Registered Nurse

Main Function: Under the supervision of the Clinical Nurse Manager, performs duties in the care and treatment of patients on maintenance dialysis.

The Dialysis Staff Nurse prepares the dialysis equipment, initiates the treatment, monitors the procedure and then discontinues the dialytic treatment. This person assists in making and implementing nursing care plans and giving medication while providing both routine and emergency care to patients; supervises non-professional nursing personnel and assists physicians and staff. The Dialysis Staff Nurse may have charge responsibilities, when so designated.

The Dialysis Staff Nurse is also responsible for instructing both staff and patients in the clinical and technical aspects of dialysis that includes patient medication needs.

The Dialysis Staff Nurse shall also maintain current CPR Certification from the American Heart Association.

Representative Functions: Complete patient admission process as outlined in policy and procedure, collaborating with team members regarding real or potential problems or needs relative to the treatment provided.

Completes initial and annual Nursing History and Assessment physical.

Procedure set-up (rinse, prime, attach, etc.) clean (sterilize and disinfect) operate and maintain all hemodialysis equipment.

Complete pre-treatment and post treatment physical assessments.

Participates in setting up individualized Comprehensive Assessment and Plan of Care for each patient with Physician and other health services personnel as per facility policy.

Prepares and administers medication as ordered.

Evaluates patient condition pre-dialysis: Weight - observe for any signs of over hydration. Check vital signs. Check for any signs of bleeding or infection. calculate fluid removal based on estimated dry weight Draw and send any blood values ordered to laboratory.

Initiates and terminates patient treatments to include connecting and disconnecting AVF, AVG and catheters and cleaning catheter sites per protocol.

Perform venopuncture for internal access.

Constant observation, monitoring and documenting of blood pressure of dialysis parameters for all access types as assigned during treatment as per unit protocol.

Sets parameters for treatment (Calculates transmembrane pressure, BFR, pressure limits).

Inter-Dialytic treatment responsibilities which include: Check and record vital signs q1/2 hr. Monitor and adjust, if necessary, the dialytic treatment parameters per 1/2 hr. Administer anticoagulant therapy, as ordered.

Administer IV Therapy for hypotension, as required.

Observe and record, as necessary, the patient's general physical and mental condition.

Discontinue dialytic treatment: Return blood in system to patient. Apply bandage to access. Perform external access care.

Observe patient post-dialysis: Check weight and record. Check vital signs and record.

Is properly trained and knowledgeable of administering blood products.

Is able to operate and trouble shoot individual dialysis machines.

Capable of checking the conductivity, temperature and PH of the dialysate.

Capable of checking for residual Sodium Hypochlorite.

Capable of checking the water system for Chlorine/Chloramine.

Capable of checking the water system as per re-established parameters.

Checking the water system for chlorine/Chloramine.

Check the water system as per established guidelines and parameters, document on log sheet and report any.

Ensuring the enforcement of all policies and procedures including patient’s bill of rights.

Proper handling and storage of bio-hazardous waste and chemical.

Disinfection of cleaning of equipment surrounding and including patient chairs.

Assist with lifting, turning moving, positioning and transferring patients.

May perform other duties and assist in areas of the department as directed by the Nurse Manager, RN, Administrator, and Medical Director.

Have knowledge of emergency procedures. Able to function in an emergency situation under the director of the person in charge: Understand CPR protocols, and can assist during an emergency situation Communicate information regarding the patient’s condition to the MD.

To take charge as assigned by the Clinical Nurse Manager, as necessary.

Reviews charts and physician orders; records medications and special treatments.

Reviews and ensures appropriate daily completion of Hemodialysis Treatment Records by all patient care staff

May act as team leader, receives and gives report, assigns responsibilities.

Ensures that the treatment area is clear, maintaining unobstructed circulation.

Issues bedpan and assist patients.

Collect specimens and tests then send to the laboratory.

Provide patient education.

Recognizes and reports patient problems to the Nurse Manager.

Contributes to the general care and maintenance of the dialysis center to provide a clean and safe atmosphere for the patients.

Must strive to contain costs while not compromising the quality of patient care.

May perform other duties deemed necessary by the Dialysis Charge Nurse, Clinical Nurse Manager or Medical Director.

Assists in the orientation of new employees and the direction of non-professional patient care staff; cooperates with other nursing personnel to provide appropriate student nurse activities.

Assists in examination and evaluation of patient appropriate treatment and services.

Completes monthly nurses' progress note.

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.

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.

Relationships: Keeps the Clinical Nurse Manager informed of any unusual patient problems or complications.

Keep the Clinical Nurse Manager informed of the operational status of all equipment on an on-going basis.

On all occasions approaches the patient and visitors in a courteous, friendly manner, with respect for the rights and concerns of the patient.

Maintains confidentiality of all patients.

Maintains a professional and functional attitude with co- workers in the presence of patients and others.

Maintains a cooperative working relationship with all co-workers, both intrafacility and interfacility with patients and with others whom contacts is made.

Implement physician's orders promptly and adequately with understanding of the purpose of each order as it relates to the patient care plan.

Willfully assists in the orientation and teaching of new employees.

Willfully teaches personnel in the areas of new techniques, usage of new equipment or changes in policy and procedures.

Clearly expresses concerns to members of the inter disciplinary during patient cares conference or staff meetings.

Reports to the Clinical Nurse Manager appropriate information.

Recognizes and secures guidance from appropriate sources regarding problems related to patient care and/or facility activity.

Maintain established Standards of Caring Behavior.

Accountability: The performance of the Dialysis Staff Nurse will be measured by: The degree to which operations, procedures and set-ups are conducted in a safe manner.

The degree to which patient status is continually assessed, identifying all aspects of current status and/or acquires needed information.

The demonstrated quality of sound nursing judgment seen through the retention of basic clinical and humanistic skills pertinent to the practice and education of a Registered Nurse working in a dialysis specialty area.

The degree to which physician's orders are promptly and adequately implemented with an understanding of the purpose of each order as it relates to the patient's plan of care.

The degree, to which a written plan of care is developed, implemented and evaluated including goals and nursing actions as seen through regular contributions and revisions.

The degree to which the Dialysis Staff Nurse accurately documents changes in the patient's mental and/or physical status and adequately reflects the care given to the patient through nursing intervention.

The quality to which the Dialysis Staff Nurse assumes the operational shift responsibilities of the Dialysis Charge Nurse in his/her absence by performing such duties.

The degree to which sufficient knowledge is retained to deal with related dialysis complications when they arise.

The extent to which the individual keeps clinically and technically up-to-date through in-service programs, journals, etc.

The quality of orientation assistance given to new personnel, student nurses, new patients, etc.

The degree to which confidentiality of all patients and others is maintained.

The degree of voluntary cooperation given co-workers with whom contacts are made while carrying out the daily work load requirements.

The relationship with Administration, Director of Nursing and the Medical Director as indicated by the degree to which they are kept informed of all unusual matters.

The degree, quality and timeliness to which assignments are completed paying particular attention to detail.

The degree to which responsibility is assumed for staying abreast of new clinical and theoretical advance in the field of dialysis nursing through continuing education.

The degree to which the individual is personally responsible for arriving on duty punctually, his/her attendance record and overall attitude toward the job, including neatness of appearance.

The degree to which the Dialysis Staff Nurse performs other duties as requested.

Physical, Emotional and Sensory Requirements: Must be in good mental and physical condition.

Must be able to move intermittently throughout the work day.

Must be able to cope with mental and emotional stress of the position.

Must function independently, have flexibility, personal integrity and the ability to work effectively with the patients, staff, family members, visitors and support regulatory agencies.

Must be in good general health and demonstrate emotional stability.

Must demonstrate a caring attitude and be able to relate to and work with the ill, disabled, elderly, emotionally upset, and at time hostile people within the facility.

May be required to lift, push, and move at least 50 lbs.

Must be able to assist in the evacuation of patients.

Must be able to climb several flights of stairs in an emergency.

Must adhere to dress code and maintain a high level of personal hygiene and cleanliness.

Must be able to operate dialysis specific equipment.

Ability to read, write, understand and speak English and basic math skills in a clear and concise manner.

Must have communication and interpersonal skills to work effectively with a wide variety of individuals.

Standards of Caring Behavior: On all occasions, to approach the patients, families and all visitors in a courteous, friendly manner with respect to their rights and concerns.

To reduce patients, families and visitors anxieties by introducing yourself, explaining all procedures and possible delays in schedule, orienting them to the facility, and maintaining a neat, professional appearance.

To converse with patients and their families to ascertain any specific problems that need attention and refers them to appropriate sources when indicated: i.e. Physician, Administrator, Nurse, Dietitian and Social Worker.

To maintain the confidentiality and privacy of all patients by providing an area for confidential conversation and screening when necessary.

Demonstrate caring behaviors through making eye contact, smiling, initiating conversation and sharing a genuine concern for the situation.

Education And Training Requirements: This position requires graduation from an accredited school of professional nursing and the holding of a current license as a registered nurse in the State of New York. The individual should have at least one year of Medical/Surgical Nursing experience prior to employment in the dialysis center. Additionally, experience in performing venipunctures and the handling of emergencies is desirable. Candidate must have dialysis nursing experience and at least 1 year caring for patients on dialysis. Candidate must be licensed in New York and have current BCLS certification. Candidate should have knowledge with computers and electronic charting.