Davita Ddialysis Nurse

westieluv · Feb 12, 2014

Okay, so I work for the other of the "Big Two" companies and as such don't know really anything about working for Davita, much less their starting salary in the Las Vegas area, but I do know about transitioning from a busy intermediate care unit in a hospital to dialysis, because that's what I did about a year ago.

I originally started out as an acute dialysis nurse, which means I did dialysis treatments in several hospitals in our area. The hours were extremely long, there was no routine at all, as in, you could work five hours on Monday and 19 hours on Tuesday, depending on which hospital you were at and how many patients rolled into the ER between Monday and Tuesday. Also, we had to be on call for 2-3 nights a week (6pm-6am, and on the same day when we worked during the day which was ROUGH!) and every other weekend. These conditions are pretty much universal in acute dialysis, with possibly less on call hours if you're lucky. That job was definitely not gonna fly with me, so I recently transitioned into a chronic dialysis unit and am working there full-time now.

I remember very, very well how stressful working on the floor at the hospital was. Admissions rolling up all day long, doctors expecting you to drop everything to round with them and hold their hand (figuratively) and then blaming you and everyone else if anything was not as they liked it, etc., etc. However, I have to tell you that working as an RN in a chronic dialysis unit comes with its own types of stress. If Davita is like my company, you have a group of around twenty patients that you case manage. That means that everything pertaining to their care, their treatments, and their other health issues lands on you and you are expected to address it appropriately. The craziest time is first thing in the morning when the first shift of patients rolls in and you have to assess, pass meds, and chart on your group of patients. Then if you're lucky things slow down a bit during first shift treatments until those patients are done and the next shift starts rolling in. They sometimes come in 2-3 at a time, so you are busy, busy getting everyone settled, assessed, and their meds passed. If you are blessed with awesome dialysis techs like I am, it makes a night and day difference in how your day will go. If you have unskilled/lazy/unhappy techs, God help you, because they do the bulk of the actual dialysis treatments, as there's no way the RN could run treatments on ten people and do all of the paperwork, foot checks, rounding with doctors, etc. that we have to do.

Basically, you would be trading one type of stress for another. Personally, I much prefer chronic dialysis to working on the floor and will never, God willing, work in a hospital as a floor nurse again. I am just hoping that I get quicker and more polished at my dialysis job with time and experience, because there is a lot of responsiblity. And if you don't already know dialysis at all, you will have that learning curve as well, which I fortunately didn't have to worry about since I had done acute dialysis. The techs will ask you what you want them to do when someone's blood pressure suddenly crashes or they develop severe leg cramps, because the RN has to approve and document on any changes in the ordered treatment, and you have to feel confident enough to give them instruction on what to do, such as decrease the patient's UF goal (amount of fluid being removed), decrease the temperature of the dialysate (to cause vasoconstriction and increase BP), or give the patient some fluid back.

I don't know what else to say except good luck. I know what life can be like on the floor!

PomPomRN · Feb 13, 2014

Well, unfortunately, I happen to be one who can testify as to how extremely difficult the techs can make your life. I had an episode where I witnessed something very unsafe and pointed it out to the nurse orienting me to my unit. She evidently used my name when she asked the techs not to perform the task in an unsafe manner.

Well, that went over like a fart in church!! The techs no longer speak to me, for any reason, they don't answer the alarms if I am any where in the general vicinity and do not even check the patients vital signs and sign them off. It is making life very difficult as I spoke to my FA and decided at this time I should be the bigger person. However, I would also like to hold on to my license, so I have a lot of thinking to do. And I thank God I only work 3 days a week!!

Hoping it will be much easier on you!

madwife2002, BSN, RN · Feb 15, 2014

There needs to be some sort of discussion going on between you and your manager. This is a form of bullying and cannot be allowed to continue. The potential for causing patients harm could be occurring here, if they do not do the vital signs and sign them off.

Your FA ot HR needs to stop this behavior now

gollybabbler · Feb 16, 2014

I agree with the post above- it's trading one type of stress for another. I used to work ICU and loved it until I needed a break. Now I'm in acutes, and although the hours are just about killing me, the pace is better than ICU. We are on call from twice to five times in 4 weeks (depending on staffing), all on Fri-Sat- or Sun for now. You have to be really flexible, and dependable too, because the same amount of work still has to be done for the day if there are callouts. And I find myself working alone a lot, which suits me, but it may not be for you. Good luck!

Yetzer · Mar 4, 2014

Can anyone tell me what to expect as far as orientation in a DaVita Setting? Sufficient amount? Method? I am an as of yet, NON-prior-clinically employed RN, (Some call us 'new' Grads, other could call us 'Dalit') but am seeking HD work as a start of my more clinical nursing experience. info, thoughts, feedback, pearls of clinical and professional wisdom...?

Sandibeach63 · Mar 20, 2014

\ said:

Can anyone tell me what to expect as far as orientation in a DaVita Setting? Sufficient amount? Method? I am an as of yet NON-prior-clinically employed RN, (Some call us 'new' Grads, other could call us 'Dalit') but am seeking HD work as a start of my more clinical nursing experience. info, thoughts, feedback, pearls of clinical and professional wisdom...?

Hi I work for Davita in Michigan and am a preceptor . If you have no experience in dialysis then you get 90 days of paid training. You work with a technician and learn how to set the machines up , cannulate ( stick ) , catheter care ( some states RN has to do) trouble shoot machines and learn the flow of the clinic. You then go to theory class to really understand dialysis . The culture of clinics are different but policy and procedures are the same and must be followed ! As a RN you the precept with a RN to learn their role . Hope this helps

nitengale166 · Apr 9, 2014

Im new to dialysis after 15 years bedside. Just remember this has its own stressors... Being on call couple times a week, small team... may be a catty bunch, docs could be hard to work with, plus there seems to be alot more responsibilty ... things can go wrong real quickly. Talk to the dialysis nurses at your hosp. Visit the chronic unit. Just remember its all relative

Marshall1 · Apr 10, 2014

I have had an interest in dialysis for sometime and come to this area (dialysis specialty) of allnurses from time to time to see if anything is changes...always hesitate to pursue a dialysis position because it seems that an overwhelming majority of nurses that work dialysis are unhappy/work 14-16 hr shifts, fight with techs etc. or that training is far from one's house or even in another state - which seems odd to me. I wonder how this effects the patients.meaning..they must see/sense the unhappiness/tension among the staff, the staff turn over..are any of the dialysis companies worth a ___? Then I read about nurses working in the hospital setting and it seems the same way now....long shifts, tension...it's been some years since I worked in a hospital so I'm sure things have changed a lot. Just wish there was more positive about dialysis..

NurseRies, BSN, RN · Apr 13, 2014

Marshall1, I believe that most happiness or unhappiness comes from your own attitude towards your job. Although there are some clinics that are like hell on earth, if you work in the hospital (autonomously, I might add), as long as you have a good attitude about your work, you will love it! If 14-16 don't appeal to you, don't be an acute dialysis nurse. But if you can find a good clinic, dialysis is the best!

These forums are often for complaining. People who are happy in their job don't often come onto all nurses and rave about how great things are. I believe there are a lot of happy dialysis nurses, but just like any job, there are ups and downs. Most people that leave dialysis have a poor attitude. Bring a positive outlook and a hard work ethic, and you will love it.

CarlLewisB · Apr 13, 2014

There are A LOT of unhappy, stressed out people working in dialysis clinics. They make so may rule changes that would slow you down if you followed them. Then there is low pay for PCT's in some areas.

The patients are scheduled to start treatment so close to the ones ending treatment which means everyone can not get on or off on time.

Medicare cutting the amount of money they will pay per treatment probably means that staffing will not improve.

The Patient Care Tech to patient ratio seems to be increasing or has no limit in some clinics.

In some clinics the Nurses will not help PCT's put patients on or help get them off.

PCT's must study on off days to keep their certification and read to keep up with changes or study to review Policy and Procedures.

In some clinics, there is animosity, bitterness and hatred between the PCT's and even among nurses in some clinics.

Some Nurses and PCT's are excellent and nice to work with. Others are rude, unprofessional, and hostile.

CarlLewisB · Apr 13, 2014

Working in dialysis clinics can be madness with certain types of staff. By that I mean hateful, unprofessional, and rude PCTs. PCT's will often disappear off the treatment floor often if there is not the kind of Charge Nurse who will not allow that sort of thing. Some may have several mean, rude,bitter insulting, patients. Some patients are so nice and sweet that PCT's and nurses will cry when we get the news that they will no longer be coming too dialysis because they have died. Some clinics have so many patients and not enough staff. Some staff is too slow and others work so fast that it makes the patients nervous. Mistakes sometimes happen when corners are cut in the name of speed. "GET THEN IN, ON THE MACHINES AND GET THEM OFF" is how it is in some dialysis clinics. You are expected to work as fast as if you are on crack. I have seen some corners cut that I dare not mention here.