Registered Nurse

Transitional Care Unit (TCU) - Registered Nurse

A Transitional Care Unit (TCU) helps ease patients into dialysis. The first weeks of dialysis involve a great deal of adjustment, along with increased risk of hospitalization and mortality. As a TCU nurse, you will provide patients with a solid foundation to start their dialysis journey.  The TCU nurse coordinates the care and education of patients to help them feel better and make more informed decisions about their care, including choice of treatment modality—in-center or at-home dialysis.

PURPOSE AND SCOPE:

The professional registered nurse Home Therapies RN CAP 2 may be an entry level designation into the Clinical Advancement Program (CAP) for new employees who meet the RN CAP 2 criteria or attained through advancement from RN CAP 1. 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 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 therapies 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, leader, coach, mentor and role model for new and incumbent employees by setting examples of appropriate behavior, work habits and attitudes towards patients, co-workers, supervisors and the company at the facility and area level. 
• 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 a formal standardized Home Dialysis Training Program.
• Participates in education and quality improvement projects at the facility and area level as directed by Supervisor.
• May serve as a Preceptor to new employees.
• Required to complete CAP requirements to either maintain or 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.
• Rotates coverage with other licensed home therapy 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 and 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.

SUPERVISION:

Assigned oversight of RNs, LPNs/LVNs, Patient Care Technicians and Home Therapies 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 3 months experience home dialysis therapies 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 a minimum of 2 years or more of Nephrology Nursing experience within the last 2 years as a RN.

Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.

Fresenius Medical Care is an equal opportunity employer and does not discriminate on the basis of race, color, religion, sexual orientation, gender identity, parental status, national origin, age, disability, military service, or other non-merit-based factors