opinion for seasoned dialysis nurse/manager

Specialties Urology

Published

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?

Specializes in Dialysis (acute & chronic).

I don't even think they are making parts for the H's or Cobe C3's any more. That clinic is going to be like a scrape yard, using machines for parts to keep the ones on the floor running.

I have looked at H's and C3's on ebay with the starting bid at $1.

We have the Phoenix machines in my clinic and I think they are junk - we should have went with the K's. I think they are more user friendly.

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Specializes in Dialysis (acute & chronic).

Lacie,

As far as the chair with holes like that, the department of health would have a field day with them and handing out citations.

Is there any other clinic closer that those patients could go to or are the "kind of" stuck going there?

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Specializes in jack of all trades.

Situation is the neph here is great!! Knows his patients without looking at a chart, young, smart and puts himself on the pt level for communication. The other clinics dont have this advantage with a couple of Neph's who wont even carry a stethoscope much less touch a pt. The other choices of clinics is Davita and this area well are run very much on the conveyor belt mentality. Many of my patients have been in the other clinics and left to come to mine or were booted out of the others for noncompliance knowing they wont get booted from KRU's.

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Specializes in Dialysis (acute & chronic).
Situation is the neph here is great!! Knows his patients without looking at a chart, young, smart and puts himself on the pt level for communication. The other clinics dont have this advantage with a couple of Neph's who wont even carry a stethoscope much less touch a pt. The other choices of clinics is Davita and this area well are run very much on the conveyor belt mentality. Many of my patients have been in the other clinics and left to come to mine or were booted out of the others for noncompliance knowing they wont get booted from KRU's.

I have some good nephrologist too.

If KRU is physician driven clinics, the neph there should be standing up to the administrator as to how she is treating her managers and how often the this clinic is losing managers.

You would think the neph would want a manager to stay for as long as possible for the continuity of care for their patients.

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Specializes in jack of all trades.

Tish and Val I want to say thanks so much for the support and responses you have given here. The one place I can vent without the retaliation factor in play. I have an interview on Monday regarding a position overseeing 2 group homes for developementally disabled. Each home has 6 beds. This is a whole new world in nursing for me as I've pretty much decided to stay out of dialysis. So far it's been 2 clinics with either the converyor belt mentality or just a real sucky admin lol. I wasnt terminated nor did I really completely resign as I did offer to remain as staff and move to acutes which was my original contract with the company. I guess they call it constructive discharge since I left due to conditions and thier failure to honor my contract. I'm not sure how to explain this and not be deragatory to my previous employer or sound long winded. I'm pretty tough bird so to speak so I never regret anything but turn things around to be either a learning experience or most of time it just makes a better nurse and person out of me in the long run.

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Specializes in Dialysis.

Whew! I think one step into the building and inspectors would shut it down! We had a patient complaint (was not justified, the family is crazy) and inspector ended up staying 2 weeks for a full-on survey! "Well, you haven't had federal in over 5 years, so it's time anyway." Agh! There are clinics all over this city that can't take Medicare patients or hire new staff or basically do anything because they are waiting on YOU to survey them!

We passed with flying colors though. Main "dings" were in the charts and records. The Floor passed everything!

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Specializes in Dialysis (acute & chronic).

You are welcome Lacie and let us know how everything goes with your new adventure - you can still visit us here in RENAL!!!

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You're welcome, Lacie. Keep us updated. :)

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