workingmomRN

I have been hearing alot of changes coming in the future for dialysis, none sound very good. What have you all heard & how do you think it will affect our careers as dialysis professionals in the future?

Our FA told our staff this week that CMS is going to cut Medicare reimbursements by 2% for sure and is considering a nearly 10% cut that will result in a lot of smaller dialysis clinics closing causing pts to have to travel farther to get their treat...

I have been in dialysis since 2000, started with Fresenius then went to Davita. I have worked in some great clinics & 1 particular clinic that was an absolute hellhole. It is hard work, but I like the relationships that we develop with our pati...

I am considering starting massage therapy classes this fall. I have been an RN for 10 years. I was wondering if massage therapy can be a full-time lucrative career or will it remain as something to do on the side along with a nursing job?

When I started in dialysis, I trained with a PCT to learn about the machines, cannulation, how to troubleshoot the machine when alarms go off. I learned alot from the PCT's I worked with then, and still go to the experienced PCT's if I need to. The...

I agree with your post, but your insights about patients come from years of experience. Our OP may be a young nurse starting out & has not gained these insights yet. Kind words of instruction go a long way rather than being harsh & judgment...

The nurse/patient ratios vary from state to state. In NC, there is no set limit for tech/patient ratio, but the general norm is 4 pts to each tech & 25 patients for 1 nurse. Now, with the new Medicare bundling, etc. we have been told that at t...

I agree with Acute Dialysis RN. You should go ahead & apply for the job. Clinics would like to get nurses with dialysis experience & certification, but there are not alot of them out there. I think that a nurse has to already have some nephr...

These patients with severe hypertension need to control their fluid gains, avoid high sodium foods, & take their bp meds as directed. If they are doing all these things & their bp continues to be high, then the MD needs to adjust their medic...

The clinics that I have worked in used to have ACLS meds at one time & there was discussion a few years ago about requiring nurses to have ACLS certification. But that fell away because there has to be a MD in the building before the meds can be...

Watch the experienced techs & nurses who are good "stickers". They will give you alot of helpful tips to make it easier for you. Sticking accesses is different, but remember that the grafts are made to accommodate larger needles so they can obt...

In my state there are no dialysis training programs. I got a job at a dialysis clinic & got all on the job training. The clinics will train you in everything you need to know, they have classes that cover all of the aspects of the job. Then th...

Davita is not too bad to work for. At my clinic, there are only 2 RN's so we each work 3 days a week. I'm not sure how they schedule at larger clinics, probably 4 10-hour days. Davita likes for employees to get involved in different projects like ...

I agree with the previous posts 100%. Dialysis is not the place for a new grad. You need good assessment skills & the ability to supervise the techs. They can make or break your day, & depending on the size of the clinic, you may be the on...

I've been in dialysis for 10 years & it definitely is not just basic nursing stuff. When I first started, I thought it was the hardest job I had ever done. It still is the hardest job I've ever done at times, but I can't see myself doing anythi...

Rock nurse has described the charge nurse's duties very well. It is a lot of headaches because you are responsible not only for your own patients but for supervising the rest of the team as well. It is hard work, but some nurses are handle it very ...

Try to go with Davita first before FMC. I believe Davita is more patient-oriented than FMC, but it depends on the staff at the individual clinics as to how good or bad it is to work for them. If you can't find a position with either one of them, tr...

585.6 is the code for ESRD stage V, you can use it as well for scheduling procedures such as fistulograms, thrombectomies, that are specific for dialysis pts. Blood cultures can also be 136.9 for unspecified infection The ICD-9 codes listed by dialec...

I wouldn't want to go back to management again, it was for me a horrible experience. It requires alot from you, and you don't really have any time when you are not on call for your clinic. There is a lot of turnover in management with FMC, much mor...

As a medical facility, the dialysis clinic is responsible to provide O2 if the patients need it. Our clinic recently ordered 2 additional oxygen concentrators because we are getting more patients who are dependent on O2. We had one little man who h...

I got a letter from FMC last week about unions. Is there a union trying to get into FMC?

Some of the patients will have c/o CP,SOB, not feeling right, anxiety, etc prior to arresting. Some will not have any symptoms at all. You have to be diligent when they go to sleep because they may not have any obvious symptoms. I always look for ...

I've worked in HD for 10 years & have seen a few codes. It seems like it is always the one you least expect. When you have a relationship with the patient, it is certainly an emotional experience. You also don't really have time to grieve when...

You are exactly right about dialysis. It is a growing population of patients because people are living longer with chronic conditions than ever before. All your previous experience will be alot of help because almost all of the patients have other ...

I have been a nurse for 10 years, but just recently started working in hospice. My PCC recommended the articles that are posted on the hospice nursing forum in this website.