Attitude Problem

Specialties Urology

Published

Hi,

Yea, I'm writing mostly because I'm POed right now. I have been working in a dialysis clinic for the past year while I completed my fourth and final year of nursing school. I just graduated, passed the boards and got a great job in an ICU :) But the job doesn't start until Sept. so I've been perdiem at the dialysis clinic as a tech and will be until Sept. (By the time I would be done with training to work at the clinic as a nurse, it would be time for me to leave). It's been hard to work as a tech even though I'm an RN!

So to get to the point.. over the past year I have very much been turned off by the nurses I work with. Our standard assignments are 3 patients per tech/nurse. However, the night nurse likes to forgoe any assignments and just "take them as they come." This often means that I'll put on/take off 4 or 5 while the nurse does other nursely duties (and chats and eats, etc.) Am I wrong to feel that I should not have to take care of more than 3 patients or is it really the tech's job to do as much patient care as they can so the nurse is free to do.. um... paperwork?

And it really bugs me when all the blood pressures are going off and the nurses completely ignore them and I and the other techs have to run around the room like crazy while they sit there and print up a medication report. Or when as soon as i walk in the door the nurse says "oh good you can have my assignment, bye."

we have this new nurse that is a new RN (associates) training. she hasn't been an RN for more than 2 months and already she has caught this disease. I just feel like these nurses are avoiding the essence of what they do: patient care. They would rather sit around and do paperwork that touch a patient. I had a BP going off for 15 minutes the other day before I got to it.. found the patients BP to be 70/40. The nurse stood by and let it beep for 15 minutes. If this patient had coded it would have been because of the nurse's irresponsibility.

Has anyone else seen this trend in dialysis? It really makes me feel like crap and these nurses.. if anything.. have taught me how NOT to treat techs/cna's/etc.

sorry for the rant!

As a traveler, I bust my butt in all different types of chronic units. Most of the time, I am the only nurse. I rarely ever work with other nurses.

What is getting so old with me is techs who think they are doctors. Thinking they know everything, and telling pts incorrect information and going beyond their scope of practice in giving medical advise, much of which is incorrect.

Recently, a tech disappeared off of the floor. I finally found her- in her car, asleep!

I've found others sleeping in empty conferance rooms. Some pretend they are going to check the water, and they really go outside for a smoke break.

Hardworkers are hardworkers, and crappy workers are crappy workers. It doesn't matter if they are techs, nurses, BSNs or ADNs.

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i am surprised that you are allowed to continue to work there, having passed the boards you are now required to act at the level of your lic. and you havent been oriented to that job...therefore you would be a liability to them...

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well i'm not working as a nurse there because i didn't orient. so for the past month ive been working as a tech even though i'm an RN now. but this is my last week and i start as a staff nurse in a MICU at the end of the month :)

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well i'm not working as a nurse there because i didn't orient. so for the past month ive been working as a tech even though i'm an RN now. but this is my last week and i start as a staff nurse in a MICU at the end of the month :)

I think what pp meant is that you can never really work as a UAP (PCT, CNA, etc) again once you have your nursing license (LPN or RN) because you will legally be held to a higher standard, no matter what title they give you. This puts your license at risk, even if you don't "officially" work as a nurse.

DeLana

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As a traveler, I bust my butt in all different types of chronic units. Most of the time, I am the only nurse. I rarely ever work with other nurses.

What is getting so old with me is techs who think they are doctors. Thinking they know everything, and telling pts incorrect information and going beyond their scope of practice in giving medical advise, much of which is incorrect.

Recently, a tech disappeared off of the floor. I finally found her- in her car, asleep!

I've found others sleeping in empty conferance rooms. Some pretend they are going to check the water, and they really go outside for a smoke break.

Hardworkers are hardworkers, and crappy workers are crappy workers. It doesn't matter if they are techs, nurses, BSNs or ADNs.

I have to second that, in my 5+ years in a chronic unit we had excellent PCTs, LPNs and RNs but also horrible, incompetent, lazy ones with bad attitudes. Most of those, unfortunately, were techs (and one LPN who has been written up so many times it's unreal he still works there - but that's poor leadership at the top. But I digress).

The lines were so blurred - all nurses (including RN team leaders and/or charge nurses) set up/tore down/put on/took off/tested water/dealt with machine problems/cleaned equipment and chairs; it's no wonder that the patients were often confused as to who was a nurse - and the fact that many PCTs called themselves nurses did not help :angryfire And while I never minded doing all these tasks, I minded very much when I overheard PCTs giving patients nursing and medical advice clearly out of their scope (access care would be acceptable, but they were telling them, among other things, what meds to take! In fact, I have even heard some patients say that they were convinced that "X" and "Y" ran the unit - X is a PCT, Y an LPN. (Part of the problem there was, again, poor FA leadership). And not just patients - some float nurses told me that the PCTs ran our clinic!

I have to admit that constant problems with staff with bad attitudes (and lack of empowerment of the nurses to deal with this) is one reason that I'm glad I'm no longer in chronics (it's so different in inpatient/acutes - a unit run by the hospital and staffed with only nurses).

DeLana

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i never thought of it being a liability. i passed my boards the middle of july and my job didn't start until september 24th. i needed to have some kind of income and fresenius wouldn't put me through the training when i would be leaving before it was over.. i haven't been happy working as a pct but i didn't really have any choice.

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I have to second that, in my 5+ years in a chronic unit we had excellent PCTs, LPNs and RNs but also horrible, incompetent, lazy ones with bad attitudes. Most of those, unfortunately, were techs (and one LPN who has been written up so many times it's unreal he still works there - but that's poor leadership at the top. But I digress).

The lines were so blurred - all nurses (including RN team leaders and/or charge nurses) set up/tore down/put on/took off/tested water/dealt with machine problems/cleaned equipment and chairs; it's no wonder that the patients were often confused as to who was a nurse - and the fact that many PCTs called themselves nurses did not help :angryfire And while I never minded doing all these tasks, I minded very much when I overheard PCTs giving patients nursing and medical advice clearly out of their scope (access care would be acceptable, but they were telling them, among other things, what meds to take! In fact, I have even heard some patients say that they were convinced that "X" and "Y" ran the unit - X is a PCT, Y an LPN. (Part of the problem there was, again, poor FA leadership). And not just patients - some float nurses told me that the PCTs ran our clinic!

I have to admit that constant problems with staff with bad attitudes (and lack of empowerment of the nurses to deal with this) is one reason that I'm glad I'm no longer in chronics (it's so different in inpatient/acutes - a unit run by the hospital and staffed with only nurses).

DeLana

Hi DeLana-

Was this an FMC unit? Sounds like typical FMC. In most of their units, the nurses are so overwhelmed with work and so disrespected, that the unit becomes "upside down" meaning it is run by the techs, and the nurses have no power or control over anything. It just does not work when all levels RN/LPN/PCT have the same duties- When RN have to haul jugs and do set ups/tear downs, and PCT are allowed to do "assessments"- that just screws everything up.

I do not have enough acutes experience to do travel acutes, so I am stuck with chronics for now.

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Hi DeLana-

Was this an FMC unit? Sounds like typical FMC. In most of their units, the nurses are so overwhelmed with work and so disrespected, that the unit becomes "upside down" meaning it is run by the techs, and the nurses have no power or control over anything. It just just not work when all levels RN/LPN/PCT have the same duties- When RN have to haul jugs and do set ups/tear downs, and PCT are allowed to do "assessments"- that just screws everything up.

I do not have enough acutes experience to do travel acutes, so I am stuck with chronics for now.

No, Gambro. And I hear that things have only gotten worse under DaVita! :eek: I guess all the big companies are similar :uhoh3: - I'm sure as a travel nurse you have seen it all (judging from some of your posts!)

BTW, if you can work in all these units under difficult conditions (i.e., being the only RN), you can do acutes (I had a coworker in the clinic who had worked as an acute travel HD nurse with no previous hospital experience). In fact, one of the reasons I left outpatient was that the new RD (a :devil: - no exaggeration!) forced all the RNs to take acute call in a community hospital the company covered; with no additional training*! The problem was that we had to do this in addition to our full-time (including every other Sat.) chronics load.

Good luck to you!

DeLana

*Of course, we didn't have to do PD, Gambro's PD nurses were responsible for that.

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Specializes in Dialysis.
No, Gambro. And I hear that things have only gotten worse under DaVita! :eek: I guess all the big companies are similar :uhoh3: -

DeLana

Davita is not the problem. Poor administrators are the problem! I am offended at your statement. Davita is a wonderful company to work for; it all depends on the clinic you work in. FMC, Davita, Renal Ventures--it doesn't matter who it is; as you probably know, there are bad apples in every company! One of my coworkers went acroos town to help out another Davita unit and she said it was a night-and-day difference b/t their clinic and ours. Theirs is a "tech-run clinic", like a previous poster said. One tech in particular knows everything, runs the show, tells the nurses what to do, I am told on this day she even brought the charge nurse to tears! So, it is not what company you work for, but who is in charge, and who you work with that matters. I think we all know that. :angryfire

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DeLana,

Every agency I've contacted re: travel acutes says an RN must have one year recent experience in acutes, and I only have a couple of months.

As many units as I've worked- I've never worked Gambro or DaVita.

I just think the whole dialysis gig is going downhill.

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Specializes in ob/gyn med /surg.

i am a ADN and proud of it. i am sorry you work w/ RN' s like that.. but it will be over soon.. and you can work as the RN you went to all those years of school for. it's a shame some nurses are laxed in their job. they sure arn't setting a good example for the new girl. which is a shame because she dosen't know any better.. hopefully someone will teach her differently. good luck in ICU ..

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[Davita is not the problem. Poor administrators are the problem! I am offended at your statement. Davita is a wonderful company to work for; it all depends on the clinic you work in. FMC, Davita, Renal Ventures--it doesn't matter who it is; as you probably know, there are bad apples in every company! One of my coworkers went acroos town to help out another Davita unit and she said it was a night-and-day difference b/t their clinic and ours. Theirs is a "tech-run clinic", like a previous poster said. One tech in particular knows everything, runs the show, tells the nurses what to do, I am told on this day she even brought the charge nurse to tears! So, it is not what company you work for, but who is in charge, and who you work with that matters. I think we all know that. :angryfire

I am well aware that individual clinics can differ due to their management; I was just referring to the particular clinic I used to work in. Patients from that clinic, as well as a hospital coworker who works there PRN, are keeping me informed. Yes, I'm still interested, because if things improve I might even work there again one day.

When I heard DaVita was buying the company, I had great hopes and thought, maybe they'll get rid of the problem employees (possibly including managers). Soon after the merger, when I no longer worked there, I ran into the manager of a sister clinic who was all excited about DaVita and told me, among other things, how empowered she now was to correct problems with her staff. I thought, great. Maybe things will be better now.

I don't know how it turned out in her clinic, but my former one has definitely not improved, if anything it has gotten worse (from what I can judge based on what I hear). I'm not blaming DaVita, I'm not saying it's a bad company at all (not having worked for them, how could I?)

I know it's hard to change the "dialysis culture", where the lines among different levels of employees (PCTs, LPNs, RNs) are so blurred that it can be difficult to tell who is who. All large companies also very much depend on techs to do much of the work, so they may be tempted to overlook bad attitudes and work habits (to get back to the topic). My first manager, who had opened the clinic, had great hopes to do something about this by hiring new staff (I was among them); unfortunately, she also inherited some bad apples from another clinic and guess what? They ruined what could have been a good thing. Of course, you can't run a dialysis clinic with all new staff, somebody has to have experience... I have to say that this manager was not a strong leader or she would have never allowed these employees to corrupt some new staff.

Yes, management is the key factor. What's the answer? Better management training, better manager selection? Dialysis is also one of the only areas in nursing where you are told "any RN can be a manager with a year or more experience", and I have seen some who were definitely not qualified or leadership material (are they so desperate? This was under Gambro, to clarify.)

What do you think makes the difference at your clinic as opposed to the ones where the techs "are in charge"?

DeLana

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