Hands-On Chronic Patient RNs
6 days ago
Hospital, Outpatient Clinic, Home Health, or Chronic Care Facility Setting
Position Title: Registered Nurse - Chronic Patient Care (IV Therapy Specialist) Common Local Titles: Chronic Care Infusion RN, Home Infusion Nurse, Oncology/Dialysis IV RN, Palliative Care IV Specialist
Primary Focus
Deliver direct, hands-on nursing care to patients managing chronic conditions requiring ongoing IV therapy, such as:
- Total Parenteral Nutrition (TPN) for malabsorption or GI disorders
- Long-term IV antibiotics for recurrent infections (e.g., cystic fibrosis, Lyme disease)
- Chemotherapy, immunotherapy, and targeted therapies for cancer patients
- IV immunoglobulin (IVIG) for autoimmune or immunodeficiency disorders
- Inotropic support for advanced heart failure
- Hydration and electrolyte management for chronic kidney disease or dialysis patients
- Palliative infusions for pain control in end-stage illnesses
Key Responsibilities (Hands-On & Patient-Facing)
- Execute venipuncture, PICC/midline/central line insertions, and port accesses for patients with compromised veins due to chronic illness; utilize ultrasound guidance as needed.
- Administer complex IV therapies (e.g., vesicants, biologics, TPN, blood products) per physician orders, with vigilant monitoring for complications like infiltration, sepsis, or hypersensitivity.
- Perform site assessments, dressing changes with chlorhexidine protocols, and line flushes to minimize central line-associated bloodstream infections (CLABSIs).
- Titrate infusions (e.g., vasopressors, opioids) based on real-time vital signs and lab results; respond to emergencies like anaphylaxis or fluid overload.
- Conduct thorough patient assessments, including pain scales, nutritional status, and psychosocial needs; collaborate on care plans with multidisciplinary teams (e.g., nephrologists, oncologists).
- Provide education to patients and caregivers on home IV management, pump usage, infection prevention, and recognizing complications; facilitate transitions from hospital to home care.
- Document in electronic health records (e.g., Epic at UC Davis or Cerner at Sutter) with detailed notes on infusions, responses, and follow-ups; ensure compliance with HIPAA and Joint Commission standards.
- In home health roles (common with agencies like Kaiser Permanente or Alignment Health), perform field visits, coordinate supplies, and manage on-call emergencies in Sacramento metro areas.
- Support triage via phone or secure messaging for chronic patients; assist in clinic flow for high-volume days.
CategoryRequirementsLicenseActive California Board of Registered Nursing (BRN) RN license; no restrictions.EducationAssociate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) from an accredited program; BSN preferred for Magnet hospitals like UC Davis.Training/Certification• Competency in IV therapy via nursing education or employer-verified experience (BRN does not require separate IV certification for RNs, but specialized training needed for high-risk therapies). • Basic Life Support (BLS) required; Advanced Cardiac Life Support (ACLS) mandatory for critical care/chronic settings. • ONS/ONCC Chemotherapy Immunotherapy Certificate for oncology roles; CRNI (Certified Registered Nurse Infusion) highly recommended for infusion expertise. • Wound care or dialysis certification preferred for relevant chronic conditions.ExperienceMinimum 1-2 years acute/chronic care experience, with 6+ months in IV therapy (e.g., oncology, ICU, home infusion); 2-3 years preferred for independent roles.SkillsProficiency in venipuncture, central access management, pharmacology of chronic meds; strong cultural competency for Sacramento's diverse population (e.g., Spanish/Asian language skills valued); EMR fluency (Epic/Cerner).OtherValid CA driver's license and insurable record for home health; ability to lift 50 lbs and stand for extended periods; TB test, flu vaccine, and background check.
Common Work Settings in Sacramento, CA
- Major hospitals: UC Davis Health (oncology infusion), Sutter Medical Center (chronic disease clinics), Kaiser Permanente (integrated chronic care).
- Outpatient/infusion centers: Dignity Health or freestanding clinics like those affiliated with CommonSpirit Health.
- Home health/hospice: Alignment Health, VITAS Healthcare, or Dialysis Clinic, Inc. for CKD patients.
- Specialty units: Nephrology/dialysis at Sacramento County facilities or wound care clinics serving chronic ulcers.
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