Outpatient Registered Nurse - RN - Dialysis

Fresenius Medical Care · Houston, TX Full Time
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Job Description

PURPOSE AND SCOPE: The professional registered nurse Outpatient 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 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, 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. 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 maintain or advance. Performs all other duties as assigned by Supervisor. PHYSICAL DEMANDS AND WORKING CONDITIONS: The physical demands and work environment characteristics described h

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What Most Job Listings Don’t Tell You

General overview for this role type — specific duties and requirements vary by employer.

Nursing roles in senior living are fundamentally different from hospital nursing. Most positions involve building long-term relationships with the same residents over months or years rather than cycling through new patients every shift. Facilities in the Houston area typically require an active Texas RN or LVN license, current CPR/BLS certification, and many prefer at least one year of geriatric or long-term care experience.

Shift patterns vary widely — some facilities run traditional 8-hour shifts (day, evening, night), while others use 12-hour rotations. Weekend and holiday coverage is almost always part of the schedule. The nurse-to-resident ratio in assisted living is generally more favorable than in hospitals, but you will likely be the highest-level clinical staff on the floor during your shift, which means more autonomy and more responsibility for clinical judgment calls.

What to Expect in This Role Day-to-Day

Based on typical senior living facilities in the Houston area.

A typical shift starts with medication pass and resident assessments. You will review overnight notes from the previous shift, check vitals for residents on your watch list, and coordinate with CNAs on any changes in condition. Mid-shift usually involves documentation, family communication, and working with physicians on care plan updates — often by phone or telehealth rather than in-person rounds.

Depending on the facility, you may also handle admissions paperwork, manage wound care, supervise medication techs, and respond to emergencies. The documentation load in senior living is significant — state surveys and compliance requirements mean thorough charting is non-negotiable. Many nurses in this setting say the most rewarding part is knowing their residents personally and being able to notice subtle changes that a rotating hospital nurse might miss.

Houston Area Salary Data

According to the Bureau of Labor Statistics, Registered Nurse positions in the Houston metro area earn a median wage of $47.02/hr ($97,802/yr). The typical range is $38.29 – $50.95/hr (25th–75th percentile).

Entry Level (10th) $69,368/yr
Houston Median $97,802/yr
Experienced (90th) $125,320/yr
vs. National Median +4.5%

Source: Bureau of Labor Statistics, Occupational Employment & Wage Statistics (Houston-Pasadena-The Woodlands, TX Metro Area). Salary data provided by Houston Senior Living Guide.

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