Dialysis

[ConfuseRN]

I'm so confused right now . Question for dialysis nurses . So if you're the only RN in the building but you're still on training but there's another LPN working as a charge nurse , if something happen for that day say for instance pt UF was accidentally turn off so tech decided in order to remove fluid have pt stay additional 2 hours to do sequential in order to remove 3 hours of fluid without notifying the doctor . So since I'm still trainee who will be held accountable for it? The other nurse ? The charge LPN? Is this normal in dialysis ?

[Flatline, BSN, RN]

The title of "charge nurse" is mostly an employer designation. As the individual with the highest level of licensure you are de facto in charge and responsible.

There was a case years ago in a LTC facility where a LPN inserted a Foley with some difficulty. The RN was in the facility but working on another hall with her own assignment. The Foley drainage bag continued to fill with frank blood until the next shift came on when it was discovered. Turns out the the Foley was somehow inserted through the prostate.

The RN being the highest level of licensure within the facility was found to be at fault for not performing an assessment on the patient after the LPN performed the invasive task despite not being in charge nor having any employment authority over the LPN. The way the board and the law saw it was regardless of employment policy, licensure and the duty that comes with it supersedes all.

I think you might be able to still find it in the NSO legal database.

[ConfuseRN]

I'm quitting .. the reason behind it is I feel I'm being used by my FA. Imagine after she put me on schedule as the only RN in the building now she will have me work as a tech for a month while she's training two new tech . I have no problem working as a tech , the problem is since my training been cut short I haven't able to cannulate a lot of people and now she will have me work a pod . I talked to her about how I feel about it . She just didn't listen and doesn't seem to care at all . The tech in my job is great but they make their own decision without even asking the nurse input but then they will document that they notify the nurse even if they didn't .

[Marisette, BSN, RN]

I'm quitting .. the reason behind it is I feel I'm being used by my FA. Imagine after she put me on schedule as the only RN in the building now she will have me work as a tech for a month while she's training two new tech . I have no problem working as a tech , the problem is since my training been cut short I haven't able to cannulate a lot of people and now she will have me work a pod . I talked to her about how I feel about it . She just didn't listen and doesn't seem to care at all . The tech in my job is great but they make their own decision without even asking the nurse input but then they will document that they notify the nurse even if they didn't .

This is not the norm in dialysis. This employer is taking advantage of you. Go with your gut feeling on this one.

[ConfuseRN]

Thank you ! That's exactly what I feel . I'm actively looking for another job . Can't wait to get a new one . It just sad because I like the job but I don't think it's worth the risk.