Duncan6

And this is part of the reason I'm heading back to FMC next month. If it wasn't an infection control issue I might just hug the 2008T,LOL. Staffing is also a huge reason I'm going back. In the almost 2 years I've been here I've only had 1 other nurse for 6 months and she left in January. I'm staying long enough to train the new nurse and that's it. I'm at a rehab hospital and they didn't have a dialysis program previously so there was no one here with dialysis experience to talk them out of Tablo.

Thanks for all the info from everyone. I have used pto for low census in other jobs, but it was more or less left up to us- if I could find legit work I could stay. It just doesn't matter here. I'm still debating staying or going. It's happened twice- once in September and once in October. If it happens again I'll probably have to go elsewhere.

Thanks for the feedback. It sounds like this isn't an uncommon practice. @JKL33 I agree with you. I don't have a lot of good options right now, so I'm staying where I am unless something comes along unexpectedly. It does irritate me that it all seems to be what is beneficial for the company. I'd take it unpaid, but I just can't afford that- espcially as often as it's happened lately.

I've been in nursing 28 years- and this is a new situation for me. I started a job as a dialysis manager at a rehab hospital over a year ago. I spent the majority of the year running dialysis txs by myself and then training a staff nurse. For over a year I couldn't take vacation, call off sick, etc. As of August, my staff nurse was fully trained and I took a week of vacation. The total time I've taken is around 70 hours but, due to being required to use my PTO during low census, I've used 111 hours total this year and only have 32 hours left in my bank. We're at low census again and they want me to cut 20 hours this week. My PRN nurse is talking about quitting because she was told when hired she could get plenty of hours, and now I either take 20 hours of pto myself, or she gets cut for the week. It's frustrating- but is it typical? It seems like an employer shouldn't be able to use my benefits for their gain. Thoughts?

Interviewed but passed on the HT position, ended up also requiring coverage of a clinic over an hour away from home. They do want me to consider coming back to incenter. Tempting but 4am start time and pay decrease is holding me back. However, I am currently on week 3 of no patients. The first week I found a lot to do, now every day I'm trying to figure out how to fill 8 hours. I've been auditing charts and doing the occasional diabetes education when needed, but that doesn't really fill up my day. I spoke with another dialysis manager at a sister clinic in our company and he's on 8 weeks of no patients. I know a lot of people are way too busy and would see it as a relief, but this is painful.

Depends on your area of the country. There are no pay scales or anywhere to find max rates. I don't think they really want you to know. As of 2023 I was making $37 with 20 years of dialysis experience- 28 years total.

The last 5 years I have left and returned to outpatient dialysis twice. The first time I left was just a mistake- I didn't ask the right questions before I took the job. I'm now a dialysis manager at a rehab hospital. Really small program, fairly low stress, pretty good pay. Staffing is a pain, but that's anywhere for the most part. Truthfully, I hate to even complain, but it's kind of boring. I miss outpatient, working with a team, having a full, busy day. I left outpatient mostly because the 4am start time was killing me. I keep in touch with several managers at outpatient clinics due to my current position and I became aware of an opening for a home therapy nurse at one of the clinics and I think I'm interested in pursuing it . I have done some PD, but over 20 years ago. I enjoy the teaching aspect and 1:1. It also would let me have a more regular schedule than HD while being back in strictly dialysis. (I am so not a rehab nurse.) I'm just talking with the manager now- haven't officially applied. My concern is that I've been at my current position for just over a year and I'm starting to think that maybe I'm just looking for something that doesn't exist and I should be happy where I'm at. Maybe it's just nursing in general that I'm dissatisfied with? I don't want to jump to another job and feel the same way I do now in a year. because it's not the job specifically but nursing in general. One good thing is that I don't feel like I'd be leaving the hospital in a bad spot- one of our local acute nurses is chomping at the bit to manage the program and really I think he would be fantastic, so the program wouldn't suffer.

I think that's fairly typical for acutes. When I did acutes- albeit 20 years ago- I often got stuck late into the evening/night with patients coming in the ER, etc. It's why I wouldn't consider doing it anymore.

I would agree with all your assessments of tablo. I had a tmp alarm the other day, I could have worked on it, it most likely just needed flushed and it did an end tx. So frustrating! Outset also pushes cross training. I have not been able to find any hd nurses, and the rehab hospital wants a dialysis nurse that will work the floor also. That didn't happen. No surprise. So they want me to train rehab nurses for dialysis. "Tablo says they can be trained in 4 hours". I don't think so. I have to explain repeatedly how much more there is to learn than just setting up a machine. I've been trying to stay positive with the machine, and there are some things that are good about it, but more often than not I'm frustrated with it.

Wow! So sorry for all of your situations! I'm just checking back in and realizing I had more replies. ? I ended up leaving in July to take a dialysis manager position for a new program in a rehab hospital. Most of the time I love it! I run pt treatments MWF, do my management stuff, some marketing, education, develop curriculum for cross-training rehab nurses to HD, help out with admissions when they need it- so some nice variety. Doing it all by myself right now, but max census for me is 4, so pretty doable- 2 in the morning, 2 in the afternoon. I'm in the process of hiring another one or 2 RNs so I can have some coverage in case I'm sick or actually want to take a vacation-and maybe expand to 6 days a week- but I don't have to be worried about getting called to cover other clinics or call-offs. I work M-F, usually 8-4:30. If I have 2 shifts of patients I might work a 10-12 hour day, but then I can leave early other days, or just take a day off. If I run pts afternoon only, then I don't go in until 9 or so. If I just have 1st shift I come in early, but leave early, too- around 3. There are weeks I don't have any patients at all, so plenty of time to work on all my things. Other than missing my old patients and coworkers, I don't regret leaving the outpatient clinic at all!

@Krissi MacInnis Kelley Thanks for your feedback. I have been with my rehab hosp since July, running treatments since September with Tablo. I have some annoyances and I do prefer a traditional HD machine, but it works for the rehab setting. Did you get any kind of training? Some of your issues have fixes that they should have covered. My company is national and they sent me out to Las Vegas for a week of manager training to run the program and learn the machines. We have a national group of dialysis program managers and we ask each other questions all the time. I also have the Outset customer support for technical issues. I'm sorry you have had such a bad experience! 1. Melting cords should not be happening- can you talk to your facilities director or whoever is over maintenance? I have never had that happen. 2. I had machine issues for a while, but we've worked out the bugs. I do agree it's geared too much for home use- it takes away too much of my clinical judgment and technical know-how. I have to outsmart it and prevent any issues that might arise. 3. I don't mind the uf increments too much, in my setting being within 50ml is acceptable. Acutes may be a different story. 4. The acid cap alarm is weird- do you have a contract with Outset? They have a 24/7 customer support number/email and you should have a Field Service Specialist who can fix those issues. 5. You can recirc- just hit pause treatment, and it will ask if you want to end tx or take a break. Choose take a break and it should walk you through the steps. Just use a recirc cap and makes sure the saline line is open (it already should be) like any other machine. It will leave an option to resume treatment. 6. There is an option to skip the draining into the bag at the end. If you are in the step-by-step mode it will give you the option to drain or skip draining. Before checking it off, click on skip draining and you should be fine. 7. Not sure what the cartridge issue is- I've never had that problem. I know my clinical specialist from Outset recommended that once you push the cartridge into the green bars, use your hand to push the cartridge firmly into place- starting with the venous chamber area and then across finishing with the blood pump area. Maybe that will help? And did they tell you that you can adjust the blood clot timer? You can change it from 3 minutes to 10 minutes to allow you time to work on needle issues, etc without feeling under the gun. That has helped save my sanity more than once. If you have access to tablohub.com it has a lot of training videos on it that may help when issues arise, I believe it also has the user guide. Hope this helps- best of luck to you!

@intergrativenurse Thanks for the info. The concept looks really cool, but I definitely have some concerns.

I know this is an older thread, but any updates on pros/cons of Tablo? Looking at a Dialysis Program Manager position at a small rehab hospital. They are currently using Fresenius, but will be going to Tablo when the FMC contract runs out.

I'm considering changing specialties from dialysis to employee health. Our regional hospital has an opening and after 28 years of nursing, I'm ready for a 9-5 schedule and a more laidback atmosphere. I'm heading into my 50s and don't want to get up at 0300 anymore! I applied for the position, but the description was super general. Is anyone out there working for a hospital that could shed some light on the basic expectations of the job? My background is primarily dialysis (16 years), diabetes education, and I was a clinical coordinator for an endocrinology and weight management practice for a while. Thanks for any information!

Thanks for your feedback! It sounds like we aren't in too bad of shape considering what everyone else is dealing with!