Outpatient Registered Nurse - RN - Dialysis

Fresenius Medical Care · Houston, TX Prn
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Job Description

TRAVEL REQUIRED: This is a Regional Float position. PURPOSE AND SCOPE: 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 homeostasi

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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 $48.00/hr ($99,840/yr). The typical range is $39.37 – $55.77/hr (25th–75th percentile).

Entry Level (10th) $74,859/yr
Houston Median $99,840/yr
Experienced (90th) $130,437/yr
vs. National Median +2.3%

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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