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If you are not comfortable with talking with the techs and other people working under you license you need to talk with your manager. I have a lot of the same issues in my clinic. Most of the same mistakes (wrong dialysate flow, BF, forgetting to set goal or turning it on, etc) are made because of the fast pace environment that the techs are in. A lot of the time I will only have 4 techs on the floor, 1 charge RN, and one new staff nurse on the floor for 22 pts. The nurse is responsible for everything the techs do, so you just have to double check everything that they do. Make rounds soon after each pt is put on to make sure assessment is complete, and machines are set correctly. If you see things that are not being done right, you need to pull that person aside and talk to them, you dont have to be rude. Just acknowledege that you know that they may feel like they are being rushed, but tell them the importance of the dialysis perscription, and the reason it needs to be set per orders. I really encourage the techs that I work with to make rounds on the pt after they are put on the machine to make sure everything is set correctly. I tell them to come to me if they are feeling rushed so I can help them in anyway possible. Maybe since you feel new and uncomfortable you should talk with your manager, or bring it up in a nursing meeting or staff meeting.

Can all the dialysis nurses tell me what companies you currently work for and what you think of the company overall. You can include any previous companies that you worked at. I am just interested in comparing all the choices available. Thanks so much!

When I started out my orientation in dialysis I oriented with a PCT for the setting up the machine and sticking pts part of the orientation. My orientation with the PCT last 4 wks. After that I oriented with a nurse and learned the nursing part, for 2 wks.

Thanks for the great reply. Everyone has made me feel better. :) I think my week all by myself as a tech has made me feel better. It went pretty well. I think I just need to have more confidence in myself. I always seem to be hard on myself. I am starting my nurse training in the morning, and I am very excited. I really like dialysis and I want to stay in it for long term, thats why I want to make sure I am getting good training at the start. How long was everyones nursing training when they first started? My nurse manager says it will be 2 wks. Is that average? Thanks so much.

So far this week is going ok. I am able to handle about 2-3 pts in a timely manner. The other techs help me out a lot. I feel confident with everything I am doing, I just am as not fast, and I guess that will come with time. I am just doing the best I can do! My nurse manager said that I am going to start my nurse training next week.

I had 12 wks orientation at my hospital. I didn't feel really confident for about a yr.

It is the Nurse manager of the clinic that has the expectations for me to beable to handle a pod of four pts by myself. I have told her that I am worried that I will fall behind , but she told me that I need to bable to handle a pod of four pts without working with my preceptor, and really didn't give me any other options. I am NOT looking forward to next week at all. I am going to have to rely on other techs to help me with shift change, and they already have enough to do. The clinic I am working at is a clinic owned by a group of doctors. Everyone tells me that speed will come later and not to worry, but then why am I being put in this situation? I do like the pts at this clinic and the techs and nurses are great (very friendly and helpful) but they just have GREAT expectations for me. I am just freaking out about next wk being all by myself, I am actullay loosing sleep over it. I cant just leave because I dont know where else to work. The only other dialysis place in my area in Davita, and I dont think they are hiring. I guess I am gong to have to tough out next wk. Should I talk to my nurse manager again? Thanks for everyones post.

someone...anyone?

Hi. I am an RN with 1 yr experience in a busy medsurg floor. I recently left that floor for a dialysis clinic. I really think I like it at this clinic. I am still in training with a tech (learning machines, sticking pts, troubleshooting, etc...). I am in my 5th and final wk of tech training and at the end of this wk I am expected to beable to handle a pod of 4 pts all by myself with eveything the tech does (put on, take off, break down and set up machines and stick the pt.) There is 15 minutes allowed with each pt before the next one comes in. The problem is I am not able to handle this load of 4 pts in a timely manner. I feel confident in performing all the skills, I am just not fast enough. I am getting very frustrated because I have high expectations for myself and I feel I am failing. I was able to handle 7 pts on medsurg why cant I do this? I am wondering if this is the job for me, maybe I just am not cut out for it. I really do find it interesting and enjoy the pts and roles the nurses have. What has everyones experiences been when they first started there new dialysis job for the first time? Another question is my manager told me that my nursing training is going to be two wks. Is this average for a nurse who has no dialysis experience? It will be a total of 7 wks with tech and nurse training put together. Thanks for reading this! I look forward to everyone s answers.

When people need dialysis there kidneys are not able to excrete the waste that there body produces and it builds up in the blood. This is called uremia (urine in the blood). When these levels are very elevated in the blood it comes through the skin causing a frost. That could have possibly been what you were seeing on the wash cloth. It also cause very itchy skin that can appear tan/yellowish. I hope this helps with your question.

I think it is a good idea to get at least 1 yr medsurg experience. I learned so much working on a medsurg floor. You work with different types of pts everyday with many different medical problems and illnesses. People with ESRD have multiple medical issues and working on a medsurg floor lets you work with all these different types of problems, see the medications that they are recieving, and the treatment they are recieving from doctors and nurses. I think you will feel more confident and prepared for many different situations that can arise while a pt is on dialysis if you work on a medsurg floor first. I dont think you would have a hard time getting a dilaysis job without previous experience. The dilaysis clinics in my area happily higher new grads. Usually what I have seen with home care is that employers what a nurse with experience in medsurg. Medsurg is difficult at times but it made me a more confident nurse.

Hi. The interview went really well. I took the job. The starting pay for nurses with no dialysis experience is about the same as I was making at nights at the med-surg floor I am currently working on, so I was happy with that. It is an outpt clinic owned by a group of doctors. They offer a great training program that is a few wks classroom, 5 wks with a tech, and then 4-6 mnths with an RN. All the nurses I met where happy and said that the loved their job. I am really excited. I have already bought a dialysis review book so I can be a step ahead before I start the class.

Hi. Just want to say hello to everyone. This is a great site with a lot of great informaition. SO, I am going to have an interview next wk at a dialysis clinic in the austin tx area. I currently am working nights and cant handle that anymore. I want to have a normal life again!:wink2: So my question is how much do you think the starting salary for a new dialysis RN at an outpt clinic would be. I have 1 yr medsurg experience and currently make 19 dollars an hr plus a 3 dollar diff. for nights (so really 22 dollars and hr). I just want to get an idea before I go to my interview. What is the most important thing to look at to see if this would be a great dialysis clinic to work at? I want a job that I can stay a long time at and not feel burned out in a yr. Thanks for all your help!! I will keep everyone updated!