Registered Nurse

Registered Nurse - Fresno, CAJob Type: Per diem and Full-TimePay Rate: Open to discussionBenefits: Company Vehicle | Paid Time Off (PTO) | 401(k)Location: Fresno, CACore clinical skillsThese are the “must-have” hands-on skills that come up constantly in a skilled home health caseload.• Comprehensive head‑to‑toe assessment, focused systems assessments, and skilled observation, including early recognition of deterioration and triage/escalation.• Vital signs, pain assessment, and monitoring trends over time, including orthostatic, pulse ox, and sometimes telemonitoring data• Medication administration and reconciliation: oral, SQ/IM injections, insulin, anticoagulants, and high‑risk meds; identifying polypharmacy issues and interactions.• Chronic disease management: HF, COPD, diabetes, CKD, post‑stroke, post‑MI—assessing status, titrating plans with MD orders, and reinforcing self‑management.IV and infusion therapy• Venipuncture and peripheral IV insertion, securement, and troubleshooting; recognizing and responding to infiltration, phlebitis, and systemic reactions.• Management of central lines (PICC, ports, tunneled catheters): aseptic technique for access, flushing, dressing changes, and infection prevention.• Safe infusion administration in the home: pump setup, rate verification, compatibility checks, monitoring vitals during infusions, and knowing when to stop and call the provider.• Patient/family teaching for home IVs: line care, flushing protocol, signs of infection or air embolism, when to seek emergent care.Wound and skin care• Wound assessment: type (pressure, diabetic, venous, arterial, surgical), staging, size, depth, exudate, odor, tissue type, and peri wound condition.• Evidence‑based dressing selection and application: packing, negative pressure (wound vac), moisture balance, and protecting surrounding skin.• Aseptic/clean technique for dressing changes, debridement per orders (e.g., mechanical), and infection prevention (hand hygiene, PPE, disposal).• Longitudinal monitoring and documentation: measurements, photos per policy, and communicating non‑healing or deteriorating wounds to providers.