Tech vs. Nurse War - page 3

I am a new dialysis nurse, well a new nurse period, and until today I loved my job and the people I work with although they've been a little slow to warm up to me on a personal basis. Here's my... Read More

  1. Visit  DeLana_RN profile page
    0
    Quote from Hellllllo Nurse
    Good. In every TX unit I worked, techs do assessments.
    This doesn't surprise me. I'm in another state, where techs are not allowed to do assessments, but in the unit I was trained at (I wasn't there for long, and still had no idea that they weren't allowed to do so) they most certainly did - management expected them to.

    Scary, indeed.

    DeLana

    P.S. "Management" (an "RN") currently does time for fraud... for not having a license. She surely didn't have to worry about losing it
    Last edit by DeLana_RN on Oct 29, '07
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  3. Visit  Hellllllo Nurse profile page
    1
    I was reading on allnurses rececently about a case in which a pharmacy tech mixed up a dose of TPN incorrectly. The TPN was ordered for a premie in the NICU. The tech added 10X the ordered amount of zinc. The baby died.
    The case went to the pharmacy board. The two supervising pharmacists were disciplined by the board, but the tech could not be. Although the tech had been determined to be competent- he was trained, and was certified by the state, he was not legally liable for the baby's death.
    Although the pharmacists were not directly with the tech when he mixed the TPN, the pharm tech works under the license of a registered pharm.

    A member of the pharmacy board was quoted as saying he was upset, because the board had no power or authority to punish the tech in any way.

    Ironically, the baby's mother was an RN. she had been told she was infertal, and had been on fertility tx. She finally has a baby- and it dies as the result of a tech's error.

    I searched a couple of times for the article, but could not find it. Maybe someone here can find it.

    Why in the hell techs are allowed to mix TPN is beyond me.
    DeLana_RN likes this.
  4. Visit  DeLana_RN profile page
    0
    Wow, that's a scary case. I agree with you, pharm techs should not be allowed to mix something as dangerous as TPN... or KCl added to IV fluid - should they be allowed to mix anything?! Unlike pills, there is no way to check after them...

    Likewise, it's very scary to think that dialysis techs are able to access central lines in many states... give heparin in others (in my hospital, two nurses have to sign off on the heparin dose before one of them gives it), and do other invasive, risky procedures under the license of a nurse. It's truly scary to work with UAPs if nurses will be held liable for their actions! Therefore I'm glad to work in an all-nurse acute unit now.

    Thanks for the info.

    DeLana

    P.S. After being an infertility pt myself, I cannot even imagine losing a child due to some medical error... how horrible.
    Last edit by DeLana_RN on Oct 30, '07
  5. Visit  BellaCerraRN profile page
    0
    I guess that was one good thing I could find with the unit in which I worked. Yes the techs gave heparin, but it came in pre filled syringes and every patient with few exceptions got the same dose, so there wasn't much room for error.
  6. Visit  starbin profile page
    2
    Quote from DeLana_RN
    I said it before, and I'll say it again - techs precepting nurses is just a bad, bad idea - unless for a brief time (maybe two weeks), just dealing with the very basics (in conjunction with a nurse, the "official" preceptor) - and your post is just another example of why this is so.

    Your tech of course knows a whole lot more about dialysis than you do; my suspicion is, she likes it this way. Of course, she knows that eventually you will know just as much - and more, the whole picture, as a nurse (not in every way, though - she may always be able to stick better, after all she has years of experience). She knows this as well and, I suspect, resents it.

    It's a good thing that you have a quiet confidence in your abilities - and ability to learn (which is obvious from your post), because this is what you need in a situation like this. Others would be easily intimidated (and believe that they didn't get enough training - you got enough training, you just need experience, and that comes with time).

    Keep up what you have been doing, eventually she'll understand that she can't get under your skin and, I suspect, will respect you for it.

    Best of luck to you,

    DeLana
    Thanks.
    The funniest thing is the tech(my preceptor) was most annoyed because I didn't ask her a single question about dialysis. She said she felt like she was just pushing her knowledge. I heard her trying to give few illogical, unscientific rationales about a lot of things, and I decided she is not the best person to answer my questions. So I stopped asking anything. If I was in doubt, I would come home, search on internet or journals. Get my own reliable information. According to the tech (my preceptor) me not asking her any question about dialysis was just insulting to her knowledge. I said- "this is science, and I believe in getting the information from a written source or books than words of mouth". I respect her experience. she knows her job, and sticks to the company policy. I just didn't believe that a tech is the right person to give me scientific knowledge, i learned the skills from her, she is good at that.
    Her answers were too illogical like- "there is not as much recirculation with catheters as they think there is." I was like- "that is the documented fact, that is proved by researches, why do you think that the research findings are incorrect?".
    LPN2RNn2011 and Hellllllo Nurse like this.
  7. Visit  Hellllllo Nurse profile page
    1
    Sometimes, I think that some techs just make stuff up, then they start believing what they are saying.
    nursingisok likes this.
  8. Visit  PLTSGT profile page
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    I agree to everything you mentioned, DeLana. Thanks!


    Quote from DeLana_RN
    Nephro RN,

    I'm sorry you are experiencing this, but unfortunately this is a HUGE problem in chronic/outpt dialysis. Why? More so than in other areas of nursing, the perceived roles and responsibilities of nurses and techs/PCTs are very, very blurred. Of course, PCTs (with the exception of student nurses, but those don't normally cause a problem) have no idea what additional responsibilities nurses have. On the other hand, PCTs know that nurses make much more $. Therefore, the "same job, more money" perception will lead to resentment (yes, there are exceptions - excellent PCTs with great attitudes who are never subordinate - but I've encountered very few in chronics). Sad, but true.

    Usually, nurses and PCTs are even trained together. Personally, I think it's a very bad idea for a subordinate to train a nurse, even in the more technical aspects of the job (not because PCTs are not competent at their jobs - in some areas, such as cannulation, they are often better because they get more practice). Only nurses should train nurses! How will the PCT later respect a nurse that s/he got to "evaluate" (and obviously, in your case, told lies about?!) Bad, bad idea.

    It seems obvious that your are dealing with resentment/envy/attitude issues here. If I were you, I would speak to the FA in private to see if you can work with your nurse preceptor from now on. There is nothing that a PCT can teach you that a nurse cannot. Explain why - you don't have the "RN attitude" (LOL, that's a favorite one) but if the PCTs think so, then it's not a good idea to continue the training relationship. If you have any problems with the FA - and/or the PCTs - think long and hard whether you want to continue working there. Yes, it will probably get better once you're no longer being precepted, but dialysis has a long learning curve and other workers can truly make your life miserable if there are unresolved "issues".

    I'd better get off my soapbox now (you can tell, this is one of my pet peeves although I'm no longer in chronics and we have no PCTs in acutes). I hope you can get this resolved. Despite some problems, dialysis is a very rewarding nursing specialty - you will get to know and have meaningful relationships with your patients.

    Best of luck to you!

    DeLana
  9. Visit  jnette profile page
    1
    This is sad, because the techs are the backbone in dialysis and can be of tremendous value to the nurses. If nurses and techs could/would agree to work as a team, all would go very smoothly.

    I always found that techs will bend over backwards for you if they are treated with respect, acknowlegement, and appreciation.
    I also took every chance to teach them something along the way about the disease itself, and non "tech" things.. they always appreciated that, and everyone benefits from it.
    GeauxNursing likes this.
  10. Visit  PLTSGT profile page
    0
    Honestly, I think some units can be breeding grounds for this type of animosities between techs and nurses. Managers should take care of these problems ASAP. Also, I think the bigger the facility is, the more chaos there will be. I'm glad that I belong to a smaller unit and most of the so-called "troublemakers" are already weeded out.


    Quote from jnette
    This is sad, because the techs are the backbone in dialysis and can be of tremendous value to the nurses. If nurses and techs could/would agree to work as a team, all would go very smoothly.

    I always found that techs will bend over backwards for you if they are treated with respect, acknowlegement, and appreciation.
    I also took every chance to teach them something along the way about the disease itself, and non "tech" things.. they always appreciated that, and everyone benefits from it.
  11. Visit  GeauxNursing profile page
    1
    as a tech, (my boss' "favorite", everyone says) I am asked to train or "let them shadow", the new staff who come into our unit. A tech at first, no problem. I showed her how we did things, she had simply come from another company. Then the new nurse comes in. I have to show her how to use the computer, how we document vitals, giving NS for cramps, etc. No problem, except that the whole time I feel like SHE must be thinking, "what a bore, show me something real!" I felt bad bc I was expected to show her the ins and outs of our computer system, but from me, all she could get was "tech stuff". Med administration, assessments, these are to be taught by the other NURSES. I felt bad. I don't know. I felt kind of like I was expected to perform for her and show her everything, when all I wanted to do was get my patients on, get them off, then go home. I actually asked her to set up machines for me! I felt awful.. what else was I supposed to do? I got theough it, and then i asked my boss to show me the money for all this training I do. I am the least-paid tech doing all the extras for the boss.
    I can't wait to be an LVN!
    Kudos to all the nurses who put up with the "techs with attitudes." We have some of those. and trust me, the attitudes come to us, also. not just the nurses. i work with some unpleasant folks. just complaining to complain.,
    Butterfliesnroses likes this.
  12. Visit  BellaCerraRN profile page
    1
    You sound like you'd be a great person to work with. I'd have no problem with ANYONE including the janitor teaching me how to string a machine or how to use the computer system as long as they know how to do it and do it right. I had no problem stringing machines, changing out the bicarb bottles, filling them etc, after all I didn't know how to do much else and no job is beneath me. But I think it's best if preceptors are educationally superior to their preceptees no matter what area of practice one works in. That does not mean the preceptor cannot pair up a new employee with a more experienced employee to do some training.

    We can all learn from each other no matter what our education or licensure. Hardly a week goes by that I don't learn something nifty from a CNA or an LVN and I always make sure that I tell them how much I appreciate them and never qualify it by their title. They are simply co-workers of mine who've taught me something new.
    LPN2RNn2011 likes this.
  13. Visit  jnette profile page
    0
    Quote from BellaCerraRN
    You sound like you'd be a great person to work with. I'd have no problem with ANYONE including the janitor teaching me how to string a machine or how to use the computer system as long as they know how to do it and do it right. I had no problem stringing machines, changing out the bicarb bottles, filling them etc, after all I didn't know how to do much else and no job is beneath me. But I think it's best if preceptors are educationally superior to their preceptees no matter what area of practice one works in. That does not mean the preceptor cannot pair up a new employee with a more experienced employee to do some training.

    We can all learn from each other no matter what our education or licensure. Hardly a week goes by that I don't learn something nifty from a CNA or an LVN and I always make sure that I tell them how much I appreciate them and never qualify it by their title. They are simply co-workers of mine who've taught me something new.
    That's the spirit !

    Wish there was more of that attitude out there. Good for you!
  14. Visit  DeLana_RN profile page
    0
    Quote from jnette
    This is sad, because the techs are the backbone in dialysis and can be of tremendous value to the nurses. If nurses and techs could/would agree to work as a team, all would go very smoothly.

    I always found that techs will bend over backwards for you if they are treated with respect, acknowlegement, and appreciation.
    I also took every chance to teach them something along the way about the disease itself, and non "tech" things.. they always appreciated that, and everyone benefits from it.
    Some will, and some won't - you cannot change somebody else's bad attitude and sadly, in my experience (5 1/2 years in chronics) about half the PCTs had bad attitudes, were insubordinate and/or lazy (don't ask me why management put up with it - I suspect they'd rather have bad workers than none at all. This also explains why an LPN with numerous write-ups for such things as putting patients on the wrong dialyzer is still working there. He is also great at corrupting some easily influenced PTCs.

    Maybe I was just in a bad clinic (although my colleagues in other local clinics owned by the same company told me similar tales) - I sure hope it's not like this everywhere!

    I'm the first to want to work with my coworkers - other nurses and PCTs - as a team, to help them, teach them, and always treat them with respect. But sometimes this is just not enough.

    DeLana


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