How can I hate my job?

[FransBevy]

I'm an older RN who has had it up to here with the abuse that most ICHD impose on their staff. I'm done. Every day they load even more BS on to my job and since I'm old I'm savvy enough to recognize that most of what they add on is simply profit-driven baloney. 'Protein supplements' that do nothing for albumin levels? Glucose checks when we don't keep insulin on our formulary? Just for the record, since I own a blood sugar level I refuse to do glucose monitoring if a patient has brought neither insulin or glucose tabs with them. I feel embarrassed when asked to do foot checks on patients who tell me that they won't take their socks off and to quit trying to profit on their disease. I really like my patients and do everything I can do for them but since I'm reality based and pragmatic I've decided that the ladt years left to my working life will NOT be spent driving stock prices up and reality down

[SmilingBluEyes]

My company and CMS do require monthly foot checks. I have caught quite a few problems before they became huge and required amputations----and a couple of times, huge problems that required immediate hospitalization and amputation. Either way, my foot check was the impetus for action in those cases. How is that a bad thing?

[FransBevy]

Hi, How are you, GC?

I've left dialysis. I could no longer manage the workload and I respected my patients too much to subject them to my ambivalence towards the job. The profit driven add-ons were just frosting on the cake. I was giving a protein supplement over months with zero change in albumin levels! That's crazy. Twinsmom seems to be a company lackey but I'm too proud of my work to foist unnecessary tests and treatments just to drive up profit margins.

i've appreciated your wise, seasoned comments and thank you.

[FransBevy]

Twins, give up the company kool-aid and re-read my post. I didn't 'refuse' to do foot checks. My patients are 'refusing' them and I am documenting that. My patients cried when I told them I was leaving dialysis and not because I was 'giving in'. They recognized that I wasn't about to compromise on real care.

[4everpurple]

I am fairly new to dialysis, hired as a charge RN at a for-profit facility. I have worked briefly in hospital nursing (I gave it the "old college try of 1.5 years). We do not do foot checks, I have not even heard of doing them, though we assess as necessary. We have a glucose meter and standing PRN orders for IV dextrose in an emergency. Even they are for profit, I do not feel like they are pushing cost-cutting any more than the non-profit hospital I worked for.

In the hospital, the nurses were rude, competitive and not even helpful. I never got to know my patients, even though i deperately wanted to. I was giving 20 meds to each of 5 different patients every shift and had to trust that the pharmacy was double checking, because I was never able to. I felt lost and small.

In my dialysis facility, the number of patients does not vary much, and I already know so much about my patients. I can follow a trend in their blood work such as high potassium, talk to the doctors about it, help the patient before they have a critically high level and get a ton of support from my teammates if I need it. I know in my heart that this is where I was meant to be. It is the best decision I have made.

I am sorry you feel that you are being pressured to do things to "add to the bottom line" of your company. Maybe you need to look at a different company. I feel that at my company, everybody matters and has a say in the patients' treatments, from the Administrative Assistants to the PCTS to the RNS and the Clinical Coordinator to the Facility Admin.

I have a hard time seeing the down side of this. After my 2 tries in the hospital setting and a few years in pediatric home health care, this is the most rewarding of all of those experiences. I can honestly say I will never leave this field and probably not the company, either.

I hope you can find happiness.....

Sorry I am rambling a bit, this is my first post and I have strong feelings about this.....

[Natkat, BSN, MSN, RN]

Thank you. I needed this today.

I have been been feeling disillusioned with my job and thinking about switching to another specialty. In the past when I would talk about that, my coworkers would say "don't do it. You'll hate it". So I wouldn't. Then lately I have felt so burned out and disillusioned and thinking about a change, but your post snapped me back into reality. No matter how bad my day is, dialysis is still easier to cope with than just about anything else.