LAL and culturing machines

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Hi All, I have begun a job in an acute HD department in a hospital. The previous supervisor left unexpectedly along with his girlfriend who was the only other nurse in the dept. I am trying to take over and am having problems with finding out how often to do LAL testing and cultures of the R.O. water and the dialysate. I have thus far been doing them both once per month and they are coming back fine. Could any one tell me how often they are to be done? I am ordering some AAMI standards but they are expensive and have to go through a process to get the funding. I am also looking for nurses to work. I am in El Centro, CA (close to San Diego) The pay is great, the docs are wonderful and the hours are very flexible so it is a great job! I just need to get the place back to a reasonable level of function since the leaving of two at once. I am fairly new to dialysis and I am working with all travelers right now from different states etc. and have different ideas of how to do everything! Thanks!

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Specializes in dialysis (mostly) some L&D, Rehab/LTC.

Wow...what a position to be in...don't you have mechanical? Also...what is the pay...Im looking in that direction...but I want $$$ for the sunshine tax...I hold a CA RN license...

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Specializes in hemo and peritoneal dialysis.

Lal's monthly along with monthly cultures before disinfecting. I charge an acute unit in Georgia and love it. You can PM me if you have other questions. Congratulations. It's a great challenge and learning experience.:yeah:

Steve

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Thanks for the update Steve! And to the poster looking in this direction, the pay is based on experience and then there is a $4 added per hour for dialysis, so for me I have 6 years nursing experience and then I get the extra $4 so that brings me to $32/hour. The hospital is owned by the city so we are govt. employees and we get a pension.

let me know if you are interested, and you can look it up online and apply to El Centro Regional Medical Center.

Thanks again@

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Make sure you are also following, completely, the new Conditions which include AAMI standards/guidelines. The bottom line is patient safety so do not do what many do and use shortcuts or bypass those tests that are needed for safety eg culturing. Is El Centro Regional the one that was almost, or yet was, closed by the state several years ago? Also was a huge trial where the surveyors were put on the stand and some were found to have not provided valid information? Heard about it through a friend in that area, but not sure that was the hospital. Aren't there free standing dialysis units also in El Centro like FMC or Davita? RenalRuth:nurse:

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Forgot to ask - Is this a separate unit within a hospital and if so how many chairs/beds or is this where RNs go to the patient's bedside and provide dialysis treatments (for inpatients)? RenalRuth :nurse:

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I have never heard of any problems like that. There are 3 machines right now and we have a large room (old ICU) where we usually bring one or two from the med surg unit. then we take the machines and go upstairs to do the ICU patients. We have 2 7-7 nurses and one 3-11 nurse. The only drawback right now is that each 7-7 nurse has to take call on the days they work from 11pm to 0700. but we get $4 per hour for being on call and time and a half or double time for coming back in.

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Specializes in dialysis (mostly) some L&D, Rehab/LTC.

Well, I've done acutes and that on-call eventually catches up with ya...but then again...the chronics want to make me admit myself to a mental hospital on some days.....:bugeyes:

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The docs are pretty good about not running someone in the night unless they really need it. We probably only do between 3 and 5 patients a day and they only call about once or twice a week at night or on Sunday. I think the most patients in a day were 8. We basically only have one nurse on at a time. It is a pretty small hospital but the winter does get more busy because of the snow birds. There are some Fresenius clinics in town, that is where I worked last for about 7 months. (Had a few surgeries, long story). Anyhoo, they decided that Fresenius charged too much or something so the hospital does it them self now. No, I don't take any shortcuts and the travelers that we have now believe that there is nothing more we are missing..except regular staff. lol. We started putting every one on the monitor since we are in the old ICU because of the advice of one traveler who stated that that is what many other hospitals do. It is nice in a way because we can arrange things any way we want. The boss above me does not know anything about dialysis but she is really great and takes every ones suggestions. She gets things done very fast and spends any amount of money we need to make sure things are getting up to par asap. So all in all, I feel pretty blessed. I have a great boss and we can do whatever we need to do to get the patients cared for and make our own schedule! It is frustrating sometimes because it is harder to learn this way and I am taking on a lot for being so new. but you got to take the bad with the good! When we get fully staffed there will be much less call and they eventually want to expand the program with SLED and other such things that I will also have to learn..LOL Thanks for the replies! Any other advice is appreciated!

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