This position provides safe and effective nursing care and treatment to patients undergoing hemodialysis.  Under the general supervision of the nurse manager, the acute hemodialysis RN is responsible and accountable for the dialysis of patients in the facility.  The acute hemodialysis RN is able to respond quickly and accurately to changes in condition or response to treatment of the patient. 

This position is full-time. On-call hours required.

Essential Functions:

• Provides nursing care to meet the needs of the patient population served as qualified; i.e., adult, and geriatric patients.
• Delivers patient care within defined hospital and critical care standards for assessment, care planning, interventions, and reassessment, and delegates care appropriately to other team members and support staff.
• Evaluates patient’s care status frequently.  Reports variances in care and/or medication administration for quality improvement.
• Performs duties with a clear understanding of the JCAHO Safety Goals and delivers care with patient safety as a goal.  Follows hospital policies guiding compliance with National Patient Safety Goals.
• Performs duties in accordance with pathogen transmission practices; i.e., follows hand washing procedures and utilizes protective equipment effectively.
• Performs nursing care within the guidelines of the Relationship and Results Oriented Healthcare Model utilizing the recommended bundles of best practice.
• Delegates and supervises care appropriately to LPN & CNAs with follow up and feedback procedures to ensure quality of care.  Initiates appropriate actions as needed.
• Develops plan of care and patient focused goals with the patient and family as appropriate, ensuring patient understanding and involvement in their care.
• Delivers patient care in accordance with established infection control standards for patient placement, IV therapy, medication administration and the performance of all patient procedures; demonstrating adherence to hand washing policy.
• Follows policies for administration of high risk drugs, patient identification, documentation and taking telephone orders with read back and communication of critical values/diagnostic results.
• Communicates effectively with other patient care providers and team members for efficiencies and safety of care through appropriate ordering procedures, preparing patients for surgery and other procedures, communicating fall potential and other risk identifiers.
• Evaluates clinical/diagnostic reports and reports variances to the physician and documents same.
• Follows guidelines for performance improvement and demonstrates understanding of participation in the Core Measures for Lakeside Medical Center, and for documentation review and restraint review process.
• Utilizes patient care equipment and patient restraints appropriately and safely, following hospital policy and procedure.  Reports any identified equipment breakdown or malfunction by hospital policy.  Maintains cleanliness of equipment after use.
• Works cooperatively with ancillary departments in ensuring the patient’s care is safe, following protocols as applicable.
• Documents and maintains all patient care records and related required documentation.  Maintains records and communications with respect to patient’s privacy.
• Participates in department’s QI activities on a daily basis.
• Participates in the orientation and mentoring of new staff members recognizing importance of bringing new staff into a friendly and supportive work environment.
• Utilizes and ensures staff uses supplies efficiently, following infection control procedures, avoiding waste and follows patient charging procedures.
• Follows ACLS protocol for patients as indicated
• Orders initial lab tests and x-rays by established protocols or per physician orders.  Ensures patients are appropriately prepared for tests.
• Serves as an example for team members in cost saving practices.
• Assists manager and other staff members to maintain competence and skills for procedures assigned and assist in validation of skills and competence of new staff members prior to delegation of patient care.
• Participates in the hospital Utilization Management Program by assisting with discharge planning, reporting to case managers, and keeping patient, family, physician, and other personnel informed.
• Participates with team members and manager to identify opportunities for improvement in patient care processes.
• Maintains accurate and current record of patient’s care and response to care following the guidelines for appropriate electronic documentation.
• Documents the administration of medicines including dosage, medicine route, medicine site, and patient's response as required in the documentation system.
• Performs time out procedures on all invasive procedures at the bedside as needed.
• Utilizes good communication skills, critical thinking and checkpoints for teamwork.  Provides patient information timely and effectively during shift report and with patient’s hand-offs.
• Provides teaching and training to staff members as needed.
• Maintains competencies and participates in required training and in-services for unit.
• Demonstrates understanding and commitment to hospital’s mission, philosophy, standards, policies and procedures.  Recognizes all staff, physicians and visitors, as well as, patients as customers and provides courteous and respectful service.
• Documents and reports any complaints from patients, physicians and visitors to supervisor as guided by hospital policies and procedures. 
• Explains all procedures and care plans to patients, and as appropriate to family.  Ensures patient and/or family are educated for appropriate health maintenance.
• Participates in the cleanliness of the work environment.
• Demonstrates an understanding of responsibility of emergency plans and is available for patient care as needed or scheduled when hospital emergency preparedness plans are activated.
• Ensures completion of continuing education requirements in subjects pertinent to critical care nursing or position related information.
• Serves as a leader for change, positively promoting new systems and changes implemented which improves the hospital and the service provided to its patients.
• Participates in hospital community activities and helps portray a positive image of the hospital in the community.
• Observes cardiac rhythm and initiates or ACLS protocol as indicated.
• Demonstrates competency required to serve the complex needs of the dialysis patients.
• Performs start up, set-up, operation, rinse and disinfection of the hemodialysis machine and R/O equipment.
• Primes dialyzer, including all equipment safety checks.
• Performs pre and post dialysis nursing evaluation of patients, including hand off after each treatment to accepting nurse.
• Initiates and discontinues dialysis treatment on all assigned patients.
• Monitors patients throughout their hemodialysis treatment including vital signs, machine checks, emergency intervention and tends to miscellaneous patient needs.
• Administers medication to patients per physician orders.
• Implements and signs off all physician orders.
• Revises patients plan of care as indicated by the patients response to treatment and evaluates overall plan continuously for effectiveness.
• Performs waived testing (point of care testing) per clinical laboratory policy and procedures.  Interprets results of waived testing taking appropriate action on results.
• Cleans and disinfects all dialysis machines and related equipment.
• Performs specialized patient assessments as needed.
• Ensures availability of appropriate supplies and equipment.
• Understanding of on-call procedures and resonsibilities 
• Emergency duty may be required of the incumbent that includes assisting community or hospital based organizations or the Red Cross. Staff will be directed to perform other emergency duties based on clinical experience including, but not limited to, responses to threats or disasters, man-made or natural.

Education: 

• Associate’s, Bachelor’s, or Diploma in Nursing from an accredited nursing school required.

Experience: 

• Two (2) to four (4) years experience in Hemodialysis or Critical Care preferred.

Certification:

• BLS certification required. ACLS certification required.

Licensure:

• State of Florida Registered Nurse license required.

On Call:

• Rotating on call coverage is required.

Health Care District of Palm Beach County is proud to be an Equal Opportunity Employer and Drug Free Workplace. We embrace diversity and do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.