Provide day to day guidance, support and direction to direct patient care staff, providing informal feedback on an ongoing basis and formal feedback input for the annual performance evaluation. Participate in the department staffing and the appropriate hiring, firing and disciplinary actions. Recommend disciplinary action to Facility Administrator and initiate as appropriate. Ensure compliance with all company and facility approved procedures and policies as well as regulations set forth by state and federal agencies. Approve or disapprove time or personnel schedule changes in the absence on the Facility Administrator ensuring compliance with applicable regulations, policies and procedures for documenting time of work hours for staff members on assigned shift. Participate in patient care plan meetings. Maintain knowledge in the current practices related to the principles and techniques of dialysis by participating in all scheduled in- services. Train and orient staff as necessary. Routinely observe and guide direct patient care staff for appropriate technique and adherence to facility policies and procedures. Promote and assist with compliance to OSHA programs in order to maintain a safe and clean working environment. Maintain overall shift operation in a safe, efficient, and effective matter. With Facility Administrator conduct staff meetings at least monthly or as needed to keep patient care staff informed of changes in patient care needs or operations to improve delivery of care. Meet routinely with the Facility Administrator to discuss personnel and patient care status, issues, and information. Supervise all documentation of patient information. Coordinate Charge Nurse duties with Staff RNs acting in the relief charge capacity. Assess daily patient care needs and develop and distribute patient care assignments appropriately. Assume primary responsibility in an emergency situation. Assess patient needs, respond to dialysis treatments, and communicate concerns to rounding physician. Implement changes in patient care/treatment as directed. Monitor and supervise all patient care activity during dialysis and assist as necessary. Collaborate with direct patient care team in making decisions to benefit patient care. Continuously monitor patient's condition with regards to problems and potential complications associated with dialysis. Administer medications to patients per physician's orders. Act as the subject matter expert and as a resource for staff members. Supervise and participate in completion of short and long term care plans. Admit new patients according to facility procedure. Ensure educational needs of patients are met and educate the patient and family about End Stage Renal Disease, dialysis therapy, diet and medication. Supervise the safe and effective use of all equipment involved in direct patient care. Operate all dialysis related and emergency equipment safely and efficiently when needed. Perform required testing and verification and initial the checklist for start-up and shut-down procedures as outlined in the Technical Services Manual. Complete Nurse's Technical Training Program/ Water Quality Facility Assist with special projects or other duties as assigned by the Facility Administrator. Assist with the interviewing of potential direct patient care staff Promote efficient use of medical supplies. Attend and participate in monthly Quality Assurance meetings. Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions.