Fresenius Medical Care North America Holdings Limited Partnership jobs in Newport News, VA - 23 jobs

**PURPOSE AND SCOPE:** Provides psychosocial services to patients treated by the facility including in-center and home dialysis patients (if applicable) utilizing Social Work Theory of Human Behavior and accepted methods of social work practice. Works with the health care team to promote positive adjustment, rehabilitation and improved quality of life for our patients. In collaboration with the interdisciplinary team, informs, educates and supports staff in understanding the emotional, psychological and behavioral impact of Chronic Kidney Disease on the patient and family to ensure comprehensive quality care of our patients. Supports the FMCNA commitment to the Quality Indicators and Outcomes and Quality Assessment and Improvement (QAI) Activities, including those related to patient satisfaction and quality of life and actively participates in process improvement activities that enhance the likelihood that patients will achieve the FMCNA Quality Goals. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** + Patient Assessment / Care Planning / Counseling + As a member of the interdisciplinary team, assesses patients' psychosocial status, strengths and areas of need that may affect rehabilitation and optimal treatment outcomes as part of the comprehensive patient assessment. + Participates in care planning in collaboration with the patient and healthcare team to identify effective interventions that will help the patient meet rehabilitation, treatment goals, and improve quality of life. + Utilizes FKC patient education programs, established social work theory and methods, social work focused interventions, and quality of life measurement instruments as part of assessment and care planning to address barriers and meet patient treatment goals. + Provides monitoring and interventions for the patient to adjust to dialysis and achieve optimal psychosocial status and quality of life. + Provides supportive counseling services to patients as permitted within the scope of their clinical training and state license. + Provides educational and goal directed counseling to patients who are seeking transplant. + Provides information and assists the team and patient with referral to community resources (home health services, vocational rehabilitation, etc.) to facilitate optimal treatment outcomes. + Maintains current knowledge regarding local vocational/educational rehabilitation programs and assist patients with referral and access to vocational rehabilitation to enable them to remain employed, become employed or receive education. + Assesses patient awareness of advance directives; assists with accessing advance directive forms/information and facilitates discussion of advance directive wishes, if necessary, with the healthcare team and the patient's family/support persons. + In collaboration with the physician and nurse, participates in the discussion of patient DNR status in the facility to ensure patient and/or family understand and make an informed decision about their care. + Knowledgeable of and adheres to FMCNA Social Work Policy and Measuring Patient Physical and Mental Function Policy, including documentation. + Documents based on MSW interaction and interventions provided to patient and/or family. + Quality + Provides psychosocial support and/or Social Work Focused Interventions to address non-adherence, quality outcome, and quality of life concerns for all patients based on acuity level. + Participates in monthly Quality review meetings with the interdisciplinary team. Reports on quality indicators related to adherence, such as Missed and Shortened Treatments, Quality of Life Trends, and Service Recovery. + Patient Education + Assesses patient knowledge of kidney disease for barriers that may affect adherence to treatment. Works with patient, family and health care team to provide education tailored to the patient's learning style, communication barriers, and needs. + With other members of the interdisciplinary team, provides appropriate information about all treatment modalities. + Facilitates the transplant referral process and collaborates with interdisciplinary team on transplant waitlist management. + Provides ongoing education to patient/family regarding psychosocial issues related to End Stage Renal Disease (ESRD) and all support services that are available. + Reviews patient rights and responsibilities, grievance information (company and network) and other facilities policies with patient and/or the patients' representative to ensure patients' understanding of the rights and expectations of them. + Collaborates with the team on appropriate QAI activities. + Patient Admission and Continuity of Care + Reviews Patient Rights and Responsibilities, Grievance Procedure & Important Numbers Handout, FKC Non-discrimination policy, DNR Statement (if applicable) and address any immediate needs/concerns. + Understands the referral and admission process and supports the clinic in regard to the patient needs for scheduling to maximize adherence and adjustment. + The Social Worker will interview the patient to identify root causes or concerns for the discharge request, (i.e. transfer to hospice, relocation, dissatisfaction with services or staff) and share causes/concerns with operational leadership, + Insurance and Financial Assistance + Collaborates and functions as a liaison for patient with Insurance Coordinators to address issues related to insurance. + In collaboration with Insurance Coordinators, provides information and education to patients about payment to dialysis (federal, state, commercial insurance, state renal programs, AKF HIPP, and entitlement programs). + Collaborates with the Insurance Coordinator of any changes to patient state that impacts insurance i.e. transplantation, discharged, loss of coverage, or extended travel. + Refers patients to patient billing solutions (PBS) department for questions/concerns in regard to treatment related bills + Staff Related + Assists with interview process and decision to hire new personnel if requested by SW Manager/Senior Manager. + Works with the administrative support staff to maintain updated patient resource lists (e.g. maintain updated list of transportation resources). + Provides training to staff pertaining to psychosocial topics as needed. + Contributes and participates with weekly team huddles. Discusses any urgent patient issues with staff. + Adheres to work defined caseload guidelines based on state regulatory requirements. + Performs other related duties as assigned. **PHYSICAL DEMANDS AND WORKING CONDITIONS** **:** + The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + Travel required (if multiple facilities) **SUPERVISION:** + None **EDUCATION AND REQUIRED CREDENTIALS** **:** + Masters in Social Work + Must have state required license **EXPERIENCE AND SKILLS** **:** + 2 - 5 years' related experience **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. Functions as part of the hemodialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with FMCNA 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 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 FMC Quality Enhancement Goals (QEP). **DUTIES / ACTIVITIES:** CUSTOMER SERVICE: + Responsible for driving the FMS culture through values and customer service standards. + Accountable for outstanding customer service to all external and internal customers. + Develops and maintains effective relationships through effective and timely communication. + Takes initiative and action to respond resolve and follow up regarding customer service issues with all customers in a timely manner. **PRINCIPAL RESPONSIBILITIES AND DUTIES** PATIENT CARE: + 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. + Welcome assigned patients and inquire as to their well-being since their last treatment. Report any complaints or observations to the nurse supervisor. + Evaluate vascular access for patency and report any unusual findings to nurse supervisor. + Obtain necessary pre and post treatment vital signs and weight. Report unusual findings to nurse supervisor. + Perform vascular access evaluation pre-treatment and report unusual findings to nurse supervisor. + Perform vascular access cannulation and report any difficulties in cannulation or unusual findings to nurse supervisor. + Perform administration of Heparin as delegated or as allowed by state law. + 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 and report any unusual findings to nurse supervisor. + Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of treatment - document. + Discontinue dialysis treatment according to established procedures + Evaluate patient prior to termination of venous access - standing & sitting blood pressure. + Obtain Hemostasis and apply appropriate dressings. + Evaluate the patient for prior to discharge and report any unusual findings to nurse supervisor. + 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; Sodium (Na) modeling; 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 nurse supervisor. + Observe patient and conduct machine safety checks according to facility policy. Report any change or unusual findings to the nurse 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 nurse supervisor. + Obtain all prescribed laboratory testing and prepare specimens for collection. MAINTENANCE/TECHNICAL: + 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. + Perform all required pretreatment dialysis machine alarm testing including Pressure Holding (PHT). + Initiate Solution Delivery System (SDS) system. + 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. CLERICAL & ADMINISTRATIVE: + Complete and document ongoing participation in Continuous Quality Improvement (CQI) activities. + Enters all treatment data into the designated clinical application accurately and in a timely manner. + Review treatment sheets for completeness ensure nursing signatures are documented and ensure omitted entries are completed or corrected where appropriate. + Prepare initial patient chart for admission and compile paperwork for appropriate placement in chart. + Prepare 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. OTHER: + Perform additional duties as assigned. **ADDENDUM FOR PATIENT CARE TECHNICIANS WORKING IN THE HOME PROGRAMS (NOT HOME ASSIST):** Assisting the HT RN: + May assist HT RN on Home Visit as directed + Reinforces PD / HHD education under supervision of qualified HT RN + Schedules and contacts patients regarding appointments + Weigh patient and obtain vital signs + Collect treatment records and review for completion. Notify RN of incomplete / missing records. + Cleaning and prepping treatment room; prep charts + Preparing lab tubes and requisitions & assisting with lab draw days both pre and post draw (PCT certified phlebotomy or per state regulations) + Clerical duties as assigned (faxing mailing to physician offices etc.) + Obtain home hemo water sampling as directed by the HT RN + Set-up of the home hemo machine and PD Cycler. + Assist with exit site care when directed by HT RN. + Warm dialysate solution when directed by the HT RN + Draw dialysate solution for testing as directed by the HT RN + Creates and sends patient reminders (supply inventory for order Kt/V collection bringing meds to clinic visit for review) + Assembles/breaks down charts/thins charts + Maintains logs as directed and applicable + Inventory of Home Program + Maintains par levels of home department supplies + Files home patient packing slips/invoices + Inventory for Patients + Assists patient with supply management and contacting customer service **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 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. 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 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** + Center for Medicaid/Medicare Services (CMS)-approved state and/or national certification or High School diploma or G.E.D. and must meet certification requirements within the required state or CMS timeline. + All appropriate state licensure education and training (if any) required. **EXPERIENCE AND REQUIRED SKILLS** + Previous patient care experience in a hospital setting or related facility preferred. + Continued employment is dependent on successful completion of the FMCNA 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**

**_Description_** _Provide your personal attention and kindness, professional insight, and a generosity of spirit. Offer expertise and encouragement. Enhance each patient's future-as well as your own._ **Connect with your goals and change lives** **with Fresenius Medical Care North America.** Here, we make connections that empower patients, their families, and our team members. As the global leader in dialysis healthcare, we form bonds that enable the best possible outcomes and professional satisfaction. While our extensive organization continues to grow, so do opportunities for our professionals to learn, grow, and advance. **Why Join the Fresenius Team?** Passion. Dedication. Knowledge. Motivation. Experience. These are the impressive qualities you'll find in the Fresenius Leadership Team. Our strength in the North American market and extensive global network provide our employees with the best of both worlds-the friendliness of a local organization and the stability of a worldwide organization-for diverse experiences and challenging career opportunities. When you join the Fresenius Medical Care team, you'll be welcomed into a company that is built on the philosophy that our employees are our most important asset. Our career advantages include the following: + Fresenius Medical Care is the nation's largest provider of renal care, meeting the needs of more than 135,000 patients at 1,800 clinics throughout the country. + Our well-established, trusted organization fosters a spirit of camaraderie, emphasizing friendly collaboration, professional support, and career development. + Superior training, UltraCare quality control, and certification procedures ensure your potential to succeed and advance as a professional. + Competitive compensation and exceptional benefits. + Outstanding tuition reimbursement program. + Recognized among Fortune's World's Most Admired Companies in 2011. + National Safety Award from CNA insurance companies for 11 consecutive years. + Opportunities to give back by participating in philanthropy and community outreach programs. **Registered Dietitian-Renal Care** Embrace this opportunity to help patients live better lives and accomplish important professional objectives. As part of an interdisciplinary team within our Medical Services division, the professional we select will provide patients with counseling and nutritional assessments, and calculate prescription diets. This individual will assess patient knowledge of diet and kidney disease, and offer patient-specific, detailed information about nutritional status, adequacy measures and results, fluid status, and nutrition-related lab parameters. **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. Provides nutritional services for the facility's in-center and home patients as applicable in order to maximize the patient's nutritional status and improve clinical outcomes. Functions as a member of the interdisciplinary healthcare team, supporting the FMCNA commitment to the Quality Enhancement Program (QEP) and Quality Assessment and Performance Improvement (QAI) activities. Actively participates in process improvement activities that enhance the likelihood that patients will achieve their individualized patient-specific goals as determined by the patient's physician. **DUTIES / ACTIVITIES** : **CUSTOMER SERVICE:** + Responsible for driving the FMS culture through values and customer service standards. + Accountable for outstanding customer service to all external and internal customers. + Develops and maintains effective relationships through effective and timely communication. + Takes initiative and action to respond, resolve and follow up regarding customer service issues with all customers in a timely manner. **PRINCIPAL RESPONSIBILITIES AND DUTIES:** + Assesses patient's knowledge of diet and kidney disease and provides education appropriate to patient's learning needs regarding the relationship of diet and kidney disease and the impact on the treatment process. + Provides patient specific detailed 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 participates in the interdisciplinary comprehensive assessments. + Participates with the interdisciplinary team in the development of a written, individualized comprehensive plan of care that specifies the services necessary to address the patient's needs, in accordance with established Federal and, where applicable, state licensure guidelines. + Calculates diet prescription according to standard of practice. + Completes progress notes on all chronic dialysis patients according to established FMCNA guidelines. Maintains complete and accurate documentation of all appropriate information in medical record according to established FMCNA policies and Federal and state regulations. + Provides patient with ongoing nutrition assessment and outcome-oriented nutrition counseling necessary to assist patient in achieving and sustaining an effective nutritional status. + Identifies malnourished patients as well as patients at risk for malnutrition and works collaboratively with interdisciplinary team to identify appropriate interventions, resources or solutions. Reviews each patient's albumin level and body weight at least monthly. Implements plan of care with involvement of patient/family/caregiver. + Monitors adherence and response to nutrition therapy, adjusts therapy as needed to achieve and sustain an effective nutritional status, documents why the patient was unable to achieve the goals and implements the plan of care to address 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. + Collaborates with the interdisciplinary team on management and recommendations for mineral metabolism and renal bone disease, anemia and iron status, nutritional status, psychosocial status, vascular access, modality, rehabilitation status and sodium/volume control. + Adheres to FMCNA algorithm and medical record policies. + Reports on nutrition QAI results and participates in the interdisciplinary QAI program. + Collaborates and coordinates with team members in provision of Pre-ESRD education as appropriate. + When appropriate, works with Case Manager to coordinate plan of care for patient education and identifies candidates to refer to physician for nutritional supplements, as per disease management agreements. + Reviews nutrition related lab results: - Counsels patient and/or caregiver and formulates appropriate action. - Recommends treatment changes to the interdisciplinary team as appropriate. - Communicates with physician and/or facility staff regarding lab results as appropriate. - Communicates lab results and recommended treatment changes to providers of patient care in nursing facilities (i.e. hospitals, short term and long term care facilities). + Participates in pertinent staff meetings (i.e. general staff, quality improvement), Care plan meetings, and others as applicable. + Consults with FMS Corporate Dietitian regarding nutrition concerns as needed. + Maintains and improves knowledge and skills for a competent and innovative practice. + Maintains dietetic registration and continuing education hours as specified by American Dietetic Association and state licensure regulations where applicable. + Collaborates with interdisciplinary team, ensuring that all work areas are safe and clean. + Other nutrition management duties as assigned. **PHYSICAL DEMANDS AND WORKING CONDITIONS:** The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Day to day work includes desk and personal computer work and interaction with patients, facility staff and physicians. The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. **EDUCATION:** + Registered Dietitian as per Commission on Dietetic Registration. + Board Certified Specialist in Renal Nutrition encouraged. + Current state licensure if applicable. **EXPERIENCE AND REQUIRED SKILLS:** + Minimum of 1 year professional work experience in clinical nutrition as a Registered Dietitian. + Previous renal experience preferred. + Demonstrated leadership competencies and skills for the position, including ability to teach, strong organizational skills, excellent communication, customer service, relationship development, results orientation, team building and decision making. + Able to perform responsibilities with minimum supervision. + Basic computer skills required. **Fresenius Medical Care North America 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**

**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. + Associate Degree in electronics / biomedical technology, or equivalent (preferred but not 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: 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:** 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 the hemodialysis team leader in the provision of chronic hemodialysis care and treatment. Provides day to day direction and supervision to assigned direct patient care staff. Communicates with the physician and other members of the healthcare team to interpret, adjust, and complete patient care plans. Provides safe, effective delivery of patient care in compliance with standards outlined in the facility procedure manual, as well as regulations set forth by the company, state, and federal agencies. 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. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** General and Staff Related: + Provide day to day guidance, support and direction to direct patient care staff, providing informal feedback on an ongoing basis and formal feedback input for the annual performance evaluation. Participate in the department staffing and the appropriate hiring, firing and disciplinary actions. Recommend disciplinary action to Clinical Manager and initiate as appropriate. + Ensure compliance with all company and facility approved procedures and policies as well as regulations set forth by state and federal agencies in clinics with more than 100 patients. + Approve or disapprove time or personnel schedule changes in the absence on the Clinical Manager ensuring compliance with applicable regulations, policies and procedures for documenting time of work hours for staff members on assigned shift. + Participate in patient care plan meetings. + Maintain knowledge in the current practices related to the principles and techniques of dialysis by participating in all scheduled in-services. + Train and orient staff as necessary. + Routinely observe and guide direct patient care staff for appropriate technique and adherence to facility policies and procedures. + Promote and assist with compliance to OSHA programs in order to maintain a safe and clean working environment. + Maintain overall shift operation in a safe, efficient, and effective matter. + With Clinical Manager conduct staff meetings at least monthly or as needed to keep patient care staff informed of changes in patient care needs or operations to improve delivery of care. + Meet routinely with the Clinical Manager to discuss personnel and patient care status, issues, and information. + Supervise all documentation of patient information. + Coordinate Charge Nurse duties with Staff RNs acting in the relief charge capacity. Patient Care: + Assess daily patient care needs and develop and distribute patient care assignments appropriately. + Assume primary responsibility in an emergency situation. + Assess patient needs, respond to dialysis treatments, and communicate concerns to rounding physician. Implement changes in patient care/treatment as directed. + Monitor and supervise all patient care activity during dialysis and assist as necessary. + Collaborate with direct patient care team in making decisions to benefit patient care. + Continuously monitor patient's condition with regards to problems and potential complications associated with dialysis. + Administer medications to patients per physician's orders. + Act as the subject matter expert and as a resource for staff members. + Supervise and participate in completion of short- and long-term care plans. + Admit new patients according to facility procedure. + Ensure educational needs of patients are met and educate the patient and family about End Stage Renal Disease, dialysis therapy, diet and medication. Technical: + Supervise the safe and effective use of all equipment involved in direct patient care. + Operate all dialysis related and emergency equipment safely and efficiently when needed. + Perform required testing and verification and initial the checklist for start-up and shut-down procedures as outlined in the Technical Services Manual. + Complete Nurse's Technical Training Program/Water Quality Facility Training. Other: + Assist with special projects or other duties as assigned by the Clinical Manager + Assist with the interviewing of potential direct patient care staff as requested. + Promote efficient use of medical supplies. + Attend and participate in monthly Quality Assurance meetings. + Other duties as assigned. Relationships: + Internal Contacts: Direct Patient Care Staff, Facility support staff, management teams (Clinical Manager, Area Manager, RVP) + External Contacts: Physicians, Back-up Hospitals **Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions.** The duties listed in this job description are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position. **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. **SUPERVISION:** + Direct Patient Care Staff, Ward Clerk as assigned. **EDUCATION** **:** + Graduate of an accredited school of Nursing (R.N.) + Current appropriate state licensure. **EXPERIENCE AND REQUIRED SKILLS:** + Minimum of 9 months of nursing experience and an additional 3 months of clinical experience in dialysis + RN charge nurses assuming responsibility for nursing and patient servicesin the absence of the Clinical Managermust have one-yearclinical experience and six months dialysis experience. + Supervisory or management experience preferred. + Successfully completea training course in the theory and practice of hemodialysis. + Good communication skills - verbal and written. + Must meet appropriate state requirements (if any). **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**PURPOSE AND SCOPE:** Provides nutritional services for the facility's in-center and home patients as applicable in order to maximize the patient's nutritional status and improve clinical outcomes. Functions as a member of the interdisciplinary healthcare team, supporting the FMCNA commitment to the Quality Enhancement Program (QEP) and Quality Assessment and Performance Improvement (QAI) activities. Actively participates in process improvement activities that enhance the likelihood that patients will achieve their individualized patient-specific goals as determined by the patient's physician. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** + Assesses patient's knowledge of diet and kidney disease and provides education appropriate to patient's learning needs regarding the relationship of diet and kidney disease and the impact on the treatment process. + Provides patient specific detailed 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 participates in the interdisciplinary comprehensive assessments. + Participates with the interdisciplinary team in the development of a written, individualized comprehensive plan of care that specifies the services necessary to address the patient's needs, in accordance with established Federal and, where applicable, state licensure guidelines. + Calculates diet prescription according to standard of practice. + Completes progress notes on all chronic dialysis patients according to established FMCNA guidelines. Maintains complete and accurate documentation of all appropriate information in medical record according to established FMCNA policies and Federal and state regulations. + Provides patient with ongoing nutrition assessment and outcome-oriented nutrition counseling necessary to assist patient in achieving and sustaining an effective nutritional status. + Identifies malnourished patients as well as patients at risk for malnutrition and works collaboratively with interdisciplinary team to identify appropriate interventions, resources or solutions. Reviews each patient's albumin level and body weight at least monthly. Implements plan of care with involvement of patient/family/caregiver. + Monitors adherence and response to nutrition therapy, adjusts therapy as needed to achieve and sustain an effective nutritional status, documents why the patient was unable to achieve the goals and implements the plan of care to address 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. + Collaborates with the interdisciplinary team on management and recommendations for mineral metabolism and renal bone disease, anemia and iron status, nutritional status, psychosocial status, vascular access, modality, rehabilitation status and sodium/volume control. + Adheres to FMCNA algorithm and medical record policies. + Reports on nutrition QAI results and participates in the interdisciplinary QAI program. + Collaborates and coordinates with team members in provision of Pre-ESRD education as appropriate. + When appropriate, works with Case Manager to coordinate plan of care for patient education and identifies candidates to refer to physician for nutritional supplements, as per disease management agreements. + Reviews nutrition related lab results: + Counsels patient and/or caregiver and formulates appropriate action. + Recommends treatment changes to the interdisciplinary team as appropriate. + Communicates with physician and/or facility staff regarding lab results as appropriate. + Communicates lab results and recommended treatment changes to providers of patient care in nursing facilities (i.e., hospitals, short term and long-term care facilities). + Participates in pertinent staff meetings (i.e., general staff, quality improvement), Care plan meetings, and others as applicable. + Consults with FMS Corporate Dietitian regarding nutrition concerns as needed. + Maintains and improves knowledge and skills for a competent and innovative practice. + Maintains dietetic registration and continuing education hours as specified by American Dietetic Association and state licensure regulations where applicable. + Collaborates with interdisciplinary team, ensuring that all work areas are safe and clean. + Other nutrition management duties as assigned. + Performs other related duties as assigned. **PHYSICAL DEMANDS AND WORKING CONDITIONS** **:** + The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + 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 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. **SUPERVISION:** + None **EDUCATION AND REQUIRED CREDENTIALS** **:** + Registered Dietitian as per Commission on Dietetic Registration + Board Certified Specialist in Renal Nutrition encouraged. + Current state licensure if applicable. **EXPERIENCE AND SKILLS** **:** + Minimum of 1-year professional work experience in clinical nutrition as a Registered Dietitian. + Previous renal experience preferred. + Demonstrated leadership competencies and skills for the position, including ability to teach, strong organizational skills, excellent communication, customer service, relationship development, results orientation, team building and decision making. + Able to perform responsibilities with minimum supervision. + Basic computer skills required. **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 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:** + 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:** + 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:** **_Willing to Train_** 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. **_Travel 5-10% required_** **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 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:** **_Training Provided_** Functions as part of the hemodialysis health care team as a Staff Registered Nurse to ensure provision of quality patient care on a daily basis in accordance with FMS policies, procedures, and training. Supports the FMCNA's mission, vision, values, and customer service philosophy. Supports the FMCNA commitment to the Quality Enhancement Program (QEP) and CQI Activities, including those related to patient satisfaction and actively participates in process improvement activities that enhance the likelihood that patients will achieve the FMCNA Quality Enhancement Goals (QEP). Adheres to all requirements of the FMCNA Compliance Program, and FMS patient care and administrative policies. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** + Directs Patient Care Technician's provision of safe and effective delivery of chronic hemodialysis therapy to patients in compliance with standards outlined in the facility policy procedure manuals, as well as regulations set forth by the corporation, state, and federal agencies. + Delegates tasks to all direct patient care staff including but not limited to LVN/LPNs, Patient Care Technicians, and Dialysis Assistants. + Assesses daily patient care needs and develops appropriate patient care assignments. + Routinely monitors patient care staff for appropriate techniques and adherence to facility policy and procedures. + Participates in staff training and orientation of new staff as assigned + Participates in all required staff meetings as scheduled. + Ensures educational needs of patients and family are met regarding End Stage Renal Disease (ESRD). + Provides ongoing education to patients regarding their renal disease, vascular access and dialysis therapy, and other related health conditions. + Discusses with patient, and records education related to diet/fluid and medication compliance. + Provides patient specific detailed education regarding adequacy measures where applicable - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM). + Ensures transplant awareness, modality awareness, and drive catheter reduction. + Educates patients regarding laboratory values and the relationship to adequate dialysis therapy, compliance with treatment schedule, medications, and fluid. + Provides safe and effective delivery of care to patients with ESRD. + Accurately implements treatment prescriptions including Sodium (Na) modeling prescription, and Ultrafiltration modeling (where appropriate) to ensure stable treatment therapy as indicated. + Assesses patients' response to hemodialysis treatment therapy, making appropriate adjustments and modifications to the treatment plan as indicated by the prescribing physician. Communicates problems or concerns to the Team Leader or physician. + Identifies and communicates patient related issues to Team Leader or physician. + Initiates Initial and Annual Nursing Assessment, and ongoing evaluation and documentation of patient care needs according to FMC Policies and Procedures. + Actively participates in the pre-evaluation, initiation, monitoring, termination, access homeostasis, and post evaluation of patients receiving hemodialysis treatment therapy according to established FMC procedures. + Takes appropriate intervention for changes in patient adequacy status and troubleshooting access flow issues as identified by OLC/AMP yellow lights. + Provides, supervises (if applicable), and monitors hemodialysis access care according to established procedures. + Implements, administers, monitors, and documents patient's response to prescribed interdialytic transfusions, including appropriate notification of adverse reactions to physician and appropriate blood supplier. + Ensures accurate and complete documentation by Patient Care Technician on the Hemodialysis Treatment Sheet. + Reviews, transcribes, and enters physician lab orders accurately into the Medical Information System. + Ensures appropriate preparation of lab requisitions for Spectra or alternate lab. + Ensures correct labs tubes are utilized for prescribed lab specimens and that lab draw and processing procedures are performed appropriately for all lab samples. + Identifies and ensures appropriate follow-through regarding missed labs and specimens reported to be insufficient according to company policies and procedures. + Ensures all specimens are appropriately packaged according to Department of Transportation (DOT) policies and procedures relating to shipment of blood or body fluid specimens and potentially hazardous material. + Ensures that all labs are directed and delivered to appropriate labs. + Reports alert/panic and abnormal labs results to appropriate physician. + Ensures lab results are forwarded to physicians as requested. + Enforces all company approved policies and procedures, as well as regulations set forth by state and federal agencies and departments. + Maintains overall shift operation in a safe, efficient, and effective manner. + Act as a resource for other staff members. + Routinely meets with the Clinical Manager to discuss personnel and patient care status, issues, and information. + Collaborate and communicate with physicians and other members of the healthcare team to interpret, adjust, and coordinate care provided to the patient. + Provides assistance as needed to patients regarding prescription refills according to FMCNA Policies. + Ensures all physician orders are transcribed and entered into the Medical Information system in a timely manner. + Oversees all documentation of patient information. + Maintains facility drug list for all required stock medications. + Maintains competency with all emergency operational procedures, and initiates CPR and emergency measures in the event of a cardiac and/or respiratory arrest. + Ensures verification and availability of adequate emergency equipment. + Ensures provision of appropriate vaccinations, immunizations, and annual Tuberculosis (TB) testing. + Administers medications as prescribed or in accordance with approved algorithm(s), and documents appropriate medical justification if indicated. + Administers PRN medications as prescribed and completes appropriate documentation of assessment of effectiveness. + Maintains appropriate recording of controlled substances as required by law. + Assists with the coordination of patient transportation if necessary. + Ensures a clean, safe, and sanitary environment in the dialysis facility treatment area. + Ensures competency in the operation of all dialysis-related equipment safely and effectively. + Ensures all patient stations, including machines and chairs, are clean and free of blood and placed appropriately. + Ensures that all blood spills are immediately addressed according to FMCNA Bloodborne Pathogen Control Policies. + Ensures all relevant data including physician orders, lab results, vital signs and treatment parameters, and patient status are documented appropriately and entered into Medical Information System. + Ensures all appropriate patient related treatment data is entered into the Medical Information System. + Ensures all FMCNA policies regarding patient admission, transfer, and discharge are appropriately implemented. + Ensures and verify accuracy of Patient Care Technician documentation. + Reviews and ensures appropriate daily completion of Hemodialysis Treatment Sheets by all patient care staff. + Ensures that all appropriate procedures are followed regarding opening and closing procedures, inclusive of monitoring that all staff and patients have safely left the premises. + Initiates, documents, and completes ongoing Continuous Quality Improvement (CQI) activities including monthly reports. + Completes monthly nurses' progress note. + Ensures patient medical records are complete with appropriate information, documentation, and identification on each page (Addressograph label is on all chart forms). + Reviews transplant status and follows established procedure regarding appropriate action to be taken. + Completes patient care plans for new patients within the initial 30 days or any patients deemed unstable requiring monthly patient care plans. + Completes any long-term programs that are due. + Completes initial and annual Nursing History and Assessment physical. + Ensures completion of Annual Standing Order Review with each physician as required. + Performs additional duties as assigned. **PHYSICAL DEMANDS AND WORKING CONDITIONS** **:** The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + The position provides direct patient care that regularly involves heavy lifting and moving of patients, and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. This position requires frequent, prolonged periods of standing and the employee must be able to bend over. The employee may occasionally be required to move, with assistance, machines and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. up as high as 5 feet. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. + Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodation can be made. **SUPERVISION:** + None **EDUCATION AND REQUIRED CREDENTIALS:** + Graduate of an accredited School of Nursing. + Current appropriate state licensure. + Must meet the practice requirements in the state in which he or she is employed. **EXPERIENCE AND SKILLS** : + Minimum of one-year medical-surgical nursing experience preferred. + Hemodialysis experience preferred. + ICU experience preferred. + Successfully complete a training course in the theory and practice of hemodialysis. + Successfully complete CPR Certification. + Employees have to meet the necessary requirements of Ishihara's Color Blindness test as a condition of employment. + Provide coverage at any or all area facilities as required by management. + Icd-9 coding Training. + Nurses Technical Training. + Must meet appropriate state requirements (if any). **_Travel 5-10% required_** **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:** The registered professional nurse Home Therapies 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. Assesses and manages patients' response to home dialysis training and treatment therapy by following prescribed predetermined protocols and communicates patient related issues to the physician as needed. 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 with guidance from the Educator, Preceptor or in collaboration with another Registered Nurse. + Performs ongoing, systematic collection and analysis of dialysis data for assigned patients and documents in the patient medical record, makes adjustments or modifications to treatment plan as indicated and notifies 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 the patient, home care partner, direct and ancillary patient care staff, all aspects of the provision of safe and effective delivery of dialysis 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. + Assists in the identification, evaluation, selection and education of Home Dialysis candidates and Home Partners. + Performs assessment and identifies barriers of the Home Dialysis candidate's home environment and partner / family readiness and ability to perform dialysis treatments in the home. + Trains Home Dialysis patients and / or Home Partners on the safe, effective operation and maintenance of all Home Dialysis equipment and treatment supplies through an organized and formal Home Dialysis Training Program. + 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 equipment, patients and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. + This position requires frequent, prolonged periods of standing and the employee must be able to bend over. + The employee may occasionally be required to move, with assistance, machines and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. as high as 5 feet. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. + May be exposed to infectious and contagious diseases/materials. + Rotates coverage with other licensed home therapies staff as assigned to ensure reliable and adequate coverage. + Position requires participation in on-call rotation, night, weekend, holiday or as defined by individual program needs. + The position may require travel to training sites, other facilities or patient homes. + May be asked to provide essential functions of this position in other locations including patient's home 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. + 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:** Assigned oversight of LPNs/LVNs, RNs, Patient Care Technicians and Home Therapy Care Team Assistants 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 12 months experience as a RN. + Successful completion of 3 months experience as a RN in home peritoneal dialysis and / or hemodialysis. **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 1 year of Nephrology Nursing experience in the last two years as a RN. + Minimum of 1-year experience as a Registered Nurse (preferred) + Home dialysis therapy experience (preferred). Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws. **EOE, disability/veterans**