Fresenius Medical Care North America Holdings Limited Partnership jobs in Louisville, KY - 25 jobs

**About this role:** As a Biomedical Technician with Fresenius Medical Care, you will maintain and repair medical and water treatment equipment within our kidney care clinics. You will also train and educate colleagues on operational maintenance of our dialysis machines to ensure the safety of our dialysis patients, as well as manage the medical supplies required. **How you grow or advance in your career:** We believe in encouraging our employees to achieve their full potential by offering opportunities for advancement. We have a Biomedical Technician specific career ladder with three potential levels of Biomedical Technician role as well as a leadership path from Area Technical Operations Manager, Regional Technical Operations Manager, and Senior Director Technical Services, overseen by a Vice President of Technical Services and supported by Corporate Biomedical Support Managers. **Our culture:** We believe our employees are our most important asset - we value, care about, and support our people. We are there when you may need us most, from tuition reimbursement to support your education goals, granting scholarships to family members, delivering relief when natural disasters strike, or providing financial support when personal hardship hits; we take care of our people. **Our focus on diversity:** We have built a nurturing environment that welcomes every age, race, gender, sexual orientation, background, and cultural tradition. We have a diverse range of employee resource groups (ERGs) to encourage employees with similar interests, goals, social and cultural backgrounds, or experiences to come together for professional and personal development, discussion, activities, and peer support. Our diverse workforce and culture encourage opportunity, equity, and inclusion for all, which is a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in the lives of people living with kidney disease. If this sounds like the career and company you have been looking for, and you want to be a vital part of the future of healthcare, apply today. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** - Maintains, troubleshoots, and repairs dialysis equipment, ancillary equipment, and water treatment systems. - Maintains the physical plant, as directed. - Ensures outside vendor services are completed per contract. - Purchases and retain an inventory of service parts. - Performs, evaluates, and reports water/dialysate sample collection and any actions required. - Conducts daily, weekly, and monthly trend analysis on the water system to assure system functions as designed. - Documents all repairs and maintenance activity. - Assists in planning and installing biomedical equipment to assure safe and effective operation of facility. - Transports equipment as needed with supervisor consent. - Participates in monthly technical and regulatory meetings. - Collaborates with facility staff to ensure all regulatory and OSHA requirements are met. - Manages inventory, including receiving and putting up deliveries, inventory counts, transporting goods between clinics as needed and assist clinical management with inventory costs. - Performs initial and annual verification and ongoing monitoring of patient care staff's technique for testing water system, assuring tests and documentation comply with manufacturer's specifications for the devices and test equipment used. - Completes all technical training programs required by state/federal regulations and company policy. - Provides scheduled after hour technical on-call coverage for your clinics as needed. **EDUCATION AND CREDENTIALS:** + High school diploma or G.E.D. required. + Valid Driver's License issued in the employee's state of residence required. + Continued employment is dependent on successful completion of Fresenius Biomedical Technician training within the first 24 months of service from date of hire. **EXPERIENCE AND REQUIRED SKILLS:** + Qualities and traits: customer service, collaborative, independent, analytical, mechanical, self-motivated, self-starter, continuously strives for staying up to date and increasing their knowledge/skills + Less than 1-year related experience. + Prior experience working in a mechanical, automotive, or construction industry, dialysis, or medical technical setting (preferred but not required). + Manual dexterity required - ability to use common hand tools and small power equipment. + Good verbal and written communication skills. + Ability to lift up to 50 lbs. and safely move large/bulky equipment Ability to create a safe and efficient work environment, OSHA - 6S - Infection Control **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. - Position involves active work including lifting, bending, walking, and standing for considerable lengths of time. - The use of dollies or other equipment is mandatory when moving heavy weight items. May be required to frequently lift items weighing up to 50 lbs. as high as 5 feet. - There is potential exposure to chemicals and infectious materials. Scope of work includes high voltage equipment. Personal Protective Equipment (PPE) is provided by the company. - Work environment is typically air temperature controlled with moderate noise levels. May be required to work in various outdoor elements. - Evening, weekend, and holiday availability, as well as ability to take Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws. **EOE, disability/veterans**

**PURPOSE** **AND** **SCOPE:** _Performing_ _general_ _office_ _duties_ _incorporating_ _a_ _variety_ _of basic_ _and_ _routine_ _clerical_ _and_ _secretarial_ _duties_ _in_ _a_ _clinical_ _environment._ Be the "face" of one of our outpatient or hospital facilities-and use your administrative skills to impact the lives of our patients and their families. As a secretary/receptionist at Fresenius Kidney Care, you will be an integral part of a cross-functional team, providing administrative support to maintain clinic operations and provide the best customer care for patients living with kidney disease. **PRINCIPAL** **DUTIES** **AND** **RESPONSIBILITIES:** Under general supervision, follows established company policies and procedures and applies acquired job skills to: **Patient Engagement and Front Desk** **-** Responsibilities may include the following based on location and business need: + Answering telephone & routing calls to the appropriate person + Professionally greet all patients and guests. + Maintain a professional environment at all times. Monitors the reception and waiting areas. + Distributing incoming mail. + ObtainnecessarysignaturestoensuretheefficientprocessingofadmissionsdatainaccordancewithFMCNApolicies and procedures. + Ensureallaspectsofpatientconfidentialityaremaintainedatalltimes **Scheduling and Registration** **-** Responsibilities may include the following based on location and business need: + Maintains accurate records of hospitalization, patient travel, etc. to facilitate coordination of patient scheduling, ancillary testing, etc. + Prepares medical records for facsimile or mail related to travel, transplant, disability and others. + Organizes travel for patients by contacting and providing requested medical records. + Coordinates with transient patient paperwork. + Coordinates transfer placements and confirmations along with Clinical Manager. + Confirms admissions paperwork is completed and sent to designated department(s), such as billing, by collecting, faxing and scanning. + Assist with medical appointment referrals and scheduling. + Assist with transportation coordination and referrals. + Ensures data entry has been completed for Crown Web. Related to ESRD 2728. ESRD 2746 and PART. + Monthly insurance card scanning **Administrative and Additional Responsibilities** **-** Responsibilities may include the following based on location and business need: + Setting up and maintaining filing systems and basic databases as applicable. + Completing forms and reports as required by the various company offices and outside vendors and agencies. + Preparing purchase orders using the appropriate software application. + Assisting with department/facility accounts receivable and accounts payable functions and responsibilities as needed. + Maintaining inventory of the necessary office supplies + Assists in auditing records for ongoing compliance with medical records standards (H&Ps, monthly physician progress notes, care plans, etc). + Assists in the collection of Patient Demographic Information and Continuous Quality Improvement Data. + Assemble,fileandmaintainpatientmedicalrecords + Printpatientscheduleandpullpatientchartsdaily. + Arrangeforpackagepickupanddelivery. + Assists with month-end reporting requirements. + Participate in collaboration sessions such as center/team huddles and staff meetings. + Attend education and training sessions as appropriate and apply key learnings. **SKILLS:** + Knowledge of office procedures required. + Proficient in Microsoft office applications + Ability to adapt to supporting software applications. + Professional attitude and appearance + Solid written and verbal communication skills + Ability to be resourceful and proactive when issues arise + Strong organizational skills + Multitasking and time-management skills, with the ability to prioritize tasks + Customer service attitude **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 possible interaction with patients, facility staff and physicians. The position may require travel between assigned facilities and various locations within the community. The work environment may be characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials **SUPERVISION:** + None **EDUCATION** : + HighSchoolDiploma or GED required **EXPERIENCE AND REQUIRED SKILLS** **:** + Minimum 6 months relevant experience without a degree. + 1-2 years related experience preferred. + Experience working knowledge of computers with Microsoft Word, Excel and PowerPoint preferred. Good verbal communication skills. + Pleasanttelephonemanner. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**About this role:** As a Dietitian with Fresenius Medical Care, you will be a valuable member of the interdisciplinary team and a part of a close-knit, collaborative team responsible for delivering unique nutritional care to patients facing end stage renal disease. Our RDs build strong bonds and lasting relationships with patients, their families, and all team members. **How you grow or advance:** We offer a Core Curriculum program, which includes CEUs, specifically for dietitians on all the topics of renal nutrition therapy. Our orientation and training program is designed to develop experts in the field of renal nutrition, allowing you to work at the top of your license. **Our culture:** We believe our employees are our most important asset - we value, care about, and support our people. We are there when you may need us most, from tuition reimbursement to support your education goals, granting scholarships to family members, delivering relief when natural disasters strike, or providing financial support when personal hardship hits, we take care of our people. **Our focus on diversity:** We have built a nurturing environment that welcomes every age, race, gender, sexual orientation, background, and cultural tradition. We have a diverse range of employee resource groups (ERGs) to encourage employees with similar interests, goals, social and cultural backgrounds, or experiences to come together for professional and personal development, discussion, activities, and peer support. Our diverse workforce and culture encourage opportunity, equity, and inclusion for all, which is a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in the lives of people living with kidney disease. If this sounds like the career and company you have been looking for, and you want to be a vital part of the future of healthcare, apply today. **PRINCIPAL RESPONSIBILITIES AND DUTIES:** + Assesses patient's knowledge and provides education regarding the relationship of diet and kidney disease and the impact on the treatment process. + Provides education to patient/family/caregiver regarding nutritional status, adequacy measures and results, fluid status, and all nutrition related lab parameters pertaining to their disease process. + Completes nutritional assessment and works with the interdisciplinary team to develop an individualized comprehensive plan of care for patients. + Maintains complete and accurate medical records including progress notes. + Provides ongoing assessment and counseling necessary to assist patient in achieving and sustaining an effective nutritional status. + Identifies malnourished or at-risk patients and works collaboratively with the interdisciplinary team to identify appropriate interventions, resources, or solutions. + Monitors, adjusts, and documents response to nutrition therapy and addresses any issues impacting the patient's ability to achieve the goals. + Collaborates with the interdisciplinary team on Urea Kinetic Modeling recommendations to achieve the physician's prescription of Kt/V. + Reports on nutrition QAI results and participates in the interdisciplinary QAI program. + Reviews nutrition related lab results: + Counsels patient and/or caregiver and formulates appropriate action. + Recommends treatment changes to the interdisciplinary team as appropriate. + Identifies candidates to refer to physician for nutritional supplements. + Communicates with physician and/or facility staff as appropriate. + Maintains dietetic registration and continuing education hours as specified by American Dietetic Association and state licensure regulations where applicable. **EDUCATION:** + Registered Dietitian as per Commission on Dietetic Registration. + Board Certified Specialist in Renal Nutrition encouraged. + Current state licensure if applicable. **EXPERIENCE AND SKILLS:** + 1+ year experience in clinical nutrition as a Registered Dietitian. + Previous renal experience preferred. **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. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

+ Monday - Friday schedule, no nights/weekends/holidays/on call + Rewarding development of direct patient care staff + Structured professional development to enhance personal growth + Collaboration with operational and clinical leaders to ensure quality patient care is provided to our dialysis patients + Facilitation and implementation of our world-class dialysis training program + Opportunity for professional development by participating in national projects related to the development of our staff + Ability to support all dialysis modalities **PURPOSE AND SCOPE:** Supports the training and education of employees based in company facilities and programs within an assigned geographical area. Delivers standardized, competency based, training and development programs including new employee orientation, preceptor training, facility specific in- services, and clinical, quality, and customer service training programs to promote quality patient care, and achieve Area, Regional and/or Enterprise wide initiatives & goals. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** + Aligns with regional, group, and corporate, business-related goals through all activities and actions. + Adheres to standards and scope of nursing practice, company policy, procedures, compliance, regulatory, legal, and ethical, requirements. + Focuses all programs towards achieving a culture of patient safety, clinical quality goals, and improving patient outcomes, using company and industry guidelines and standards. + Develops competency and skills to educate personnel in all chronic kidney disease treatment programs. + Empowers and promotes a culture of lifelong learning through professional programs, coaching, and available technologies. + Collaborates with relevant partners at all levels to schedule, provide, and implement education programs, technologies, and processes for new and current personnel. + Utilizes appropriate educational venues and generational learning techniques to deliver, support, and evaluate training. + Partners in the implementation of action plans through to resolution, as appropriate. + Uses facilitation techniques and the variety of tools and resources available to promote immersive, engaging, learning experiences. + Develops and maintains open, effective, and timely communication with internal and external customers such as, but not limited to, company management and facility team, government agencies, physicians, hospitals, and contracted travel personnel. + Demonstrates leadership competencies, excellent communication, customer service, continuous quality improvement, relationship development, critical thinking, team building, motivating employees, performance management, and decision- making skills. + Supports metric / KPI programs, with timely and complete data documentation, reporting, and ongoing quality improvement processes. + Maintains knowledge of products, services, and strategies to support and train staff appropriately in all modalities. + Perform 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, Regional and facility/program employees and physicians. The position requires travel between assigned facilities and various locations within the community. Travel to regional, departmental, 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. + 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. + May be asked to provide essential functions of this position in other locations which may include overnight stays, with the same physical demands and working conditions as described above. + This position requires between approximately 35-80% travel **SUPERVISION:** + None **EDUCATION AND REQUIRED SKILLS** **:** + Associate or Bachelor's degree from an accredited School of Nursing. + Advanced degree BSN or MSN (preferred) + Current appropriate RN state licensure in primary state of residence + Obtain and maintain RN state licensure in assigned states as directed + Must meet the practice requirements in the state of employment + Minimum 1-year dialysis experience as a Registered Nurse + CDN or CNN (preferred) or must attain within 18 months of employment + Successful completion and maintenance of CPR BLS (Basic Life Safety) Certification, all annual and ongoing required education / training / competencies. **Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.** ADDENDUM: Training Support Team (TST) - Partner with the local clinical educators to support HT Education and Training need of assigned regions - Support standardization of clinical DPC workflow in HT programs - Focus on critical HT markets, identifying knowledge gaps, collaborating in creation and implementation of action plans - Support the continued HT knowledge and skills development of local education and N&CS teams - Foster a direct relationship with new HT learners i.e., virtual coaching sessions, facilitating / performing initial skills validation, HT expert for question and new employee support - Support the design and delivery of HT training workshops - Collaborate and direct vendor resource support - 60-70% Travel **EOE, disability/veterans**

**About this role:** As a Patient Care Technician (PCT) at Fresenius Medical Care, you play a vital part in supporting people who entrust us with their care, their families, and your fellow care team members. You will build deep relationships with patients when they come into our clinic. **How you grow or advance:** Previous healthcare experience is not required to join us as a PCT. Passion for helping others, teamwork, and a desire to learn and grow are what you need to be successful. We will provide robust training and support as you kick off your career, and we will introduce you to career path options as you grow with us either as a PCT or venture into a new role such as Registered Nurse or a leadership role. **Our culture:** We believe our employees are our most important asset - we value, care about, and support our people. We are there when you may need us most, from tuition reimbursement to support your education goals, scholarships to family members, relief when natural disasters strike, and financial support when personal hardship hits; we take care of our people. **Our focus on diversity:** We have built a nurturing environment that welcomes every age, race, gender, sexual orientation, background, and cultural tradition. We have a diverse range of employee resource groups (ERGs) to encourage employees with similar interests, goals, social and cultural backgrounds, or experiences to come together for professional and personal development, discussion, activities, and peer support. Our diverse workforce and culture encourage opportunity, equity, and inclusion for all, which is a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in the lives of people living with kidney disease. If this sounds like the career and company you have been looking for, and you want to be a vital part of the future of healthcare, apply today. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** As a member of the nephrology healthcare team, you will provide safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse. + Sets up, tests, and operates hemodialysis machines for patient treatments. + Obtains and documents necessary pre- and post-treatment vital signs and weight for each patient. + Evaluates vascular access pre-treatment and performs vascular access cannulation. + Evaluates intradialytic problems and provides intervention as prescribed by physician order or as directed. + Monitors patients' response to dialysis therapy. + Evaluates patient prior to termination of venous access and discontinues dialysis treatment according to established procedures. + Reports any significant information and/or change in patient condition directly to supervisor. + Enters all treatment data into the designated clinical application in an accurate and timely manner. + Collects, labels, appropriately prepares, and stores lab samples according to required laboratory specifications. + Cleans and disinfects dialysis machine surface, chair, equipment, and surrounding area between treatments according to facility policy. + Assists other healthcare members in providing patient education. + Prepares, organizes, and efficiently uses supplies and equipment to prevent waste. **EDUCATION AND LICENSES** **:** + High school diploma or G.E.D. required. **EXPERIENCE AND REQUIRED SKILLS** **:** + Qualities and traits: dependable, compassionate, caring, supportive, collaborative, reliable. + Previous patient care experience in a hospital setting or a related facility (preferred but not required). + Continued employment is dependent on successful completion of the Fresenius Medical Care dialysis training program and successful completion of CPR certification. **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. We 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 healthcare 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 basis lift up to 40 lbs., as high as 5 feet. There is a 2-person assist program and "material assist" devices for the heavier items. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

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 . 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 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.** **EOE, disability/veterans**

**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.** **EOE, disability/veterans**

**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.Equipmentaidsand/orcoworkersmayprovideassistance.Thispositionrequiresfrequent,prolongedperiodsof 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:** + HighSchooldiplomaorG.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. + Allappropriatestatelicensure,education,andtraining(ifany) required. + Demonstrated commitment to organization culture, values, and customer service standards **EXPERIENCE AND REQUIRED SKILLS** **:** + Previouspatientcareexperienceinahospitalsettingorarelatedfacility preferred. + Continued employment is dependent on successful completion of the organization dialysis training program and successful completion of CPR certification. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**PURPOSE AND SCOPE:** Functions as part of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of 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. Employees hired into this position will be required to obtain their nursing license and registration within the timeframe outlined in state specific regulations, or within 90 days from hire date, whichever comes sooner. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** **STAFF RELATED:** + 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. **PATIENT RELATED:** Education: + 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. Dialysis Treatment: + 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. Laboratory-related: + 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. General duties: + 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. **MAINTENANCE/TECHNICAL:** + 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. **MEDICAL RECORDS & DOCUMENTATION:** General + 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. Daily + 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. Monthly + 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. Annually + Completes initial and annual Nursing History and Assessment physical. + Ensures completion of Annual Standing Order Review with each physician as required. **OTHER:** + As a condition of continued employment, you are required to obtain and maintain any required credentials or certifications necessary for your position in an active and valid status (including renewal of such credentials or certifications prior to any expiration date). In the event that your credential or certified status changes, you must notify your supervisor immediately. + Capable of working in a challenging environment which requires the ability to handle demanding situations, multitasking, and remaining flexible to changing needs. + Maintain regular and punctual attendance. + Perform other related duties as assigned. **_Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions._** **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** **:** + Graduated from an accredited nursing program within the past 12 months **EXPERIENCE AND REQUIRED SKILLS** **:** + 0 - 1 year's related experience. **Experience and required skills:** + Required to obtain nursing license and registration within the timeline defined by state regulations, or within 90 days of hire, whichever occurs first. + Current appropriate state Temporary Permit. + Must meet the practice requirements in the state in which he or she is employed **ACKNOWLEDGEMENT:** I acknowledge that I have read and accepted this . 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 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:** Managers in each state must determine if their state regulations permit employees to operate in this capacity, as well as the allowable duties and practice restrictions if permitted. Managers should consult their state-specific regulations at: ********************************************************************************************************************************************************** . For additional information please contact your Regional Education Coordinator. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

Dialysis experience required **PURPOSE AND SCOPE:** Functionsas part of the Inpatient Services Hemodialysis Health Care team in providing safe and effective dialysis therapy for assigned patients inaccordance with FMCNA policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federalagencies. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** Providespatient care under the directsupervision of Hemodialysis Registered Nurse for assignedpatient(s) in the dialysissuite in the acutesetting; excluding Intensive Care Units. + Responsible for reporting and documenting all new and unusual incidents, information, complaints, or problems to the RN. + Promotes andassists in themaintenance of a safe and cleanworking environment. Supportsthe FMCNA commitment to the Quality Enhancement Program (QEP) and Quality Assessment and Performance Improvement (QAI) Activities; including those related to patientsatisfaction and actively participates in process improvement activities that enhance the likelihood that patients will achievethe FKC Quality Enhancement Goals (QEP). + With documented competency and proficiency may set up and prime equipment as directed by the FreseniusNurse for renal replacement therapies(hemodialysis, continuous renal replacement and peritoneal dialysis therapies). + Will be responsible for assuring the dialysis machine hasbeen set up, tested and found to be safe fordialysis treatment in accordance with manufacturer instructions for use and company policy and procedures. + Welcomes assignedpatients and inquires as to their well-being since their last treatment. Reports any complaints or observations to the FMCNA RN. + Obtains necessary pre and post treatment vital signs and weight. Reportsunusual findingsto FMCNA RN. + Reports any difficulties in cannulation to FMCNA RN as permitted by state requirements; or unusual findings to FMCNA RN. + Responsible for accuratedocumentation of information related to the patienttreatment. This information is documented appropriately in the individual patient record to include the hospital Electronic Medical System (EMS) and the Acute Care Electronic System (ACES). + Responsible for calculating and entry of individual patients'dialysis machineprogramming for Ultrafiltration (UF) goal; treatmenttime; Sodium (Na) modeling; and UF modeling as prescribed. + Responsible for ensuringappropriate safety alarmsare enabled including narrowvenous limits (NVL 160). + Collects, labels specimens and ensurestimely delivery to laboratory per facilitypolicy. + Evaluates intradialytic problemsand provides intervention as prescribedby physician's order or as directedby FMCNA RN. Monitorspatient's responseto dialysis therapyand report any unusual findingsto FMCNA RN. + Obtains vital signs prior to reinfusion; performing all relevant functionsnecessary for the discontinuation of treatment- documentation. + Reports any change or unusual findingsto FMCNA RN. + Evaluates patient prior to termination of venousaccess - standing and sitting blood pressures prior to termination of venousaccess. Obtains hemostasis and appliesappropriate dressings. Evaluates the patientprior to dischargeand reports any unusualfindings to the FMCNA RN + Review and comply with the Code of Business Conduct and all applicable company policies and procedures, local, state and federal laws and regulations. + Assist with various projectsas assigned by direct supervisor or supervising RN. + Other duties as assigned. **Additional responsibilities may include focuson one or moredepartments or locations. See applicable addendum for department or locationspecific functions.** **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 functionsof this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + Day-to-day work includes personalcomputer work while standingand sitting, interaction with patients, facility staff and physicians. + The position requires travel between assignedfacilities and variouslocations within the community. + The work environment is characteristic of a healthcare facility with air temperature control and moderatenoise levels. + May be exposedto infectious and contagious diseases/materials. + The position providesdirect patient care that regularlyinvolves heavy liftingand moving of patients, and assisting with ambulation. Equipment aids and/or coworkers may provideassistance. + This position requires frequent,prolonged periodsof standing and the employee must be able to bend over. The employeemay occasionally be required to assist in moving machinesand equipment of up to 200 lbs., and may lift chemicaland water solutions of up to 30 lbs. up as high as 5 feet. + There is a two-person assist program and material assist- devices for the heavier items. **EDUCATION:** + High School Diploma required **EXPERIENCE AND REQUIRED SKILLS:** + None required. At least 6 months' experience is preferred in related Field (EMT, SurgicalTechnicians, Army, Phlebotomists, and technicians). + Must obtain CCHT within 18 monthsof hire. + Effective communication skills - both verbaland written. + Employees are required to take the Ishihara's ColorBlindness test as a conditionof employment. Note that: Failing the Ishihara Test for Color Blindnessdoes not preclude employment. The Company will consider whetherreasonable accommodations can be made. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

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.** **EOE, disability/veterans**

**PURPOSE AND SCOPE:** Functions as part of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of 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. Employees hired into this position will be required to obtain their nursing license and registration within the timeframe outlined in state specific regulations, or within 90 days from hire date, whichever comes sooner. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** **STAFF RELATED:** + 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. **PATIENT RELATED:** Education: + 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. Dialysis Treatment: + 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. Laboratory-related: + 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. General duties: + 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. **MAINTENANCE/TECHNICAL:** + 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. **MEDICAL RECORDS & DOCUMENTATION:** General + 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. Daily + 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. Monthly + 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. Annually + Completes initial and annual Nursing History and Assessment physical. + Ensures completion of Annual Standing Order Review with each physician as required. **OTHER:** + As a condition of continued employment, you are required to obtain and maintain any required credentials or certifications necessary for your position in an active and valid status (including renewal of such credentials or certifications prior to any expiration date). In the event that your credential or certified status changes, you must notify your supervisor immediately. + Capable of working in a challenging environment which requires the ability to handle demanding situations, multitasking, and remaining flexible to changing needs. + Maintain regular and punctual attendance. + Perform other related duties as assigned. **_Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions._** **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** **:** + Graduated from an accredited nursing program within the past 12 months **EXPERIENCE AND REQUIRED SKILLS** **:** + 0 - 1 year's related experience. **Experience and required skills:** + Required to obtain nursing license and registration within the timeline defined by state regulations, or within 90 days of hire, whichever occurs first. + Current appropriate state Temporary Permit. + Must meet the practice requirements in the state in which he or she is employed **ACKNOWLEDGEMENT:** I acknowledge that I have read and accepted this . 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 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:** Managers in each state must determine if their state regulations permit employees to operate in this capacity, as well as the allowable duties and practice restrictions if permitted. Managers should consult their state-specific regulations at: ********************************************************************************************************************************************************** . For additional information please contact your Regional Education Coordinator. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**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.Equipmentaidsand/orcoworkersmayprovideassistance.Thispositionrequiresfrequent,prolongedperiodsof 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:** + HighSchooldiplomaorG.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. + Allappropriatestatelicensure,education,andtraining(ifany) required. + Demonstrated commitment to organization culture, values, and customer service standards **EXPERIENCE AND REQUIRED SKILLS** **:** + Previouspatientcareexperienceinahospitalsettingorarelatedfacility preferred. + Continued employment is dependent on successful completion of the organization dialysis training program and successful completion of CPR certification. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**PURPOSE AND SCOPE:** Functions as part of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of 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. Employees hired into this position will be required to obtain their nursing license and registration within the timeframe outlined in state specific regulations, or within 90 days from hire date, whichever comes sooner. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** **STAFF RELATED:** + 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. **PATIENT RELATED:** Education: + 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. Dialysis Treatment: + 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. Laboratory-related: + 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. General duties: + 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. **MAINTENANCE/TECHNICAL:** + 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. **MEDICAL RECORDS & DOCUMENTATION:** General + 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. Daily + 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. Monthly + 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. Annually + Completes initial and annual Nursing History and Assessment physical. + Ensures completion of Annual Standing Order Review with each physician as required. **OTHER:** + As a condition of continued employment, you are required to obtain and maintain any required credentials or certifications necessary for your position in an active and valid status (including renewal of such credentials or certifications prior to any expiration date). In the event that your credential or certified status changes, you must notify your supervisor immediately. + Capable of working in a challenging environment which requires the ability to handle demanding situations, multitasking, and remaining flexible to changing needs. + Maintain regular and punctual attendance. + Perform other related duties as assigned. **_Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions._** **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** **:** + Graduated from an accredited nursing program within the past 12 months **EXPERIENCE AND REQUIRED SKILLS** **:** + 0 - 1 year's related experience. **Experience and required skills:** + Required to obtain nursing license and registration within the timeline defined by state regulations, or within 90 days of hire, whichever occurs first. + Current appropriate state Temporary Permit. + Must meet the practice requirements in the state in which he or she is employed **ACKNOWLEDGEMENT:** I acknowledge that I have read and accepted this . 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 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:** Managers in each state must determine if their state regulations permit employees to operate in this capacity, as well as the allowable duties and practice restrictions if permitted. Managers should consult their state-specific regulations at: ********************************************************************************************************************************************************** . For additional information please contact your Regional Education Coordinator. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**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.Equipmentaidsand/orcoworkersmayprovideassistance.Thispositionrequiresfrequent,prolongedperiodsof 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:** + HighSchooldiplomaorG.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. + Allappropriatestatelicensure,education,andtraining(ifany) required. + Demonstrated commitment to organization culture, values, and customer service standards **EXPERIENCE AND REQUIRED SKILLS** **:** + Previouspatientcareexperienceinahospitalsettingorarelatedfacility preferred. + Continued employment is dependent on successful completion of the organization dialysis training program and successful completion of CPR certification. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

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). ACKNOWLEDGEMENT: I acknowledge that I have read and accepted this . 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 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: 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 **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

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). ACKNOWLEDGEMENT: I acknowledge that I have read and accepted this . 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 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: 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 **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.** **EOE, disability/veterans**

**PURPOSE AND SCOPE:** Functions as part of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of 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. Employees hired into this position will be required to obtain their nursing license and registration within the timeframe outlined in state specific regulations, or within 90 days from hire date, whichever comes sooner. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** **STAFF RELATED:** + 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. **PATIENT RELATED:** Education: + 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. Dialysis Treatment: + 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. Laboratory-related: + 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. General duties: + 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. **MAINTENANCE/TECHNICAL:** + 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. **MEDICAL RECORDS & DOCUMENTATION:** General + 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. Daily + 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. Monthly + 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. Annually + Completes initial and annual Nursing History and Assessment physical. + Ensures completion of Annual Standing Order Review with each physician as required. **OTHER:** + As a condition of continued employment, you are required to obtain and maintain any required credentials or certifications necessary for your position in an active and valid status (including renewal of such credentials or certifications prior to any expiration date). In the event that your credential or certified status changes, you must notify your supervisor immediately. + Capable of working in a challenging environment which requires the ability to handle demanding situations, multitasking, and remaining flexible to changing needs. + Maintain regular and punctual attendance. + Perform other related duties as assigned. **_Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions._** **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** **:** + Graduated from an accredited nursing program within the past 12 months **EXPERIENCE AND REQUIRED SKILLS** **:** + 0 - 1 year's related experience. **Experience and required skills:** + Required to obtain nursing license and registration within the timeline defined by state regulations, or within 90 days of hire, whichever occurs first. + Current appropriate state Temporary Permit. + Must meet the practice requirements in the state in which he or she is employed **ACKNOWLEDGEMENT:** I acknowledge that I have read and accepted this . 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 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:** Managers in each state must determine if their state regulations permit employees to operate in this capacity, as well as the allowable duties and practice restrictions if permitted. Managers should consult their state-specific regulations at: ********************************************************************************************************************************************************** . For additional information please contact your Regional Education Coordinator. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**PURPOSE AND SCOPE:** Functions as part of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of 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. Employees hired into this position will be required to obtain their nursing license and registration within the timeframe outlined in state specific regulations, or within 90 days from hire date, whichever comes sooner. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** **STAFF RELATED:** + 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. **PATIENT RELATED:** Education: + 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. Dialysis Treatment: + 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. Laboratory-related: + 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. General duties: + 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. **MAINTENANCE/TECHNICAL:** + 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. **MEDICAL RECORDS & DOCUMENTATION:** General + 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. Daily + 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. Monthly + 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. Annually + Completes initial and annual Nursing History and Assessment physical. + Ensures completion of Annual Standing Order Review with each physician as required. **OTHER:** + As a condition of continued employment, you are required to obtain and maintain any required credentials or certifications necessary for your position in an active and valid status (including renewal of such credentials or certifications prior to any expiration date). In the event that your credential or certified status changes, you must notify your supervisor immediately. + Capable of working in a challenging environment which requires the ability to handle demanding situations, multitasking, and remaining flexible to changing needs. + Maintain regular and punctual attendance. + Perform other related duties as assigned. **_Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions._** **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** **:** + Graduated from an accredited nursing program within the past 12 months **EXPERIENCE AND REQUIRED SKILLS** **:** + 0 - 1 year's related experience. **Experience and required skills:** + Required to obtain nursing license and registration within the timeline defined by state regulations, or within 90 days of hire, whichever occurs first. + Current appropriate state Temporary Permit. + Must meet the practice requirements in the state in which he or she is employed **ACKNOWLEDGEMENT:** I acknowledge that I have read and accepted this . 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 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:** Managers in each state must determine if their state regulations permit employees to operate in this capacity, as well as the allowable duties and practice restrictions if permitted. Managers should consult their state-specific regulations at: ********************************************************************************************************************************************************** . For additional information please contact your Regional Education Coordinator. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**