New to Dialysis-Please enlighten me

[Hadassah]

Hello experienced HD nurses,

I've only been in dialysis for 6 months and the road has not been easy at all. I went to orientation and Nursing training classes and what's happening in my clinic is not what I learned in those classes. The patients and techs run the floor not the nurse. I attempted to put some order and organization in the clinic with lots of resistance from the staff. The techs stop talking to me if I ask them to do something or if I try to reinforce some safety policy and procedure. I respect their dialysis knowledge and experience but why do we operate outside the policies and procedures so much. Is it my clinic or is it the dialysis world in general? I've been very honest with my F.A about my concerns and states that she will support me 100% but she's hardly ever there as she's running more than one clinic. I'm not trying to be difficult but I can't work for a company or clinic where people do whatever they want and where I let the techs use my license to run the clinic. Please give me a little hope!!!!

[idodialysis]

Hello. I would be cautious about depending on the FAs word that she will back you up. I've worked in dialysis over 23 years in all settings ( acute, chronic, home, manager, staff RN). If something goes wrong they will throw you under the bus as the RN in charge. Put your concerns in writing to your FA and copy your educator, quality manager and regional manager. Offer suggestions for correction but make it clear that you need their buy in and support to accomplish any improvement. I would also request in writing to be present at the QAPI meeting and present your concerns to the Medical Director.

[BSNRNJILES]

Hello , I have been in Nephrology for over 15 years in various roles(tech, LPN, Charge as an LPN and now an educator). My advice to you is move on...your license is only valued by the company as long as you can work . This is your career. It's not worth the headache, risk or stress. Techs are the hub of that facility but the nurse is the authority. Any thing that transpire is on you. I have had my share of experiences and while I appreciate them , I do not miss the floor at all....You can copy the chain of commands only to find out patient care is not really the focus, unless you make a fatal error. I am sorry to be the truth serum about this specialty.

[Hadassah]

Thank you so much idodialysis for taking the time to help me and give me your thoughts. Expressing my concerns in writing is a good idea but I don't know if it's worth the fight. Everyone seems to know about what truly goes on but act like they don't really know. They all say to go 'be the change' when in reality it's almost impossible to do since there's so much to change. Thank you again!

[Hadassah]

Kidneypreneur,

thank you for your honest answer. Moving on is truly what I've been thinking of lately. The stress and constant aggravation is too much and I definitely do not want to put my license on the line like that.

[Chisca, RN]

I blame Kent Thiry. And KT/V.