what is it like for other acute nurse

[tracl]

I have worked in acute setting for 5 years. Hospital operated, we continue all care during dialysis (give meds, orders etc). We take turns being on call so sometimes we work as much as 20 hours straight. We have tried to develop a night shift for the past 2 years. But someone will always quit due to job change, relocation, but bottom line is no one likes taking care of ill pts alone in the middle of the night. We are losing alot of our current day staff and night staff. Things seem to be steadily going downhill since we have a new nurse manager. NO communication. Seems like the committed staff put up with alot of being dumped on. We are also now being pulled to a new Long Term Acute Care hospital. The pts are growing rapidly at this facility and it is not set up for dialyzing more than one pt at a time. This place is killing our staffing and there does not seem to be anyone putting forth any efforts to change this. The one bonus as far as pay is we do get double call pay if we work overtime that falls on a weekend. We train our new nurses for 12 weeks in HD and PD, 6 weeks ICU and 1 week CC class so any new nurses coming in won't be on the floor and taking call for 6 months approx. Guess I am venting from frustration, but would also like to know what other acute settings are like.

[happybunny1970]

Wow, that is a far cry from my Acute unit...

We are contracted by the hospital (I work for Fresenius), but they expanded our physical unit some years back... we have a 16 station unit (including one isolation room) and our water runs through the hospital so that we can do bedsides (HD or CRRT) in each of the hospital's 4 ICUs.

Our 'official' hours are 7:30-7:30 (techs come in at 6:30), but we leave when the work is done -- most days we're home for dinner. We have our unit split into 3 bays with 2 RNs and 1-2 techs per bay, plus one ICU nurse (who is the Late Nurse for the day) -- each bay works as a team which I LOVE. One nurse and tech take call every night and two on Sundays.

Our schedule is 7-on/7-off: We work Thur/Fri/Sat (call + one backup call Sunday), then Mon/Tues/Wed. This way, we only actually work 3 days per calendar week, but we get a full week off at a time, which is great for scheduling appointments and trips without draining your PTO bank. There is one Late Nurse each day, and the Late and Call are required to stay until the last patient is complete and transported back to their room, but we often have several stay to pitch in.

Our call works out to about one late and one call day every rotation and a half (or one every 3 weeks), and one Sunday call (Saturday night thru Monday morning) every 3-1/2 months.

Those late days can be exhausting -- this last rotation was intense! But our census seems to cycle, so even though it's high now, it's bound to go down again in the future.

Organization and cooperation is the key... as is hiring the right personalities that can and want to work together. And given the long learning curve, replacing staff is not something you want to have to do too often! I think all dialysis units face that, whether in- or outpatient.

Our system works great for us, and there isn't a single nurse on either rotation that is considering leaving because of the schedule -- in fact, it's one of the main things that retains our staff.

Hope this helps...

[tracl]

Thanks for the invite. I'm in Texas though it would be so great to visit other acute centers. Some of the unfairness comes from the fact that our manager does not do the scheduling we staff nurses take turns, we also do peer evaluations yearly. I feel like this is just asking for negativity. Also shifts some of the responsibility off the manager.

[thomstew]

We have 11 RNs no techs. We cover 5 hospitals. All of our HD runs are at the pts bedside. No primary care, no meds etc. We do HD, PD, CRRT, TPE. All of us work 3 , 12hr shifts but basically work till its done. One RN on call every night so about 3 call nights a month. Good pay, good manager, good co workers...I love my job.