Quote from Nurse Nessa
I am so sorry that you both feel this way. I do have to make the point that it's all about the individual units management. I work at a large inner city unit that used to be in the bottom 15% of DaVita. We had crappy FA's who did not advocate for their staff. We were always short, to the point where I dreaded coming into work because half the time, not a single opening PCT would have shown up yet when i walked in the door 30min before we opened a 28 chair unit! We never got bonuses either. 3 years ago we got a new FA who started weeding out all the bad seeds, got the patient behaviors under control (we used to have an armed gaurd because it was so bad), and fought for what the unit and staff really needed, sometimes all the way up to KT. We are now in the top 20% of DaVita!
My point is that it is easy for management to let us believe that all the hardship we go through is the companies fault when really the blame falls on them. It takes a lot of work to get a unit running well, but it is so worth it in the end! A large company is just that...it is up to us to make the company work for us and it can be done!
As for bonuses, they are not all based on pt outcomes, each unit gets to choose their quarterly goals. These range from staff retention to vaccinations. There are some we control and some we cannot...kinda sounds like life, huh?
This is just from my experience in 7 years of dialysis. Not trying to attack or discount anyone elses experience...just my 2 cents.
Always good to hear an alternative perspective. And I'm glad to hear of a success!
I have to disagree that it's "all about the individual unit's management." I agree they can make a unit miserable both for patients and staff, or make it run at optimum. But, their control is limited like it has never been before.
As an anecdote, remember there was a day when the only
patient care staff in a unit, were RN's. When I started 18 years ago, there was one RN and one tech to every 4-6 patients. And that was a very large, very well-run unit.
We've come along way medically, in understanding and treating ESRD and in that regard, the patients have advantages over their counterparts of 20 years ago.
However, they were also receiving very, very personalized care each and every time they walked into the unit. We knew them inside and out.
Economically those ratios of days gone by are unsustainable, and we have what we have now.
Very interesting evolution to watch.