I've grown tired of FMC

[JJohnson]

I've worked at FMC for several years. This is the only dialysis unit I've ever worked at, so I have nothing to compare my experiences with. This is a 30 chair unit, operating two shifts per day. I don't quite know how to word my frustrations, but I'll do my best....

I feel like they (the company, as opposed to the clinic manager) keep shoving more busy work at staff. Some of that does come from in-house. But the majority of my frustrations are from company. "Here's just 'one more' thing for you to do." Foot checks, CIA's, med reviews, admission paperwork, the mandatory education that comes around each year (that I'd have in any specialty....I understand), post-hospitalization forms.....

I'm tired of it. I've been bottling it up. But it's just overflowed in the last few days.

[Hoosier_RN, MSN]

Can you split up some of the busy work? At my clinic, 1 nurse does CIAs, another does foot checks, another does med reviews, the other is the VAM. I dont know how many nurses, or pts total, are at your clinic, but maybe you could find a way to split duties?

[JJohnson]

here’s how the work load is split in this facility:

CIAs/Med reviews: each nurse has approximately 20 patients that they are responsible for doing annual CIA and monthly Med review

Foot checks: we keep a list of diabetics at nurses station. If you are the charge nurse (what we call ‘team leader’), you do what foot checks you are able to do on any given day. Everyone just chips away at list over the month.

Vaccinations (VAM?????) are given by the team leader on the day they are due.
This may be a dumb question....
Do you think that each nurse being solely responsible for one job would be more efficient than the way I've described?
I've never experienced it the way you describe, so I'm asking your opinion.

[Duncan6]

We split up jobs as well. I do foot checks, the other staff nurse does med reconciliations, and the charge does anemia mng and vaccinations. Whoever is there that day handles meds. For CIAs we split pts up alphabetically. The charge nurse rounds with physicians, unless she isn't there and then the staff RN will do it. We only have 3 nurses in a 12 chair clinic that runs 2 shifts 6 days a week. Some of it the paperwork does seem excessive and repetitive. But things like foot checks or not turning over a machine until the 1st patient is completely gone are CMS regulations. Not too much you can do about that. Other things like Schedulewise (don't get me started) are company policy and from my experience haven't proven to really benefit our day or make it safer for patients. The nurses in my clinic have the same frustrations as you. But really, any place you go is going to have some of this.

[Hoosier_RN, MSN]

11 hours ago, JJohnson said:

Vaccinations (VAM?????) are given by the team leader on the day they are due.
This may be a dumb question....
Do you think that each nurse being solely responsible for one job would be more efficient than the way I've described?
I've never experienced it the way you describe, so I'm asking your opinion.

*VAM-vascular access manager...I also forgot anemia manager is my foot check person, but I check

Yes, it's more efficient because you know exactly what you're responsible for, instead of having to hit and miss-you can focus on the 1 task instead of multiple. And if someone isn't pulling their weight, that becomes apparent as well.

FMC has a report for foot checks (diabetics aren't the only ones required, PVD is required also) and per FMC policy, all patients get an annual check now (how that gets done varies by clinic). At least that's what got passed to me (I'm clinic manager).

But no one should feel buried under tasks!

[JJohnson]

I might bring this up just to discuss with other nurses and CM.

While I'm grumbling.... I feel like the patients we have are the most entitled, and demeaning collection of people. This is a staff-wide complaint. Not me just being whiney. I worked in ED and ICU prior to dialysis. I've never had such a large percentage of patients be so frustrating. Do you guys see that, and does it appear to be increasing over time?

[Hoosier_RN, MSN]

Some yes, some no. In 22 years, the most entitled were at this LTC that was staffed horribly and took the patients that no one else would. The male patients would grab on female staff, try to RIP off their clothes, etc. I didn't last long there

[Hoosier_RN, MSN]

13 hours ago, JJohnson said:

I might bring this up just to discuss with other nurses and CM.

While I'm grumbling.... I feel like the patients we have are the most entitled, and demeaning collection of people. This is a staff-wide complaint. Not me just being whiney. I worked in ED and ICU prior to dialysis. I've never had such a large percentage of patients be so frustrating. Do you guys see that, and does it appear to be increasing over time?

But I want to add to my prior comments that yes, they are demanding, but I'm finding that across the spectrum of healthcare, as are many of my friends in the same line of work. Hospitals (acute) support the hotel atmosphere, but the chronic realm is rough, as these folks are under care continuously, and seem to take it out on the caregivers. I know that myself and my social worker have been having more conversations with patients about unacceptable attitudes and comments towards staff. Our nephrologists have been involved as well, so you definitely have a point

[JJohnson]

I've only been in in-center dialysis for a couple years. In that time, unacceptable behavior has grown noticeably. Dietitian, Social work, CM, other nurses all agree. We talk about it fairly regularly now. I could quite easily leave if I had a better option.

[thecookingnursing]

which is the lesser evil? davita or fresenius?

[Hoosier_RN, MSN]

On 11/22/2019 at 3:39 PM, thecookingnursing said:

which is the lesser evil? davita or fresenius?

Both have good and not so good about them. And in each company, clinics vary as well. It comes down to the individual manager, and their direct support, in each clinic, regardless of the company. I love Fresenius!

[AngelKissed857, BSN, RN]

Come over to the Home Dialysis side of things. Entirely different ball of wax- absolutely LOVE my job. PD and HHD are amazing modalities.