I work in a Magnet certified hospital, in the inpatient dialysis unit to be specific. This unit has five stations plus two portable machines with a single back-up unit for running patients in the ICU's There are four of us working full time with the remainder of the positions filled by part timers and contingents.
We lack the staffing to run more than two shifts a day, and if we have more than four patients in the ICU's staffing is even more critical. God forbid anyone should call off ill. As a result we will often be required to work a third shift. Can you say "mandatory overtime"?
As for the dialysis unit itself, patient beds cannot be brought in to , or removed from, the unit without moving the beds of patients who are already on circ. Quarters are so cramped that I have fallen more than a few times trying to negotiate the space to care for a patient. Three of our monitors are more than ten years old, seven of our dialysis machines and our three portable RO units are reaching the end of their service life, with the three new machines being of questionable reliability. Our storage space is a joke, clearly in violation of state standards, and we have no means of providing more than the most rudimentary contact and respiratory isolation for patients requiring such.
Couple these with the fact that our unit is under a nurse manager in charge of a larger med/surg/tele unit, who has no concept of just what hemodialysis entails and views the dialysis unit as a drag on her financial numbers. Hospital administration seems indifferent to our situation, particularly since hemodialysis doesn't bring the big payers in as cardiac does.
I love the work, but I've really come to hate the job and the system, and the rub is that it's really no better anywhere else that I've seen. I've tried to make my views known to management, in a civil manner with realistic solutions and I'm told to basically "sit down and be quiet".
I'm just looking for a reason to remain in nursing. As I said, I love the work, I love caring for the patients, but when the system can't be troubled to make necessary changes to benefit both the patients and the staff, why bother?
