Hands-On Chronic Patient RNs

Hospital, Outpatient Clinic, Home Health, or Chronic Care Facility Setting

Position Title: Registered Nurse – Chronic Patient Care (IV Therapy Specialist) Common Local Titles: Chronic Care Infusion RN, Home Infusion Nurse, Oncology/Dialysis IV RN, Palliative Care IV Specialist

Primary Focus

Deliver direct, hands-on nursing care to patients managing chronic conditions requiring ongoing IV therapy, such as:

• Total Parenteral Nutrition (TPN) for malabsorption or GI disorders
• Long-term IV antibiotics for recurrent infections (e.g., cystic fibrosis, Lyme disease)
• Chemotherapy, immunotherapy, and targeted therapies for cancer patients
• IV immunoglobulin (IVIG) for autoimmune or immunodeficiency disorders
• Inotropic support for advanced heart failure
• Hydration and electrolyte management for chronic kidney disease or dialysis patients
• Palliative infusions for pain control in end-stage illnesses

This role emphasizes patient-centered care in Sacramento's diverse healthcare landscape, including urban hospitals like UC Davis Medical Center and Sutter Health, outpatient infusion centers, and home health agencies serving the Central Valley.

Key Responsibilities (Hands-On & Patient-Facing)

• Execute venipuncture, PICC/midline/central line insertions, and port accesses for patients with compromised veins due to chronic illness; utilize ultrasound guidance as needed.
• Administer complex IV therapies (e.g., vesicants, biologics, TPN, blood products) per physician orders, with vigilant monitoring for complications like infiltration, sepsis, or hypersensitivity.
• Perform site assessments, dressing changes with chlorhexidine protocols, and line flushes to minimize central line-associated bloodstream infections (CLABSIs).
• Titrate infusions (e.g., vasopressors, opioids) based on real-time vital signs and lab results; respond to emergencies like anaphylaxis or fluid overload.
• Conduct thorough patient assessments, including pain scales, nutritional status, and psychosocial needs; collaborate on care plans with multidisciplinary teams (e.g., nephrologists, oncologists).
• Provide education to patients and caregivers on home IV management, pump usage, infection prevention, and recognizing complications; facilitate transitions from hospital to home care.
• Document in electronic health records (e.g., Epic at UC Davis or Cerner at Sutter) with detailed notes on infusions, responses, and follow-ups; ensure compliance with HIPAA and Joint Commission standards.
• In home health roles (common with agencies like Kaiser Permanente or Alignment Health), perform field visits, coordinate supplies, and manage on-call emergencies in Sacramento metro areas.
• Support triage via phone or secure messaging for chronic patients; assist in clinic flow for high-volume days.

Required Qualifications & Credentials (California Context)

Common Work Settings in Sacramento, CA

• Major hospitals: UC Davis Health (oncology infusion), Sutter Medical Center (chronic disease clinics), Kaiser Permanente (integrated chronic care).
• Outpatient/infusion centers: Dignity Health or freestanding clinics like those affiliated with CommonSpirit Health.
• Home health/hospice: Alignment Health, VITAS Healthcare, or Dialysis Clinic, Inc. for CKD patients.
• Specialty units: Nephrology/dialysis at Sacramento County facilities or wound care clinics serving chronic ulcers.