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Main Function:
Under the supervision of the Clinical Nurse Manager, performs duties in the care and treatment of patients on maintenance dialysis.
The Dialysis Staff Nurse prepares the dialysis equipment, initiates the treatment, monitors the procedure and then discontinues the dialytic treatment. This person assists in making and implementing nursing care plans and giving medication while providing both routine and emergency care to patients; supervises non-professional nursing personnel and assists physicians and staff. The Dialysis Staff Nurse may have charge responsibilities, when so designated.
The Dialysis Staff Nurse is also responsible for instructing both staff and patients in the clinical and technical aspects of dialysis that includes patient medication needs.
The Dialysis Staff Nurse shall also maintain current CPR Certification from the American Heart Association.
Representative Functions:
1. Complete patient admission process as outlined in policy and procedure, collaborating with team members regarding real or potential problems or needs relative to the treatment provided.
2. Completes initial and annual Nursing History and Assessment physical.
3. Procedure set-up (rinse, prime, attach, etc.) clean (sterilize and disinfect) operate and maintain all hemodialysis equipment.
4. Complete pre-treatment and post treatment physical assessments.
5. Participates in setting up individualized Comprehensive Assessment and Plan of Care for each patient with Physician and other health services personnel as per facility policy.
6. Prepares and administers medication as ordered.
7. Evaluates patient condition pre-dialysis:
a. Weight - observe for any signs of over hydration.
b. Check vital signs.
c. Check for any signs of bleeding or infection.
d. calculate fluid removal based on estimated dry weight
e. Draw and send any blood values ordered to laboratory.
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8. Initiates and terminates patient treatments to include connecting and disconnecting AVF, AVG and catheters and cleaning catheter sites per protocol.
9. Perform venopuncture for internal access.
10. Constant observation, monitoring and documenting of blood pressure of dialysis parameters for all access types as assigned during treatment as per unit protocol.
11. Sets parameters for treatment (Calculates transmembrane pressure, BFR, pressure limits).
12. Inter-Dialytic treatment responsibilities which include:
a. Check and record vital signs q1/2 hr.
b. Monitor and adjust, if necessary, the dialytic treatment parameters per 1/2 hr. c. Administer anticoagulant therapy, as ordered.
13. Administer IV Therapy for hypotension, as required.
14. Observe and record, as necessary, the patient's general physical and mental condition.
15. Discontinue dialytic treatment:
a. Return blood in system to patient.
b. Apply bandage to access.
c. Perform external access care.
16. Observe patient post-dialysis:
a. Check weight and record.
b. Check vital signs and record.
17. Is properly trained and knowledgeable of administering blood products.
18. Is able to operate and trouble shoot individual dialysis machines.
19. Capable of checking the conductivity, temperature and PH of the dialysate . 20. Capable of checking for residual Sodium Hypochlorite.
21. Capable of checking the water system for Chlorine/Chloramine.
22. Capable of checking the water system as per re-established parameters.
23. Checking the water system for chlorine/Chloramine.
24. Check the water system as per established guidelines and parameters, document on log sheet and report any.
25. Ensuring the enforcement of all policies and procedures including patient's bill of rights. 26. Proper handling and storage of bio-hazardous waste and chemical.
27. Disinfection of cleaning of equipment surrounding and including patient chairs. 28. Assist with lifting, turning moving, positioning and transferring patients.
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29. May perform other duties and assist in areas of the department as directed by the Nurse Manager, RN, Administrator, and Medical Director.
30. Have knowledge of emergency procedures. Able to function in an emergency situation under the director of the person in charge:
a. Understand CPR protocols, and can assist during an emergency situation
b. Communicate information regarding the patient's condition to the MD.
31. To take charge as assigned by the Clinical Nurse Manager, as necessary.
32. Reviews charts and physician orders; records medications and special treatments.
33. Reviews and ensures appropriate daily completion of Hemodialysis Treatment Records by all patient care staff
34. May act as team leader, receives and gives report, assigns responsibilities.
35. Ensures that the treatment area is clear, maintaining unobstructed circulation. 36. Issues bedpan and assist patients.
37. Collect specimens and tests then send to the laboratory.
38. Provide patient education.
39. Recognizes and reports patient problems to the Nurse Manager.
40. Contributes to the general care and maintenance of the dialysis center to provide a clean and safe atmosphere for the patients.
41. Must strive to contain costs while not compromising the quality of patient care.
42. May perform other duties deemed necessary by the Dialysis Charge Nurse, Clinical Nurse Manager or Medical Director.
43. Assists in the orientation of new employees and the direction of non-professional patient care staff; cooperates with other nursing personnel to provide appropriate student nurse activities.
44. Assists in examination and evaluation of patient appropriate treatment and services. 45. Completes monthly nurses' progress note.
46. 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.
47. 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
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