I posted this eight years ago (!):
Nov 27, '09 by wordsmith, ADN, RN
I worked for a doctor-owned facility that was bought out by Davita. There were lots of processes and policies that Davita put in place. OMG...Everyone from Davita was really nice and helped us get this stuff going, but just getting used to it all, holy cow. Lots more paperwork, lots more computer work, way more emphasis on infection control (and we weren't slackers in that dept. before, believe me). They get crazy about measuring heparin down to a 10th of a cc. Our administrator is working 60 hours and is so stressed out, like that other person said, trying to get us what we need and still trying to be a mom, I think eventually she'll quit or go back to being a floor nurse. Overall, though, I think it would be the same for any large company. Benefits are good. Free uniforms, your choice. Pay equitable. Kept same staff. Patients were really anxious and blamed all the changes on Davita even though we kept telling them that many of them were on the new emphasis from Medicare. Whatever.
And now, today, 12/8/17: Boy, did I learn a lot after that. I'd already been working in dialysis three years, and I worked for the two sister clinics five more years, with floating to three other clinics in the state as far as 225 miles away, which was a lot of fun. It's the same thing that other people talk about though--the assembly-line mentality the company has. Every clinic is different, with the tone set by the FA (facility administrator). If the FA isn't organized and interested in making the patient schedule flow well, the whole clinic is disrupted and unorganized. If positions go unfilled and staff are stretched to the breaking point, there's little the FA can do except encourage flagging spirits and tired bodies to keep going. I eventually left DaVita because there was no support for the nurses from the FA, who had been a PCT.
I moved over 200 miles away to take a job with Fresenius (much better $$) and immediately noticed a difference--their staffing was much better--they actually had someone who did labs and stocked supplies for their whole job! I worked on the floor for a bit and then worked in PD for a year until I got an amazing job out of dialysis entirely.
Dialysis is hard work and underappreciated by everyone who has never worked in dialysis. It's a life-sustaining service that gets short shrift from acute care nursing. We have similar problems that floor nurses have. We administer treatments, we give IV antibiotics (frequently in multiples), send patients to the ED when they bottom out (and we don't have a rapid response team, either), and care for fistulas and catheters. I challenge any floor nurse to create a buttonhole access in an established fistula. Just go for it. But, there's so much crap in dialysis, too, and I don't know why. We don't get paid what floor nurses do, and I suspect it's because of Medicare and Medicaid reimbursement rates. But most of the patients make it worth it. If you get into a good clinic with supportive coworkers and a good administrator, and you like the work, stay.