LVNs do battle in dialysis!

  1. I read in a post that the staff determines the mood, pace, and atmosphere of a clinic, not the company. I fully agree that the staff makes or breaks a clinic. After all, they are the ones you will be spending your 4 x 12hrs with, lol. It is hard work, made even harder if you don't work with the best teammates.
    I am now starting to wane in my enthusiasm, and I am only in week 8 of my LVN training at my clinic! I was a PCT here for over 3 years, and I had it made! I got my 4 patients on, got my stuff ready for 2nd shift, then I sat down and chilled. Or studied. Vitals q30mins, no problem!
    Now, I have 4 patients for which I am to set up the machines, assess them, initiate tx, draw up all my meds and give, get ready for next shift, endure some pretty hardcore turnarounds, then do it all over again. Being an LVN, I am assigned 4 catheter patients, pretty much every day. We are short-staffed, so I am picking up some overtime. It is insane!!! Since transitioning, I feel that I am so overworked, exhausted all the time, and dreading certain assignments. We rotate in our bays, so I know who to expect, when. I want the fun back!
    I know we all have good days and bad days. ANd I know we are all (in my clinic) overworked and tired and stressed. I know it will get better, but I just feel like I am expected to do so much! It's not the complexity of my tasks, either, because I know my role and I know how to complete my tasks. It is the mere Volume of work that I have now that stresses me. Having 4 patients, just as a PCT does, really stretches me thin when you add in assessments, catheters, normal dialysis tx turmoil, Snappy, etc. To all you RNs in dialysis who are also expected to take a full patient load every day, Kudos to you. It would be impossible for me, without a doubt. Our RN's (we have 2 MWF and just one TTS) only take a patient IF there is overfill, which is once maybe every 3 weeks or so. God bless 'em, I don't think they'd have any idea of what to do, given a full patient load. They already work so hard, and we have many difficult patients and families to deal with every day. BUt they rock nonetheless!
    Getting back to what I think my original point was, my teammates can be amazing. They can also be incredibly difficult! Once we are all "in the weeds" and dragging a$$ because it's been such a crazy turnaround and there are mini-disasters everywhere, we either work together or we drown. It almost gets to a point that we all sense the same thing: we need to help eachother! You can hear "I need a second!" being shouted across the bay, or you see that your teammate needs a machine cleaned up, and you've actually got 2 free minutes.
    My buddy sees today that I have 2 patients (impatiently) waiting to be put on (all caths), I have a 1st shifter with a low BP, and I am stuck with a non-working cath. He goes straight to the machine and sets it up. Then he hangs out with low BP lady. The he comes to my side and makes sure I'm okay. I am so thankful for him just being there, because honestly I was about to start crying. I tell him I didn't realize I was the last one with patients to put on. He's like, "Oh, no! I've still got 2 of mine waiting for me. Machines are in recirc, and I saw you running around over here, so I came to help."
    He deserves my full gratitude for today; otherwise I probably would have cracked. Instead, I smiled and exchanged some funny talk with my other teammate to brighten her as well. There, in the middle of turnover, we all laughed together and made it through.
    (not sure when this post turned into a novel...)
  2. 4 Comments

  3. by   corky1272RN
    It is very difficult!! When I had just started out at my clinic, I had to take a full pt load for a few months. I thought how unfair! Just because I went to school does not mean I have some super power that helps me miraculously go faster to be able to do more than the pcts! Hang in there!

  4. by   workingmomRN
    Hang in there & keep reminding yourself that it won't always be like this. Taking a full pt load & doing assessments can be overwhelming. It's great that you have teammates who will help you out. It's even better when you are in a position when you can help someone else out. Most PCT's don't realize how hard it is for the nurses to take pt's and do everything else that comes with the job.
  5. by   DeLana_RN

    a full pod of four, while you're doing all assessments and meds, is a lot of work. In my unit (when I worked there), LPNs did assessments but did not have to give tx meds (epo, zemplar, iron, antibx); of course, if they had the time to give some of those, it was greatly appreciated by the RNs. RNs had to take two patients, give all meds for the team (which usually included one LPN and one PCT, but sometimes two PCTs), take all orders/call the MD, assess and administer heparin to the PCT's pts (which means, RNs were responsible for assessing 6 pts), do paperwork, handle emergencies, check the water, etc. I couldn't do it anymore, I can tell you!

    I think your prior PCT experience is very valuable; you're probably very fast during turnover and can stick anything (believe me, when I had to take a pod of four, which happened occasionally, I had a very hard time with it and got everyone on late). You will get faster with the meds and assessments as your nursing experience grows. But the most important thing of all (which wasn't always the case in my unit): your teammates actually care and help (few of ours did). This is invaluable.

    Best of luck to you,

    Last edit by DeLana_RN on Apr 21, '09
  6. by   jnette
    Teamwork is EVERYTHING in Dialysis.

    It hust can't be stated or valued enough. If everyone works together as a TEAM and helps put the others, it all runs so much smoother, and EVERYONE is happier.. staff and patients alike!

    I was fortunate enough to work with such colleagues.. RN, LPNs and Techs alike.. all pitched in to help out when and where they could... and this is what makes a great work environment, regardless of how busy or stressful.