opinion for seasoned dialysis nurse/manager

[Lacie]

I'm currently the DON of an 11-bed chronic unit. One I didnt apply for at that. Hired for acutes but got stuck in a chronic unit when they fired the previous DON. Been 1 1/2 years now!! Anyway, we have a census of 38-40 varying at this time and open 6 days/week. Not only am I doing all the administrative, careplan, initial assessments, med adjustments, unit issues, staffing I am the charge on the floor 3-4 days aweek. I have one per-diem nurse who sets her own days 1-2 aweek and her last day is this week. We have ran add after add and unable to find an experienced RN to help out. Paperwork and everything else in this unit was months behind when I got drafted so to speak and I finally have most things caught up and on track. Problem I have is I cant get through to the administrator (located at another clinic as her home office) that it's too much for 1 person to do!! In order for me to have a medical procedure done they have to send the DON from another clinic to work for me who is 1 1/2hrs drive so she doesnt exactly volunteer. Shes either not hearing me or doenst want to. I need to determine best way to get it across or I need to head out for other endeavors. They have been cutting my staff to the bone where I also have to take a patient load of 3 when on the floor besides being the only RN and still expect me to do the monthly reports, network issues, orders, fistula first, etc while I take that load. Usually it's me and 2-pcts with 11pts. Oh we arent computerized either and have to hand chart everything. I cant work any harder. Forgot to mention they just made me go salary also so no ot for all the extra bs or hours :angryfire Get comp time sometimes but heck I cant take my pto much less comp time LOL. Am I nuts or is this too too much?

[Lacie, BSN, RN]

Lol oh yes she is!! She hired a new RN who has worked 1 year in Acutes and never has worked a Chronic unit as the new manager and her friend who also has never been in a chronic unit. Staff already called me to tell me how the day went. Can you imagine. She didnt know how to draw up machine heparins and also allowed blood to travel down the who. Was 30min late so patients were in uproar then left for mcdonalds for her breakfast break. How long do you think that will last LOL. Anyway I am so relieved I went to the beach today and layed on my duff with a big smile needless to say. Pretty much decided I'm not going to stay in dialysis after this experience. My health and sanity much more important.

The real kicker is last friday a recruiter called about a new opening in my area for a full time staffer , it was for my clinic LOL!!!!!!

[Tish88]

Lacie,

Who is orienting the acute nurse to the clinic?

She leaves to go to breakfast - was there still a RN in the building?

Did you work for a privately owned dialysis unit or one of the "big" nationwide ones?

[Valerie Salva, BSN, RN]

Good for you, Lacie!

Those of us who care about dialysis and try our best to give good pt care are being used, abused and burnt-out by the big companies.

[Tish88]

Good for you, Lacie!

Those of us who care about dialysis and try our best to give good pt care are being used, abused and burnt-out by the big companies.

Amen to that :angryfire

[Lacie, BSN, RN]

They sent the DON from our sister unit to work with them for 2 days and they are on thier own today:bugeyes: One of my techs call them the Simease Twins since they seem to be joined at the hip. This was KRU Medical Ventures and the smallest clinic in the company (not concerned if a KRU reads this as its the truth). The chairs have huge tears and are duct taped. They use dental chuxs (the little small ones that blood goes through) taped to the back so the duct tape doesnt catch in the patients hair. Never mind the ones on the arms of the chairs we just pour bleach into to cover the blood that gets into them. Paper charting and too many cutbacks!!! A few patients were not there last 2 days due to procedures and out of town and they were already complaining how "difficult" it was. Wait till a full house and only nurse working 6 days. They have only been able to hire "out of towners" since the administrators reputation proceeds her. Wish I had this info before I went there. It's hard but I still think of the patients and already had 2 call me at home terrified to be there and are transferring out to another facility. They told patients that I quit and walked out which is far from the truth. Today I'm going to work in my garden and enjoy my time off while I have it. I need to let my mind have a vacation before going on to new ventures so to speak lol.

[Tish88]

Did you tell any of your patients that you was leaving?

These patients could see the working conditions that you was exposed to and will know that you didn't leave "them".

Maybe more of their patients will leave too and someone higher up will start looking into the situation as to why patients and staff are leaving.

Wasn't there anyone higher up than your administrator who you could contact?

What a shame to loss a good RN :)

[Lacie, BSN, RN]

Well the administrator has gotten away with this for 14 years so no doubt administation already knows and just doesnt care. Even the medical director's exact words to me last week was "I have worked with her 3 years in St. ****** and 6 years here. She is mean and nasty and has ran off too many good nurses here." I did tell some of my patients I was leaving but they didnt expect me to just not be there like it went down. Most patients I didnt have a chance to speak to yet. I know of 3 other managers now she did this same exact pattern with. I even have emails they had sent to her complaining of thier treatment by her. I have copies of all the ones sent to me from her also. Once I secure another position I am copying everyone of them to include the previous managers and sending to corporate. Two of the patients are calling network also and the corporate office. One has an asthma attack the day I left and was calling for me and wouldnt allow the other nurse (this nurse quit at end of day also over this) or administrator to touch her. The administrator was there and delayed calling 911 when the pt requested telling her it was "just an anxiety attack". She didnt call 911 until the pt picked up her own phone to call.

[Tish88]

i never heard of that company, so i google searched them and this is what their website states.

"known in the industry for its dedication and commitment to both the patient and the physician, kmv works in close conjunction with its physician partners to develop some of the most well-respected, state-of-the-art dialysis clinics in the country."

what about dedication and commitment to their staff and nurses!!!!

[Lacie, BSN, RN]

The CEO is the one the administrator answers to and word has it they are very similar in respect to personality. I think the CEO who also is a nurse has been out of the clinical aspect for so very long it only comes down to the bottom $.

[Tish88]

These pts should not only contact their network but the dept of health just on the conditions of the chairs and duct tape - creates such an infection control issue!

If I was the 911 patient, I would be filing a legal complaint on that administrator too.

You ought to be glad that you got out when you did.

[Tish88]

Now would be a good time to call the network and DOH, since things will all be in shambles right now with no one running the place properly.

[Lacie, BSN, RN]

These pts should not only contact their network but the dept of health just on the conditions of the chairs and duct tape - creates such an infection control issue!

If I was the 911 patient, I would be filing a legal complaint on that administrator too.

You ought to be glad that you got out when you did.

I'm talking about huge chunks out of the chairs on the arms large enough to put 2 fist into!! They keep saying we will get new chairs, some of them wont even go into trendlenburg and are malfunctioning. The "new machines" they are trying to move on the floor are H's and older then our Cobes' with more hours. They are switching as the set ups are $1.00 less then the Cobes. Also the H's were set for "trash" but she caught wind of them and had them shipped to us. So far of 14 machines the bio has been able to get one working safe to use. The 911 pt drivesf more 1 1/2hrs to treat at this clinic in order to stay with me as she said I'm the only one she feels save with. She's very young(20's) and very new to dialysis so has been absolutely terrified since it was a medical mistake that put her into renal failure (fleets enema for a colonoscopy). It's situations like hers that makes it hard to make the choices I have but in the long run I had to move on.