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I've grown tired of FMC

Urology   (665 Views 10 Comments)
by JJohnson JJohnson (New) New Nurse

JJohnson specializes in Dialysis.

52 Profile Views; 4 Posts

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.  

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Hoosier_RN has 20 years experience as a MSN and specializes in LTC, home health, hospice, ICU, ER, dialysis.

3 Followers; 1,598 Posts; 3,374 Profile Views

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?

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JJohnson specializes in Dialysis.

4 Posts; 52 Profile Views

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.

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Duncan6 has 21 years experience and specializes in Dialysis, Diabetes Education.

30 Posts; 1,181 Profile Views

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.  

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Hoosier_RN has 20 years experience as a MSN and specializes in LTC, home health, hospice, ICU, ER, dialysis.

3 Followers; 1,598 Posts; 3,374 Profile Views

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!

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JJohnson specializes in Dialysis.

4 Posts; 52 Profile Views

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?

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Hoosier_RN has 20 years experience as a MSN and specializes in LTC, home health, hospice, ICU, ER, dialysis.

3 Followers; 1,598 Posts; 3,374 Profile Views

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

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Hoosier_RN has 20 years experience as a MSN and specializes in LTC, home health, hospice, ICU, ER, dialysis.

3 Followers; 1,598 Posts; 3,374 Profile Views

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

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JJohnson specializes in Dialysis.

4 Posts; 52 Profile Views

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.

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12 Posts; 1,170 Profile Views

which is the lesser evil? davita or fresenius?

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