New to Dialysis - What's the deal?

Specialties Urology

Published

Specializes in Dialysis.

Just recently started working in a chronic care dialysis clinic. I really want to like this job. Why do they tell you that your training will be blah, blah, blah and then you show up and there is no organization, no one REALLY wants to help you and God forbid you should ask someone a question.

I have been in the unit a total of 12 days - over the past month and some of the PCTs have started to talk to me like I'm an idiot. Do we have to put up with this? I understand they are busy and stressed, but I am also stressed considering I only have a short time to learn what I need to know to be a team leader and take care of patients on my own. And not for nothing but I will be held responsible if I make a mistake and also be held responsible for what they are and are not doing for the patients.

It's a lot to learn in a fairly short time, and long days are to be working closely with people in such a negative environment. Besides that I am "following" and being told, "Oh, when you have to do this, you should make sure you are doing it the "right" way". Then I will ask a question if I think someone is doing something different than the way I was shown and they get ****** off! So, how is one to learn the "right" way if all I'm seeing is the "not-so-right" way?

How long is it going to take for me to feel really comfortable?

Nothing helpful to say except this is one of many posts I have seen about horrible dialysis training experiences.

aghhh....I don't have any answer for you but I just want to tell you I hear your frustration!! I applied for rn position in dialysis and I have no experience...so it is so sad to hear your training is not going well...May I ask you which company it is? If you don't feel comfortable to answer, it is totally fine. I hope things get better soon...

Specializes in Med/Surg, Tele, Dialysis, Hospice.

It sounds to me like it's not a problem with the company that you work for but rather with the people that you work with. It sounds like you landed in a bad clinic as far as not having nice, helpful co-workers, but that, unfortunately, can happen in any nursing specialty.

I recently transitioned from acute dialysis to chronic and the people that I work with at the chronic clinic could not be nicer or more helpful. The techs are very skilled and hard working, the manager is terrific and jumps in and helps when we get busy, and the other RNs have been beyond nice and patient with me.

I hope things get better for you. It sounds like there is a lot of negativity where you work and that is sometimes hard to overcome.

Specializes in Dialysis.

@allaboutfun, I sent you a pm.

I too feel it is not the company but the clinic I am in. This particular clinic was recently purchased by one of the big companies and I feel that the employees have been in this clinic since it opened and are not very receptive to the changes, even if they are for the better. It is

sad that they do not respond in a positive manner to new employees, as this will continue to feed into the negative atmosphere. I am not sure who to talk to at the clinic, because I don't think I want to be considered to be the "overly sensitive" new girl.

I am determined to hang in as long as I possibly can. This clinic is super close to my home, and I had to take a paycut to take this job.

Good Luck to everyone. We just have to keep our chins and spirits up!

Oh good Lord, so glad I got out of dialysis after my short six months... not for me...

Specializes in Urology, Nephology, Internal Medicine.

Unfortunately this is how several units are run. I worked as Dialysis RN for over 7 years. Takes about 1 year to really get a grasp on things even with good support. Even as the charge nurse things could get crazy and behaviors even crazier. Settle in and study to determine if this is a good fit for you. If not get out and try something else. At least in nursing you can always transition. The experience will help either way.

Specializes in Nephrology, Dialysis, Plasmapheresis.

You are working in one of those "nightmare clinics". If you are strong enough to hang on, this could be a great learning experience. When I started , my clinic was a mess, 3 nurse managers in 1 year, secretary had quit, no charge nurses, and the techs were ANGRY. They actually told me one day in the lunch room that they are going to make me quit. I felt so discouraged, but I needed that job. I ended up and fought past the mean words and unwillingness to help, and loved my job after about 9 months. The techs came around once they saw I was a team player. The patients began to trust me and I started to get the bigger picture of dialysis, I was no longer terrified of the machine. But let me tell you, it was lonely there for a while. The techs do not take well to new people, mainly bc they see so many nurses come and go, stay 6 months, only to quit. Before they invest their time and training in you, they want to see that you are invested in the clinic and willing to work hard.

I guess my words of advice are that if you can tough it out for a few months, you may end up to love it. The clinic may be a bit of a mess, but a couple of good nurses or techs can turn the attitude of the clinic around by promoting teamwork and not gossiping or adding to the drama. Help out the techs, they work SO HARD. I remember because I worked as a tech for the first year until I was charge. Wipe down a chair, or strip some lines and wipe down a machine so the tech can get the next patient in faster. Do small things for now, like cleaning or stocking. They will take notice. To learn in that environment, you will have to seek out learning opportunities. It is so fast paced that no one has time to really stop and take one hour putting on a patient. So in the mean time, ask to come in early, really early to sting a bunch of machines. Choose one patient a day to put on and take off. It's only been one month, so give it some more time. The techs will come around if you prove that you are a hard worker and don't differentiate yourself from them as a nurse. They may be able to teach you more then the dialysis nurses about a lot of things. Don't be the nurse that wants to push heparin, pass meds, and document. Be the dialysis nurse that is stringing machines, pulling needles if you have a minute, cleaning chairs, and stocking saline. Maybe my everyday, but it's the little things that they will notice. Good luck!!! I love this specialty, if you can get past the first 6 months and like it, you will be so glad you found this specialty!

Specializes in Med/Surg, Tele, Dialysis, Hospice.

I agree with all of what NurseRies said. I am learning a lot just transitioning from acutes to chronics, and I already know dialysis pretty well from working in acutes. If I was brand new to dialysis AND brand new to chronics, I think it would be much harder.

I also agree that you should try to help the techs out whenever you can. Not just to try to get them to like and accept you, but because you truly want to help to lighten their work load. If you help them with a true motive and a giving heart, they will sense that and warm up to you. They do work very hard, I never realized how hard when I worked in acutes because we didn't work with techs in that setting. I cannot believe how quickly they can get patients on and off and turn over the machines for the next patient! I try to help them whenever I can, and I can tell that they appreciate it. We are all in this together, and the more we share the load, the more the patients get good treatments in the optimal amount of time.

Definitely avoid the temptation to gossip, as NurseRies so sagely pointed out, especially since a chronic dialysis unit is a pretty small pond and whatever you say about someone is going to get back to them almost immediately and it will be extremely difficult to work together under those circumstances.

Twelve shifts is such a short amount of time, and you are still learning the basics of dialysis. When I started out in acutes, I fought the temptation to quit for the first couple of months after I was on my own because I didn't feel comfortable or able to to do the job. Confidence and competency only come with time and experience, and both of those only come if you stick it out and don't give up. At this point, I feel like I have found my long term home in chronic dialysis. I love the pace, I love the routine and the fact that there are very few surprises, such as brand new patients being added on unexpectedly all the time like in acutes. I also love the chronic dialysis patients, which I know is definitely not the case with everyone. I can see myself still here in several years.

Best of everything to you!

I agree with all of what NurseRies said. I am learning a lot just transitioning from acutes to chronics and I already know dialysis pretty well from working in acutes. If I was brand new to dialysis AND brand new to chronics, I think it would be much harder. I also agree that you should try to help the techs out whenever you can. Not just to try to get them to like and accept you, but because you truly want to help to lighten their work load. If you help them with a true motive and a giving heart, they will sense that and warm up to you. They do work very hard, I never realized how hard when I worked in acutes because we didn't work with techs in that setting. I cannot believe how quickly they can get patients on and off and turn over the machines for the next patient! I try to help them whenever I can, and I can tell that they appreciate it. We are all in this together, and the more we share the load, the more the patients get good treatments in the optimal amount of time. Definitely avoid the temptation to gossip, as NurseRies so sagely pointed out, especially since a chronic dialysis unit is a pretty small pond and whatever you say about someone is going to get back to them almost immediately and it will be extremely difficult to work together under those circumstances. Twelve shifts is such a short amount of time, and you are still learning the basics of dialysis. When I started out in acutes, I fought the temptation to quit for the first couple of months after I was on my own because I didn't feel comfortable or able to to do the job. Confidence and competency only come with time and experience, and both of those only come if you stick it out and don't give up. At this point, I feel like I have found my long term home in chronic dialysis. I love the pace, I love the routine and the fact that there are very few surprises, such as brand new patients being added on unexpectedly all the time like in acutes. I also love the chronic dialysis patients, which I know is definitely not the case with everyone. I can see myself still here in several years. Best of everything to you![/quote']

I too am new to Dialysis. It's that blasted machine ! I'm terrified of it. I am an LVN going back to school. I like some of the people at my clinic, but find the small pool of nurses and techs to be annoying sometimes with all the back biting and gossip. I did agency for 7 years so that in its self is a big change. I have our big post training test tomorrow and just blank out. I too hope this gets better. I thought dialysis may have been a health field that didn't feel the sting of government efficiency to be fast and treat it as a commodity instead of people. I do like it better than acute nursing if I can just stick it out. I'm taking a major cut in pay to do this and refuse to fail. It just sucks to not be proficient at it.

I do not personally work there, but have heard stories for years now. My wife is now a facility administrator of a dialysis clinic after working on the floor as an RN for years. From what I hear her say, it all comes down to who your coworkers are and how they work together. She's been lucky enough to work in mostly good clinics and the clinic she works in now is doing great and her teammates are being rewarded nicely for it. It still has its ups and downs and people are stressed because it is "season" here in Florida, but she will never do anything else. She loves dialysis. She said the same as a PP said; it takes about a year to become comfortable with dialysis.

Sit down and think about whether you will like the work. Take the coworkers out of it. And think about the job. If you think you will like it, you can always find another clinic or maybe sit down with your FA/Coworkers and discuss the attitudes and discuss ways to assist you as you learn the trade. Good luck with whatever you decide!

I have been a tech in dialysis for a little over 4 years now, and when I finish school I will be working in my unit as a staff nurse. The clinic that I work in has ranged from heaven to hell regarding staffing over the time that I have been there. Sometimes you'll have a nice and easy day, sometime you won't, but most of it depends on the skill of your techs as far as time management and machine turnover and cannulation go. The clinic that I am in is 24 chairs, with 6 techs (if no one calls out) and it can be really tough sometimes, but it really is what you make it. We have had nurses there who are very helpful and will set up a machine, stick a patient, etc.. and it helps us techs out tremendously. There have been others though that choose to have no part and will simply chart and pass meds all day long. If you want to get on the techs good side, seriously just help with even 1 patient during their turnover and it will mean the world.

As far as the machine goes, it looks really complicated, but it really isn't. Yeah it will probably take you a few months to get proficient with setup and operation/programming but after you get it, you got it. Dialysis is very repetitive, it's just getting to that point that's the hard part. Also, learn to troubleshoot the machines sooner rather than later, many things are easily fixed if you just know where to look. Don't give up hope, it gets better! Just remember to help help help!

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