Thanks for all the feedback so far. I am not surprised by the comments. As a traveling dialysis nurse, I do hear a lot of the same complaints. I think it goes for any unit, you have some nurses that go above and beyond their call of duty, and others who do their job responsibility only and call it a day. One thing to consider is that many hospitals get their dialysis services by an outside company, either Fresenius or Davita. If this is the case in your hospital, most of the times, the nurses do not have access to the hospitals medication systems and are not legally allowed to do anything outside of the nephrology practice.
That was hard to get used to coming from a hospital based dialysis unit. I went to California and was not a direct employee of the hospital. They told me that the only thing I could do was hook up the patient and record vital signs. If I helped move the patient up in bed and they somehow got injured, I could be in huge trouble for practicing outside of what it covered in our contract. As a Davita nurse, I didn't even have access to the computer systems to look up labs! I had to ask the nurses for saline syringes, heparin, all kinds of things that made me feel bad.
I get a lot of snide comments from floor nurses and ICU nurses, and I am just trying to figure out what I can do! It seems that the attitude is that I just go in there, plug in a machine, hook em up, and then sit on my butt for 4 hours. I will give it to them, ICU treatments are not difficult and it is very boring, but the rules are the dialysis nurse is NEVER allowed to leave the room, and I mean NEVER. Not even to pee unless someone is watching. I also must defend that there is much more to the machine then just plugging it in and hooking them up. It takes about an hour to safely set up a treatment, and it also takes 3-6 months of training to learn the equipment.
I think that we all have to work together. I like to do things for the patient since I'm in there all morning, but at certain hospitals, I am legally not allowed to even feed them! I think sometimes people think we have the easiest job in the entire field of nursing. But I have to defend that good dialysis nurses make it look easy. You have an inexperienced or lazy dialysis nurse and you will see how messy things can get in a hurry! And regarding sending the patient back with a soiled bed, some units do not have the means, or the privacy to completely change a bed. The unit is out in the open at times and I know at one hospital I've worked at, we didn't even have blankets, let alone sheets, gowns, or anything to clean anyone up with. We are kind of given the bare minimums to function. Also, I cannot carry out physician orders that are not related to dialysis. If I saw a flagged order, I would check it to make sure it wasn't STAT, but legally, most of the time, this is out of our scope of practice. (unless your hospital runs their own dialysis unit and doesn't use the big companies to do their services). Many times, we don't even have an IV pole. It is frustrating for us knowing that the patient has needs that we cannot fix. Also, patients are technically not allowed to eat while they are having treatment. And we are instructed to only check the blood sugar if they are symptomatic. sigh.. I hope you all can understand my frustrations too.
Sometimes I don't think we understand how challenging the other job can be, and let me tell ya, I don't think I could ever be a floor nurse! I really, truly respect the floor and ICU nurses, and the LTACH nurses too. It can't be easy!