formal Home Therapies training program. Educates patients and family regarding End Stage Renal Disease (ESRD) and the delivery of the company Kidney Options Program. Assesses patient and family readiness and ability to perform dialysis treatments at home and patients’ home environment for suitability in the ongoing delivery of home dialysis therapy. Provides ongoing education to patients regarding their renal dialysis, peritoneal or vascular access and home dialysis therapy, and other related health conditions. Dialysis Treatment: Provides safe and effective delivery of home therapy support care to patients with ESRD. Assesses patients’ response to home dialysis treatment therapy by following predetermined protocols. Communicates patient related issues to the physician as needed. Reports adverse patient events at home or in the clinic as well as equipment and technology related problems to the Clinical/Home Therapies management and physician including the correct documentation of such events. Coordinates the transfer of patients to the hemodialysis clinic when needed and appropriate. Laboratory Related: Reviews, transcribes, and enters physician lab orders accurately into the Medical Information System. Follows company policies and government regulations related to the collection, packaging, and delivery of lab specimens and reporting of results. General Duties: Maintains competency with all emergency operational procedures, and initiate CPR and emergency measures in the event of a cardiac and/or respiratory arrest when the patient is in the medical office. Administers medications as prescribed including following algorithms (as appropriate), and document appropriate medical justification if indicated and maintain records on controlled substances as required by law. Maintenance/Technical: Maintains appropriate skill level in the operation of all home dialysis therapy-related equipment, including the ability to troubleshoot equipment problems with the patient via telephone. Directs patients in the preventative maintenance of home therapies equipment, including water systems and analyses as appropriate. Coordinates with the company products division on the delivery, operation and maintenance of all home therapy dialysis equipment. Medical Records & Documentation: Admits all new patients and documents as needed. Documents all relevant data including physician orders, lab results, vital signs, and treatment parameters, and patient status and any treatment related data appropriately, and enters into Medical Information System. Participates in and ensures all company policies regarding patient admission, transfer, and discharge are appropriately implemented. Completes all monthly and annual reporting as required by company policies and government regulations. Other: Performs other related 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. 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 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. SUPERVISION: None EDUCATION AND REQUIRED CREDENTIALS: Graduate of an accredited School of Nursing (R.N.) Current appropriate state licensure EXPERIENCE AND SKILLS : Minimum of one year medical-surgical nursing experience preferred, ICU experience preferred. Minimum of one year dialysis experience preferred, peritoneal experience preferred. Successfully complete a training course in the theory and practice of dialysis therapies. Competent at operating all Home Therapies related equipment. Successfully complete CPR certification with maintenance as required. Icd-9 coding Training. Demonstrated teaching abilities. 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
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
PURPOSE AND SCOPE: Functions as part of the hemodialysis health care team as a Staff Registered Nurse to ensure provision of quality patient care on a daily basis in accordance with FMS policies, procedures, and training. Supports the FMCNA’s mission, vision, values, and customer service philosophy. Supports the FMCNA commitment to the Quality Enhancement Program (QEP) and CQI Activities, including those related to patient satisfaction and actively participates in process improvement activities that enhance the likelihood that patients will achieve the FMCNA Quality Enhancement Goals (QEP). Adheres to all requirements of the FMCNA Compliance Program, and FMS patient care and administrative policies. PRINCIPAL DUTIES AND RESPONSIBILITIES: Directs Patient Care Technician’s provision of safe and effective delivery of chronic hemodialysis therapy to patients in compliance with standards outlined in the facility policy procedure manuals, as well as regulations set forth by the corporation, state, and federal agencies. Delegates tasks to all direct patient care staff including but not limited to LVN/LPNs, Patient Care Technicians, and Dialysis Assistants. Assesses daily patient care needs and develops appropriate patient care assignments. Routinely monitors patient care staff for appropriate techniques and adherence to facility policy and procedures. Participates in staff training and orientation of new staff as assigned Participates in all required staff meetings as scheduled. Ensures educational needs of patients and family are met regarding End Stage Renal Disease (ESRD). Provides ongoing education to patients regarding their renal disease, vascular access and dialysis therapy, and other related health conditions. Discusses with patient, and records education related to diet/fluid and medication compliance. Provides patient specific detailed education regarding adequacy measures where applicable - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM). Ensures transplant awareness, modality awareness, and drive catheter reduction. Educates patients regarding laboratory values and the relationship to adequate dialysis therapy, compliance with treatment schedule, medications, and fluid. Provides safe and effective delivery of care to patients with ESRD. Accurately implements treatment prescriptions including Sodium (Na) modeling prescription, and Ultrafiltration modeling (where appropriate) to ensure stable treatment therapy as indicated. Assesses patients’ response to hemodialysis treatment therapy, making appropriate adjustments and modifications to the treatment plan as indicated by the prescribing physician. Communicates problems or concerns to the Team Leader or physician. Identifies and communicates patient related issues to Team Leader or physician. Initiates Initial and Annual Nursing Assessment, and ongoing evaluation and documentation of patient care needs according to FMC Policies and Procedures. Actively participates in the pre-evaluation, initiation, monitoring, termination, access homeostasis, and post evaluation of patients receiving hemodialysis treatment therapy according to established FMC procedures. Takes appropriate intervention for changes in patient adequacy status and troubleshooting access flow issues as identified by OLC/AMP yellow lights. Provides, supervises (if applicable), and monitors hemodialysis access care according to established procedures. Implements, administers, monitors, and documents patient's response to prescribed interdialytic transfusions, including appropriate notification of adverse reactions to physician and appropriate blood supplier. Ensures accurate and complete documentation by Patient Care Technician on the Hemodialysis Treatment Sheet. Reviews, transcribes, and enters physician lab orders accurately into the Medical Information System. Ensures appropriate preparation of lab requisitions for Spectra or alternate lab. Ensures correct labs tubes are utilized for prescribed lab specimens and that lab draw and processing procedures are performed appropriately for all lab samples. Identifies and ensures appropriate follow-through regarding missed labs and specimens reported to be insufficient according to company policies and procedures. Ensures all specimens are appropriately packaged according to Department of Transportation (DOT) policies and procedures relating to shipment of blood or body fluid specimens and potentially hazardous material. Ensures that all labs are directed and delivered to appropriate labs. Reports alert/panic and abnormal labs results to appropriate physician. Ensures lab results are forwarded to physicians as requested. Enforces all company approved policies and procedures, as well as regulations set forth by state and federal agencies and departments. Maintains overall shift operation in a safe, efficient, and effective manner. Act as a resource for other staff members. Routinely meets with the Clinical Manager to discuss personnel and patient care status, issues, and information. Collaborate and communicate with physicians and other members of the healthcare team to interpret, adjust, and coordinate care provided to the patient. Provides assistance as needed to patients regarding prescription refills according to FMCNA Policies. Ensures all physician orders are transcribed and entered into the Medical Information system in a timely manner. Oversees all documentation of patient information. Maintains facility drug list for all required stock medications. Maintains competency with all emergency operational procedures, and initiates CPR and emergency measures in the event of a cardiac and/or respiratory arrest. Ensures verification and availability of adequate emergency equipment. Ensures provision of appropriate vaccinations, immunizations, and annual Tuberculosis (TB) testing. Administers medications as prescribed or in accordance with approved algorithm(s), and documents appropriate medical justification if indicated. Administers PRN medications as prescribed and completes appropriate documentation of assessment of effectiveness. Maintains appropriate recording of controlled substances as required by law. Assists with the coordination of patient transportation if necessary. Ensures a clean, safe, and sanitary environment in the dialysis facility treatment area. Ensures competency in the operation of all dialysis-related equipment safely and effectively. Ensures all patient stations, including machines and chairs, are clean and free of blood and placed appropriately. Ensures that all blood spills are immediately addressed according to FMCNA Bloodborne Pathogen Control Policies. Ensures all relevant data including physician orders, lab results, vital signs and treatment parameters, and patient status are documented appropriately and entered into Medical Information System. Ensures all appropriate patient related treatment data is entered into the Medical Information System. Ensures all FMCNA policies regarding patient admission, transfer, and discharge are appropriately implemented. Ensures and verify accuracy of Patient Care Technician documentation. Reviews and ensures appropriate daily completion of Hemodialysis Treatment Sheets by all patient care staff. Ensures that all appropriate procedures are followed regarding opening and closing procedures, inclusive of monitoring that all staff and patients have safely left the premises. Initiates, documents, and completes ongoing Continuous Quality Improvement (CQI) activities including monthly reports. Completes monthly nurses' progress note. Ensures patient medical records are complete with appropriate information, documentation, and identification on each page (Addressograph label is on all chart forms). Reviews transplant status and follows established procedure regarding appropriate action to be taken. Completes patient care plans for new patients within the initial 30 days or any patients deemed unstable requiring monthly patient care plans. Completes any long-term programs that are due. Completes initial and annual Nursing History and Assessment physical. Ensures completion of Annual Standing Order Review with each physician as required. Performs additional duties as assigned. PHYSICAL DEMANDS AND WORKING CONDITIONS : The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The position provides direct patient care that regularly involves heavy lifting and moving of patients, and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. This position requires frequent, prolonged periods of standing and the employee must be able to bend over. The employee may occasionally be required to move, with assistance, machines and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. up as high as 5 feet. The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodation can be made. SUPERVISION: None EDUCATION AND REQUIRED CREDENTIALS: Graduate of an accredited School of Nursing. Current appropriate state licensure. Must meet the practice requirements in the state in which he or she is employed. EXPERIENCE AND SKILLS : Minimum of one-year medical-surgical nursing experience preferred. Hemodialysis experience preferred. ICU experience preferred. Successfully complete a training course in the theory and practice of hemodialysis. Successfully complete CPR Certification. Employees have to meet the necessary requirements of Ishihara's Color Blindness test as a condition of employment. Provide coverage at any or all area facilities as required by management. Icd-9 coding Training. Nurses Technical Training. Must meet appropriate state requirements (if any). 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