encouragement needed

**RosesrReder, BSN, MSN, RN** · Dec 28, 2005

Best wishes to you and much success in the upcoming new year.

karenlouise · Dec 31, 2005

I can't believe the attitude!! It takes way longer than 3 weeks to feel confident and if you do think you are off your learners permit at that point...well a little knowledge is a dangerous thing. I've been on the dialysis unit 5 years now but I don't think I felt easy about it for 3 months! There is so much to learn and no matter how experienced you are in other fields, even if you are a super-nurse, in dialysis you start at the beginnng again! At least that's how it is in Australia. I'm just about to start my Masters degree in renal nursing so I'll really find out how much I don't know!! Ignore her if you can and hang in there...it's a valuable skill, there's more than one dialysis centre in the world and the field is expanding really quickly...

Also I know of no other field where the patients watch everything you do and compare notes...horrible of her to dis you in front of a pt...but they tend to have the staff sussed so they probably feel for you! Can you choose to ''put on'' certain patients? If you can...and pick some easygoing smart friendly ones..they will be very supportive and boost your confidence a lot

yvonne b · Jan 1, 2006

fof encouragement, i too feilt i was all thumbs when i came to dialysis from icu, iwas trained by a tech. i'v been in dialysis now 5 years now and would not trade it for anthing. just hang in there before long you will get the hang of it. i am now training new dialysis nurses and enjoying ever new thing that comes my way. my manager had me train for 6 mos but i knew the basic in 3 mos. we nurses eat our young. don't let her run you away. you bring much knowledge to dialysis that the tech and lpn don't have . god bless stay in there it will get easier. :saint: yvonneb

TaraGenX · Jan 1, 2006

Hi,

Sorry youre having such a bad time with this"preceptor". When I started in Dialysis, as a tech might I add..i was paired up with someone for 6 weeks!!! Then once I became a nurse went to a different facility and worked with some old co-workers, and literally had a 3 hour orientation, and that all said "oh its just like falling off a bike and getting back on" YEAH RIGHT!!! Dialysis is a whole different setting. PLease ask me if you have any questions, I LOVE DIALYSIS!! And the machine SUCK!!! what machines do you have? maybe i can give you some pointers

mtnmom · Jan 2, 2006

you all are so sweet and encouraging. I am just so stressed...I dont know if I am past the point of no return. I am having major sleeping trouble which of course is not conducive to learning. I am a nervous wreck.

The other day my "preceptor" told me I was doing the machine right but I just had to get faster or else I would be way behind when I took my own load. I explained that I am not a speed demon, and that I am always slow when learning a new skill.

You are right, there is a lot of attitude and also a lot of very unprofessional conduct in my opinion. The nurse training me uses profanity freely - in front of patients too. the other day the whole staff was joking around with a "whoopee cushion" playing jokes on patients and their families. They thought I was too uptight because I didnt think it was in good taste.

Oh well I better try (ha) to get some sleep before heading to the lions den tomorrow. I am already getting nervous thinking about it. I wish they would just go ahead and fire me and put me out of my misery. I cannot quit.

Dialysisgirl · Jan 6, 2006

Hi, I have been a dialysis rn for about a year and a half. It was a good six months before I stopped asking other staff to "check over" the way I set the machine up,ect. I was told by my preceptor it would take a good year to feel very comfortable with everything. She was right!! But I still have days I may not place a needle quite right or ask someone for their opinion. I was not setting up a machine fromstart to finish by myself in two weeks,but now I amone of the fastest at setting the machine up accurately. I have worked in ICU, L&D,postpartum, newborn nursery and now dialysis. I am very content with dialysis and feel like this area of nursing is my calling. The tech you said is very good that works with you. Ask the tech questions also, I learned a lot fromthe techs I work with. Most important--Keep your head up and go slow!! Mistakes are too easy to make when you try to rush through things.

Farkinott, RN · Jan 8, 2006

I feel sorry for you that you had such a poor preceptor. It's no good being allocated to teach when you don't want too! Personally i love it teaching, but then again I also refuse to rush when teaching a new colleague. ' The rest of the team needs to opick up the slack created by the extra time required to tute a novice. Nobody in my workplace complains about this thankfully, but then again, the sooner someone is up to speed then the workload becomes normal again. We need to give novices time, more time and a fair go! As others have posted it takes time to become comfortable and competent. As a profession we need to be nice to our new chums so they stay in the field!

Kelden17 · Jan 14, 2006

I know this reply might be a little late, but hopefully you hung in there still. I can't believe the treatment you are getting. I have been a clinical preceptor for a few years now with Reanl Care Group (which was just bought by FMC) And We have an extensive training program. It is 10 weeks of class and clinical time and then you are allowwed another week with the preceptor if needed. I does take a while to learn the machines. Use notecards if you have to. Anyway, I'm sorry about your experience. Hopefully it is better. We need as much help as we can get in dialysis.

Kelly in AZ

Renate · Feb 5, 2006

Hello, I am in my second week of my new dialysis job and really enjoy the work but am having a tough time learning the machine. The nurse that I have been paired with to train is not the most patient...she keeps saying how she always has to train the new staff and it slows her down, how she should get paid extra to train but does not. I have gotten no feedback about how I am doing so today I came out and asked her point blank.
Her reply was "well (other nurse in clinic) learned it in 3 weeks". I then asked her was I behind or a slow learner in her eyes and she replied "yes, most people have it figured out by now".
What is the typical learning curve for someone changing to dialysis from another field? I am a BSN with 5 yrs total experience if that matters at all...it does not seem to matter, though, as far as I can tell. My "trainer" is an LPN who has been doing it for about 9 years I think.
i am not going to let her get me down. The ironic thing is that right now I am the only RN in the clinic since the other one resigned right before I came due to a family crisis.
I just need some reassurance that I am not "slow", or maybe someone else to tell me that I am not learning fast enough...then I can take it.

2 weeks is nothing! Dont worry about being behind, everyone gets it eventually and it will be at your own pace. I called in sick on my 3rd day of training and went to sleep every night hearing the machine alarms!!

I have been in dialysis now since the late 80's and wouldnt trade it for (almost) anything. I am a staff educator so I know what I'm talking about. Sometimes people who train forget where they come from. I think this is because dialysis gets to be so routine at times that we forget how long it took us to learn the machines. Good Luck in your new position.:blushkiss

Trvln Nurse, RN · Feb 15, 2006

Well....it is obvious that all of us with dialysis experience can't believe the treatment you are getting. We all know and agree that it takes about 6 months to really start feeling comfortable. Geeze....at three weeks...I was still busy blowing caps off the dialyzer because I left the clamps closed, etc. I look back at it now and laugh...but it wasn't funny at the time. I always joke with the new people in training "dialysis is all about the clamps"....but also give them tips and pointers to help them avoid air in the system, blood spills...and most importantly...to work safely...speed comes later. I have worked for both RCG and Fresenius...both in Acutes and in Chronics. I have my BSN in nursing....and can't help but wondering from your story if the bad treatment you are receiving might be out of pure old jelousy....as this LPN realizes that once you are proficient....you will be the likely canidate for promotions. It is too bad that you are not getting the training and support you are entitled too. Things are different from one clinic to another.....is transferring an option? How are things going for you now? Best of luck to you....hang in there. I've worked in several areas of nursing and really enjoy dialysis....but it did take 6 months to a year to feel both comfortable and proficient with it. So give yourself a little time and work with the techs who will help and support you....stay clear from those who don't. Your nursing degree and experience will come in handy for patient care in outpatient dialysis as these patients typically have a lot of comorbities and need proactive experienced nurses to be their advocates for needed care as well as access management. So hang in there.

mtnmom · Feb 16, 2006

thank you all for the support. Overall it has been a horrible experience in many ways, not the least of which is financially (it takes a few weeks to get any nursing job, with the background checks, etc....the wheels move slowly).

Even more so than the financial sting my ego is shattered. I do firmly believe that these 2 lpn's were in some way jealous...I tried my best to be nice and a team player, but I could just not join in with nor condone the unprofessional behavior I saw daily...and I think they resented that too. Besides the HIPPA violations and daily vulgarity there were "double entendres" toward some of the male patients that I was uncomfortable with.

I had always really been interested in ESRD and dialysis, and this experience has soured me from ever wanting to work in the field. I have to hold on to the faith that God has better things in store for me, maybe this was a pathway to something better.

Anyway, what can I do to help the patients in this clinic be treated more professionally? What type of agency regulates the clinics, etc....I did report the behaviors to the office manager (who is not even a nurse) who managed the clinic from a remote location. The mgr sounded receptive to hearing my comments, even thanked me...said that she had no idea...but how do I know she will act on it?

I cant help but think what if my family member had to have dialysis in that place. I'm sorry but I find it hard to believe that all 20-something patients in that clinic find that sickening behavior funny. I wonder how many just chuckle along because they feel that they have to.

I suppose it is time to let the whole thing go unless anyone thinks of a constructive way that I can help these patients.

Again, thanks for the support.

tinamacRN · Feb 23, 2006

It is very sad to hear stories such as yours...but they happen entirely too frequently. I had 17 years nursing experience when I went into dialysis 6 years ago. I quickly found that it was a totally different type of nursing. Three months after joining the company, the DON quit, and I was left as the only RN in the facility with both incenter and acute programs. The staff all had long years of experience and I was the "outsider". Needless to say, I was not welcomed with open arms. It was a battle at times, but I managed to stick it out and carve out my place. I used my index cards, cheat sheets, etc... until I had learned the fundamental skills necessary to safely dialyze patients. I met with alot of resistance, but I liked the field and refused to give in or up. It was definately a trial by fire, but I am so glad I stayed with it. I have been clinic manager now for 5 1/2 years and am very proud to say that my clinic received a zero deficiency state inspection last year. I am truly sorry that you received the negative treatment you did. Dialysis needs caring nurses.