The dialysis technician performs his/her duties as part of the dialysis team under the general administrative direction of the Nephrologist or his/her designee and in coordination with the Clinical Nurse Manager, Dialysis Coordinator, and/or Charge Nurse of the Dialysis Unit. The principal duties performed are in the area of patient contact, and are of a specialized nature. Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. English Language Proficiency. Medical Instrument Technicians must be proficient in spoken and written English in accordance with chapter 2, section D, paragraph 5a Licensure or Certification. Licensure or Certification is not required for this occupation; however, it is strongly desirable at GS-6 or above Preferred Experience: Preferred experience would include >2 years of dialysis experience in an outpatient setting and CCHT certification Grade Determinations: GS-7: At least 1 year of experience comparable to the next lower grade level which demonstrates the knowledge, skills, abilities, and other characteristics related to the duties of the positions to be filled. This would be experience which provided knowledge the equipment, standard procedures, and typical machine problems and/or patient reactions to treatment. In addition, the candidate must demonstrate the following KSAs: 1. Ability to assist the physician in more complex procedures such as central venous catheter insertion. 2. Ability to assist in training patients in home/self-care by teaching components of machine operation including water treatment and monitoring patients for compliance. 3. Ability to act as a mentor or preceptor to lower graded technicians. 4. Ability to analyze deviations from the expected, determine whether the deviations are machine or patient related, and respond according to the findings. References: VA Handbook 5005/15-54 Part II Appendix G27 The full performance level of this vacancy is GS-7. The actual grade at which an applicant may be selected for this vacancy is the GS-7 Physical Requirements: This position requires visual acuity, keen hearing, clear distinctive speech, and manual dexterity. This position requires potentially long periods of continued walking, standing, stooping, sitting, bending, pulling, and pushing. Transferring patients and objects may be required. Mechanical lifts are provided. The incumbent may be exposed to infected patients and contaminated materials and may be required to don protective clothing in isolation situations, operative/invasive procedures, or home settings. The incumbent may occasionally be exposed to patients who are combative secondary to delirium, dementia, or psychiatric disorders. The incumbent must be a mature, flexible, sensible individual capable of working effectively in stressful situations, able to shift priorities based on patient needs. Must complete annual Employee Health requirements, such as annual TB screening or testing, as a condition of employment. The incumbent who provides care in home settings or other off-site locations may be required to drive and/or ride in GSA-vehicles. Lifting and transportation of bulky supplies and equipment is required. Must be able to lift and transport large salt bags. ["Hemodialysis technicians at the VA dialysis center are responsible for the operation of hemodialysis equipment in the treatment of patients ,vith renal failure; monitoring patients during dialysis treatments; cleaning, sterilizing, and maintenance of dialysis equipment; monitoring the quality of the water used for dialysis; collecting, recording and reporting water culture results; setting up and operating hemodialysis equipment; selecting, ordering, stocking, and preparing supplies needed for dialysis procedures; and mentoring new technicians. The hemodialysis technician performs his/her duties as part of the dialysis team under the direction of the nurse manager and staff nurse. Operates, monitors, and calibrates dialysis equipment and instruments for the performance of hemodialysis. Independently provides hemodialysis treatment to patients with renal failure. Initiates and terminates dialysis treatments following standard procedures. Monitors patients throughout treatment and makes necessary adjustments without consultation per the patient's medical condition, previous experience, and accepted practices. Monitors dialysis treatment parameters, e.g., vital signs, weight loss. Collects and records vital signs using blood pressure cuffs, stethoscopes, and scales and thermometers. Records patients' condition and changes (blood pressure, excess fluid, etc.), and determines proper treatment procedure, technique, and machine adjustments. Assembles all necessary supplies and equipment at chair side. - Inspects and evaluates circulatory access site. Cleans and dresses circulato1y site using sterile techniques. Connects patient to the dialyzer (using venipunctures, external shunt, etc.) and operates equipment to initiate extracorporeal circulation and performance of dialysis. Prepares and dismantles extracorporeal blood circuits and the dialysis machines to create a sterile, air-free blood circuit using a standard aseptic procedure. Operates and monitors dialysis machinery in perfonnance of dialysis procedures using prescribed standard procedures and the machine monitoring system. Establishes amount of fluid to be removed and sets the machine pressure according to the coefficient of ultra filtration of the dialyzer. Adjusts blood flow rates. Obtains blood specin1ens for routine or special tests. Collects laboratory specimens from patients using syringes, needles, tubes, and different sterile techniques. Processes lab samples. Centrifuges samples, boxes samples, and prepares samples for shipment. Documents and charts accurately on flow sheets and medical records. Assesses and records the results of the dialysis treatment, plans future care, and reports program to' the dialysis team. Recognizes medical complications or altered response to treatment and notifies RN or MD. Assist in the cannulation of the hemodialysis fistula or graft for dialysis. Administers saline or other solutions intravenously into the dialysis line when in his/her judgment the machine has removed more fluid from the patient than indicated. Observes dialysate delivery unit for correct functioning during dialysis and adjusts when necessary. Responds to equipment alarms, adjusts alarm limits, and corrects the cause of malfunction which triggered the alarm. Observes for and/or tests for blood leaks. Administers oxygen therapy, e.g., catheter, mask when necessary. Returns blood to patient upon termination of dialysis. Recognizes when emergency measures are necessary and institutes life saving measures until medical assistance is secured. Initiates or assists in cardiopulmonary resuscitation and other emergency procedures using an Ambu bag, cardiac monitor, and oxygen equipment. Assists patients with non-nursing requests. Appropriately documents all maintenance, cleaning, disinfection, and .testing performed and identifies the equipment serviced, date of service, and name of individual performing the service in timely manner. Regularly reports status of equipment to dialysis center nurse manager and Lead MIT. Promptly reports equipment issues to the nurse manager and medical director. Responsible for the proper and safe operation of the equipment during the performance of dialysis, for the accuracy of testing, for the correction of malfunctioning, for the replacement of some or all pa11s of the system in the event of complications (clotting, blood leakage, hypotension, etc.), and for the disassembly and re-sterilization of the equipment. Tests dialysate conductivity and pH. Performs daily heat disinfection and weekly bleach sterilization of the water treatment system and confirms the adequacy of cleansing after each. Records results on dialysis flow sheet/log. Set up and operation of the dialysis machines and various related pieces of equipment Work Schedule: 7:00 am to 7:30 pm; 11:00 am to 7:30 pm (Three 12 hour shifts and three 12 hour shifts plus one 8 hour shift biweekly) Financial Disclosure Report: Not required"]
Providing Health Care for Veterans: The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,255 health care facilities, including 170 medical centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.
