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- by madwife2002 Sep 27, '11In my company the RN's first train to be a technician then at week 5 they start work on the RN skills.
We have an RN who on week 7 still cannot dialyize one patients in a timely manner and I cannot check her off her competancies.
What do other companies expect from the RN's who have no experience- is it expected they can after training turn over a pod of 4pts
- Sep 27, '11 by traumaRUsI work in five FMC chronic HDUs and its not the expectation that the RN runs a pod. In the bigger units I go to (19, 23, 32 chairs), the RNs are only expected to help with turnover if they are able but they are not responsible for pts.
In the smaller units (5 chairs) there is only one RN and one tech. In the 5 chair unit, yes the RN has some responsibility but not for any particular pt. Since it is a very small unit, the RN has to be available quickly to respond to emergencies.
In the 9 chair unit, there are two techs and one RN and again, the RN is not directly responsible for caring for the pts.
Since all assessments, meds, and sometimes catheters have to be done by the RN, the RN can't have the responsibility of pt care. An RN has to be available to handle codes, emergencies, etc..
Is this a unit where there is always an RN free? My concern is that it is not the RNs job to run the pts, but rather to manage the floor and pt flow.
- Sep 28, '11 by MJB2010In my clinic the RN has their own pod of two patients, plus all catheters, assesments, heparin pushes, and all meds. It isn't humanly possible to do all of it with the schedule we have (turning over a chair in 15 minutes for example). Their expectations are very unrealistic. I struggle with the pod of 2 in addition to all the assesments and such no way is it reasonable for 4. We do also schedule all the patients on top of each other, so for example, I will have a 6am in my pod and 2 6am catheters. Not possible to be in 3 places at once. Nevermind that all the other patients need to be assessed and have their heparin pushed. I think the appointments need to be staggered better.
- Sep 28, '11 by livelaughlove09Amen. I'm new to dialysis, training, and have not had much experience with the machines and turnover. I can strip a machine, set one up, look over the alarms (tmp/art pressure for example) and do something about those, but I'm more concerned with the BP and HR alarms. I assess and pass meds pretty well, but I'm getting the feeling the techs are really annoyed that I can't put a pt on or take them off, but at the rate we run there hasn't been much opportunity to learn those tasks because we can't slow down long enough to get there. By the time I chart, call in scripts, find out where the Pts are that didn't show up, get labs, assess, and pass meds on 20 pts, it's time to start over with the next 20. I can't imagine doing all that, turning them over, and doing their q30min checks. Really? And my nurses are happy to have me because there's usually only one of them on the floor.