Lpn in dialysis

just keep swimming · Jun 7, 2012

I don't think I understand your role either. Do you have 3-4 patients per shift total or are you running a mod as well as being a nurse?

dialysisnurseLC · Jun 7, 2012

I don't think I understand your role either. Do you have 3-4 patients per shift total or are you running a mod as well as being a nurse?

I have a pod/section...I'm on the flor and do nursing stuff. Are u an lpn as well if so what is ur role in the clinic

dialysisnurseLC · Jun 7, 2012

On another note... Our clinic has never really had Lpns before. Myself and another lpn were the first ones there. Our clinic is in a weird place ie we are trying to Improve things... The other lpn And I both feel there is not enough time in the day to do everything we are supposed to do. She is in charge of immunizations while working a section and trying to get out on time without getting overtime or not having a good patient to tech or nurse ratio.. The only times the techs will update our patients ETc is while we are on break. But our FA does not like us taking work home but that seems like the only way to get things done that need to be done

just keep swimming · Jun 13, 2012

I am not an LPN, I'm an RN. Our unit does not hire LPNs unless they want to work as PCTs since an LPN cannot be alone in the unit without an RN.

I'm not sure if I am understanding you. You say you have a full pt load of 3-4 pts per shift, are on the floor, and are doing nursing stuff. I understand this to be that you run a pod and do medications for your 3-4 pts plus managing MBD for the entire unit. Is that right?

Here is how I see it: You should be able to run 3-4 pts per shift and have plenty of time between turnover to do your MBD work. It's all about managing your time. That being said, the other PCTs who work with you may have to step up and take care of 30min vitals and other responsibilities that are within their scope between turnovers. Do you not have a dietitian? Shouldn't they be in charge of MBD anyway.

Like I said, I don't think I really understand what your daily responsibilities entail.

What is your charge nurse doing if while you do meds? How many chairs do you have? How many staff at one time?

dialysisnurseLC · Jun 13, 2012

Yes we do have a dietician. The charge nurse (an RN) is usually doing other things ie putting in orders calling doctors etc. the other LPN and I draw up and administer the Meds to all the patients ... And our Pct's usually don't help update when we have other things to do. We have 16 chairs. I do charge sometimes because my FA is an RN

dialysisnurseLC · Jun 13, 2012

And I do the water room some mornings... May e I do need better time management

just keep swimming · Jun 13, 2012

I don't think it's you; I think that your unit is definitely not functioning very efficiently though. If there is one RN for 16 chairs and she is not running a pod, she should be able to do all assessments, draw and give all meds, do anemia management, deal with docs rounding and on the phone, enter orders, etc. Now, if she is having an especially busy day, I guess I would expect LPNs to step up and help with meds or orders.

If you are running a pod without being charge, there should be no issue with time even if you have to do the water room and something like vaccination tracking. Vaccination tracking is not something that has to be done every day and you should be able to find time to do it. If you are in charge of MBD but have a dietitian, your role should only go as far as assisting the RD with education on the floor. The RD should be doing all the management of medications and should be determining if there are labs that need to be recollected, etc.

What it sound like is that they hired LPNs to take the strain off of everyone else and have not determined exactly what your role should be. You are part PCT, part nurse, part dietitian....

As for the PCTs not helping you, that should not be a choice. If you are working on something else that has been assigned to you, your teammates need to help you keep up on your checks...that's all there is to it.

I would sit down with your FA and let her know that you are confused about your role and that you would like some help defining it. Just make sure you don't come off as someone who does not want to do any extra work....

Good luck!

madwife2002, BSN, RN · Jun 15, 2012

Nessa you make good points, what we have found at our unit recently is the work load has increased so much the RN's are struggling to manage the way they used to do. The acuity has increased as the patients are becoming older, sicker and less mobile.

The hours of the secretary/receptionist have decreased, so have the hours of the social worker and the dietitian.

This has all had a huge impact on the nurses and increased their workload

The driving force in my unit to be pro active with accesses, KTV monitoring has added to their day because I expect them to be referring to vascular access as soon as problems are identified which I do not believe was a priority in the past for most RN's

When I first worked in chronic unit I found it to be quiet compared to hospital nursing, now I think this is not true.

Although I covered shifts recently as a Tech and as the RN and they were lovely shifts, sometimes it is hard to know if the RN's are just burnt out or if it is as horrible as I am led to believe

dialysisnurseLC · Jun 16, 2012

Thanks nessa for responding..myself and the other lpn agreed that we need to go back to school like now.. We feel like there is no upward mobility or growth for us unless we become RN's

ICAN! · Jun 17, 2012

the lvn at our unit works as a pct with 4 patients, she can also give their medications and if they are catheters she can start and end their tx and do catheter dressing care.

we have a 24 chair unit and the lvn is usually on the side of the room where the charge nurse is so she can help the cn by taking 4, out of 12 of her patients, leaving the cn 8 pts. the other 12 patients are managed by another rn. all our rn's assess, pass meds and are responsible for 12 pts. each (this doesn't include the cia's and other paperwork that we do). this leaves the cn doing the same amount of work with 8 pts plus her charge duties. when the doctors are making rounds the day gets even longer with things to do for both rn's on duty. i don't know if i want to be cn anytime soon although i'm sure she makes a much larger hourly wage than i do.