Home Therapy Registered Nurse

PURPOSE AND SCOPE:

The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered Nurses.  The CAP RN 1 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. 

As a member of the Chronic Kidney Disease (CKD) health care team, the CAP RN 1 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 Program Manager with guidance from the Educator, Preceptor or a Home Therapy CAP RN 2, 3, 4 or 5 for the first 6 months of employment.

• Expected to complete requirements to advance to the next CAP level, for which they qualify, within 24 months from date of hire.  

• Performs ongoing, systematic review and analysis of dialysis data for Home Therapy patients and documents in the patient medical record, adjusts or modifies the treatment plan as indicated and notifies Supervisor or Physician as needed.

• Recognizes aspects and implications of patient status that vary from normal and reports to or collaborates with appropriate health team members for input.

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

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

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

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

• Ensures physician orders for assigned patients are entered and acknowledged in the Medical Record

• Initiates or assists with emergency response measures.

• Delegates appropriate tasks to direct patient care staff including but not limited to RNs, LVN/LPNs and Patient Care Technicians.

• Monitors patient care staff for appropriate techniques and adherence to FKC policy and procedures.

• Promotes infection control, equipment and environmental safety.

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

• Assists in the identification, evaluation, selection and education of Home Dialysis candidates and Home Partners.

• Performs assessment and identifies barriers of the Home Dialysis candidate's home environment and partner/ family readiness and ability to perform dialysis treatments in the home. 

• Admits new patients to Home Therapy using the appropriate processes per Fresenius Kidney Care policy and procedure.

• Trains Home Dialysis patients and / or Home Partners on the safe and effective operation and maintenance of all Home Dialysis equipment and treatment supplies through an organized and formal Home Dialysis Training Program.  

• Assesses and manages patients' response to home dialysis training and treatment therapy by following prescribed predetermined protocols. Communicates patient related issues to the physician as needed

• 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.

• Makes referrals to Social Worker and Registered Dietitian as appropriate.

• Checks availability of adequate emergency equipment and supplies as assigned.

• Assists with medication tracking and inventory as assigned.

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

• Participates in all required staff meetings as scheduled.

• Supports and promotes the Fresenius Kidney Care mission, vision, values, and customer service philosophy.

• 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 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. 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.

• Rotates coverage with other licensed home therapy staff as assigned to ensure reliable and adequate coverage.

• Position requires participation in on-call rotation. (Night, Weekend or as defined by individual program needs).

• May be asked to provide essential functions of this position, travel to home dialysis patient homes and other locations with the same physical demands and working conditions as described above.

SUPERVISION:

• Assigned oversight of Patient Care Technicians/LPNs as a Team Leader or designated Nurse in charge, after the following:

  •  Successful completion of all FKC education and training requirements for new employees plus

  •  Must have a minimum of 12 months experience as an RN plus

  • Successful completion of 3 months experience as an RN in home peritoneal dialysis and / or home hemodialysis.

EDUCATION:

• 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 REQUIRED SKILLS:

• Entry level for RNs with less than 2 years of nephrology nursing experience within the last two years or for RNs with a BSN and less than 1 year of nephrology nursing experience within the last two years.
• Minimum of 9 months experience as a Registered Nurse (preferred).
• Chronic Home dialysis or hemodialysis experience (preferred).
• Successful completion of FKC Education and Training requirements for new employees.
• Successful completion and maintenance of CPR BLS Certification.
• Meet all conditions of employment including Ishihara's Color Blindness Test.
• Successful completion of all annual required education/training/competencies.
• Successful completion of on-going training and education as assigned or required.

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.