I'm going to have a phone interview for Davita to start with . I have no dialysis experience. I've done med-surg/tele for the last 7 years.
What pointers do you have for a positive interview? What do I need to know about dialysis going in? What is your favorite thing about being a dialysis nurse. What is the hardest thing about being a dialysis nurse? What qualities make a great dialysis nurse? Anything about Davita I need to know in particular? What specific questions do I need to ask?
Specializes in Cardiac, Nephrology, Emergency Medicine.
Oh to the OP, in my Chronics clinic, I was the only RN for 17 patients, and often had to take a 4 patient assignment on top of that (as I said bad clinic). It is apple and oranges trying to compare Acutes and Chronics. Westiluv described it beautifully.
As a manager let me tell you what I look for. Attitude!!! I can train skills, but I can not make a person nice, empathetic, easy to work with, or a team player. Speak to these personality traits and give examples of when you were a good team player, or comprised in a tough work situation to get things done.
As a manager let me tell you what I look for. Attitude!!! I can train skills, but I can not make a person nice, empathetic, easy to work with, or a team player. Speak to these personality traits and give examples of when you were a good team player, or comprised in a tough work situation to get things done.
That's it. Almost anyone can be trained but are they someone we want to hang around with for most of our waking lives.
Specializes in Cardiac, Nephrology, Emergency Medicine.
Chronic is fast paced and high stress. I recommend working at a larger clinic where you won't be the only nurse.
It varies by company and region as to how many nurses are there in the clinic. In my area with a certain large main provider 20 or less patients you have 1 RN, the other large provider has 2 RN's with 20.
In general I think Acutes is less stressful working conditions than Chronics, however not knowing when you are going home, multiple add and being on call are stressors too.
I am a new grad and had started work at a LTC unit because I couldn't land a job in a hospital. Needless to say I kept my options open because I couldn't see myself crushing meds like a robot for the next 30 years of my life. I have always had an interest in diyalysis and I checked almost everyday at the local dialysis unit in my town to see an openings. Finally one came up and I applied and got an interview. She asked me "do you have phlebotomy skills, what do you know about dialysis," Needless to say it was a tough interview. I told her that I didn't have any phlebotomy skills but have maintained lines and understand the importance of proper technique, etc and that I knew about fluid volumes, electrolyte balances and how they play critical roles in a pt on dialysis. At the LTC place I was at I did run peritoneal dialysis on a pt twice a shift.. so I had a little experience with assessments and I told her that I fought with the MD to get labs drawn every three days because she was getting it twice a shift. I tried to make it look like my in experience was actually a positive thing because I will be an open book ready to be written by them. Also when she asked me what my weakness was I told her that I am a workaholic. lol That could have been why I landed the job. I start in 2 weeks couldn't be more excited and im staying PD at the LTC place to make some extra $$ when I need it. Good luck!
While this is true about the acute patients, as a dialysis nurse, we aren't allowed to touch any of those drips or do anything much besides the dialysis. So if the patient begins going downhill, you sort of bail out and give the blood back and their primary RN will generally take over. You aren't expected to manage their drips.
"Sort of bail and give the blood back?"
Yeesh.
A thinking hemo nurse has at least a rudimentary understanding of the various vasoactive drips, and how to best plan the dialysis treatment around them as they pertain to each patient's unique status.
A thinking/problem solving approach in acute hemo is to head as many problems off at the pass before they occur. Yes, this means one should have an understanding of those drips, and should be able to communicate with docs and ICU nurses in a collaborative manner as the treatment progresses.
The ICU docs/RN's I've worked with are usually pretty happy that I can take this tact. It serves them and the patient well in making the dialysis treatment as efficacious as possible, and avoiding problems.
A thinking hemo nurse has at least a rudimentary understanding of the various vasoactive drips, and how to best plan the dialysis treatment around them as they pertain to each patient's unique status.
A thinking/problem solving approach in acute hemo is to head as many problems off at the pass before they occur. Yes, this means one should have an understanding of those drips, and should be able to communicate with docs and ICU nurses in a collaborative manner as the treatment progresses.
The ICU docs/RN's I've worked with are usually pretty happy that I can take this tact. It serves them and the patient well in making the dialysis treatment as efficacious as possible, and avoiding problems.
It's a delicate dance.
I guess I didn't take that post in the same way that you did. My impression was that the PP was saying that, in spite of your efforts to run a gentle treatment, accommodate the drips, etc., your treatment can still go south if the patient is not able to tolerate HD at all, and at that point all you can do is give their blood back and get out of the way for the ICU staff, or, God forbid, the code team, to do their jobs, since you can't adjust or administer meds unless they are ordered by the nephrologist and pertain to the patient's renal issues.
As much as we try to tweak our treatments to account for Levophed, Cardizem, etc., there are those rare occasions where the patient still doesn't tolerate their treatment and we have no choice but to take them off and call the doc. That's where I think he/she may have been coming from, not from a viewpoint that we just go in and blindly run a treatment without knowing what the drips are for or ignoring the fact that the patient is on them until something happens and then just cut and run. At least I hope that isn't where he/she was coming from!
I am fairly new to acutes, and I always discuss the patient's status and running medications with the staff before starting my treatment, and sometimes they get an order to adjust them based on the fact that the patient will be getting an HD treatment that day. I would assume (hope!) that this is standard practice in acute HD, since HD affects the entire body and is affected by so many medications. I have only had one patient, a very frail, elderly lady with a DNRCC status, react negatively to her treatment to the point where the only safe option was to take her off and call her doc, and the doc thanked me profusely for doing so, so I know that sometimes it can't be helped and is the correct course of action.
I guess I didn't take that post in the same way that you did. My impression was that the PP was saying that in spite of your efforts to run a gentle treatment, accommodate the drips, etc., your treatment can still go south if the patient is not able to tolerate HD at all, and at that point all you can do is give their blood back and get out of the way for the ICU staff, or, God forbid, the code team, to do their jobs, since you can't adjust or administer meds unless they are ordered by the nephrologist and pertain to the patient's renal issues. As much as we try to tweak our treatments to account for Levophed, Cardizem, etc., there are those rare occasions where the patient still doesn't tolerate their treatment and we have no choice but to take them off and call the doc. That's where I think he/she may have been coming from, not from a viewpoint that we just go in and blindly run a treatment without knowing what the drips are for or ignoring the fact that the patient is on them until something happens and then just cut and run. At least I hope that isn't where he/she was coming from! I am fairly new to acutes, and I always discuss the patient's status and running medications with the staff before starting my treatment, and sometimes they get an order to adjust them based on the fact that the patient will be getting an HD treatment that day. I would assume (hope!) that this is standard practice in acute HD, since HD affects the entire body and is affected by so many medications. I have only had one patient, a very frail, elderly lady with a DNRCC status, react negatively to her treatment to the point where the only safe option was to take her off and call her doc, and the doc thanked me profusely for doing so, so I know that sometimes it can't be helped and is the correct course of action.[/quote']
Yes that's definitely what I was referring to---and also that I cannot touch the other drips and rarely does the ICU nurse have time to sit by my side and adjust them as necessary. Sure would be nice if she did! Typically they tend to think that of we are in the room, that's their free time to catch up with work on their other patients.
Coleebee
31 Posts
Oh to the OP, in my Chronics clinic, I was the only RN for 17 patients, and often had to take a 4 patient assignment on top of that (as I said bad clinic). It is apple and oranges trying to compare Acutes and Chronics. Westiluv described it beautifully.