sissib

they are probably checking Hep B titer. Have you had the HepB vaccine series? Did you sign a consent for them to draw your blood?

Most places you do not have to "give up" your license to work as a tech. I would try other facilities. I assume if you work as a tech for over 1 yr your LPN license would become inactive unless you take a part time job as LPN in addition to dialysis tech. Techs usually do water room opening and closing duties, preparing machines, preparing patients for treatment, start pt tx's, monitor pt BP Q 30 min, return pt blood post tx vs. ++++ many more duties.

Some pt's we would recommend they not take their BP meds on day of dialysis if they always come in with low BP. Our Dr's wrote standing orders to do that. I would not send anyone home with BP

This is certainly not what families need to be going through. I am starting my first HH private duty position next month with agency that does mostly peds. I have noticed about every 3 months they are begging for staff. Give me a schedule and I will work it and not call in if I am dead.

Yes, speak to your supervisor. Most HH co's will assist families with getting room AC just for the patient. That must me hard on the patient also. If pt is ill enough to require private duty nurse, then needs AC during hot summer months. Just sayin

Keep in mind the new federal reg's for incenter chronic hemodialysis. That will now drive the "$ meaning more than Pt care" that is now happening all over the country now. Some units are encouraging pts to go home hemo, because the dialysis centers can make more profit. I worked in a non profit facility and they were even talking to pts about home hemo. They are now dialyzing more pts than ever in their history. I love dialysis and plan on traveling someday and hope there is still a market for that. If you like dialysis, just hang in there and see what happens, go with the flow. Jobs are not a plentiful as it may seem.

The best advice I can give is stay there and tough it out. In this economy all other nursing jobs are so stressed out, feel like they are pulled in 10 directions at once. You have your whole career in front of you and this could lead to something a lot more interesting than you may see right now. Hang in there and keep doing a fabulous job!

I feel for you. I worked in a Nonprofit facility. 28 pts, 4 rn/lpn's and 6 techs. There would also be a charge nurse to answer the phone and sit on her butt. I would have at least 2 UTI's per year. We did get our breaks and then if we got a chance we would run back to break room to take a drink or to bathroom. ONE bathroom for staff, that includes 3 biomed staff, usually a line waiting to get into br. Management won't even listen to complaints at all. I love dialysis but sounds as if they are all the same, with lots of problems and risks to our licenses. I am thinking about traveling that way I don't have to be in anyplace long enough to put up with the downside of dialysis.

How important pt compliance is with diet, fluid restriction, and taking their meds as directed.

The best time to eat is not while on the dialysis machine. Some of pt's blood is in the bloodlines, while eating, a lot of blood goes to digestive system. That leaves brain and heart:redbeathe short of blood, then blood pressures drop to dangerous levels.

Try a non profit unit. The one I work in used to be pretty bad, but all new management has got us up to full staff. One Rn per 7 pts and one tech or lpn with the rn, then we usually have a float tech or lpn between 2 teams. All our patients get on treatment on time and the second pt shift gets on timely manner now too. 10 hr shifts and we are usually out on time, maybe 30 minutes over occasionally. Our pts are happy now too.

Dialysis is all this and more. Especially LPN. You will need your nursing skills and tech skills too. I too was LPN only 2 years when I went to dialysis and I do not regret one day I spend there. Sure there will be days from ____, but those are everywhere. To me this is rewarding and hope I can do this for as long as my career lasts. One other PLUS is it is a VERY specific skill and you will be able to find a job everywhere you go, including lots of travel nursing opps. My friend is in Hawaii now for her second time. She is begging me to start traveling with her. This is also as close to intensive care that an LPN can get, if you enjoy that sort of thing. Good luck in whatever your choice is!

Yes, we had one pt that kept messing with her needles while on tx causing her to bleed all over, we documented verrrryyyyy well and the doc had her sent to psych for 96 hr hold and then she was not allowed to come back. She went to the other unit in town and they made her husband sit with her all during tx and she eventually was booted out there, reasons unknown. Pt # 2 was doing cocaine and became violent with staff and other pts, police called x2 and sent to psych x2 and now he is in an nursing home and has to take court ordered risperdal and he still comes to us but is no longer agitated.

Yep, the rolling coolers are great. They would fill them with ice from our ice machine until the machine "broke". No ice machine for 6 months and they are complaining, "when will we get our ice machine back?". They think we are a full service restaurant, "will you go to the waiting room and get me a cup of coffee?" .... "with cream?" Hope the ice machine never comes back. They tell the pts it will and tell us it never will. Keep them coming with rolling coolers!!!! Love your description!!!

I love your response, GeauxNursing! We have a guy who brings his roll up camping mattress to put in the chair, luck has it his loyal wife has to carry it in and out and roll it up. Next, they will bring their whole bedrooms and fridges. lol, thanks for the laugh.

I am LPN in dialysis for 8 months. We do everything RN does except IV push meds (state regulation). And then we also do everything the techs do too. I think all this differs at each facility. Just ask about these things when interviewing if you do not feel you can do both. I do not mind because I feel this experience will also be valuable to me in the future.

Thanks, Delana, for your reply. Our managment staff seems to have problems too. I have seen 3 nurse managers and 2 clinical directors and last administrator leave in 7 months. I love dialysis the pt to nurse relationships and the technical aspects. Current managment just had a nurse meeting with us and promised this would improve. They have even got the HR dept of the hospital involved and they are to have a Tech mtg next week. I will stay long enough to see if this helps get rid of the ones that are the worst. There are some that can change with some encouragement but the others are too far gone to have any hope for. Even our travelers threatened to leave after 2 days when they experienced the techs insubordination when it comes to patient care. Thanks for your advise though. I am looking at going back to LTC which pays more than dialysis. At least the aids in LTC understand.

Sounds very typical for a dialysis unit. I see a lot of information on this specialty of techs running the unit. We have no unit clerk or janitor and our cleaning crew will not empty the hazardous trash. I am an LPN in dialysis 7 months and am still trying to get used to the insubordination of the techs. RN's and LPN's both do all the above tasks including the water room tasks too. None of the licensed staff asks a tech to do anything we have not done ourselves. The management keeps saying changes are coming but have not seen this completed since I have been there. Sounds like a thing licensed staff has to put up with if they want to work in dialysis. I know I am becoming very discouraged with this too.

I have gone thru similar situation x2 at same facility. I felt I was set up but they could not prove where the meds were taken. The RN who counted with me took home a 1/2 full bottle of Roxanol and went on a week vacation. I never saw or heard what happened to the missing bottle or narc sheet and she still works there. I documented every word, dates, & times everything happened. I later heard after I left there, another LPN was taking oxycontin that she was getting from the facility. I even told the DON I felt I was being set up and she could not look me in the eye or say anything. I would be calling the pharmacy myself to have them fax you a copy of the delivery sheet that was signed by receiving nurse. Protect yourself at all costs. Document, document, document. Hope your situation is resolved soon, so your worries can be dismissed.

After working in both, I will take dialysis anyday! We are busy all day and not always crazy but dialysis can keep you on your toes. Those patients can go bad very fast. Your nursing assessment skills and IV skills will be the ones you will use the most. Ltc is repetitious and boring, lot of accuchecks, insulins, and creams to heels and butts plus putting up with the administrative bull. In dialysis you can actually concentrate on using your nursing skills. I will retire if someone told me I haaaavvvvvveee to work in LTC again. I love it in dialysis. Good luck with whatever you decide!

I had a similar situation, I was honest at all interviews but not specific about the details, they don't need details and most do not want details. I told them I was fired without any sort of formal warning to give me a chance to correct the action. That way I did not bash former DON. Good luck and forget about that place, if they can't give you a chance to correct your actions then I would not want to work for them. You can find something better now.

You are normal, don't give up yet, ask your manager if you can switch mentors before you decide you can't do this. I have a great trainer and have had a couple others fill in on her days off. There is a difference. Get your quality in threading and priming your machines first before you let anyone rush you, your speed will come naturally as time goes on. Don't worry too much about the nursing part now, nursing is nursing. Our trainer gave us a refresher course of 2 classes in (2 days) of the process the kidneys and that kind of brought it to light. I hated osmosis and filtration in nursing school but it really hits home when you are actually using it daily. This is my second week on the floor, my trainer usually gives me 2 machines to prime during change over, and today I actually set one up without asking questions, then I also finished one she had started too. I have not stuck anyone yet, just put on and take off ones with catheters. Changing catheter dressings, etc. Where I work, nurses and techs all do everything, they work as a team always, change over is very hectic but if the staff can't work as team it is even harder. Hope you don't give up on this sounds like you really want this to work. Good luck!

Sounds like a lot of undercurrent with upper management there that is not visible to staff. Good luck, but not all facilities are that bad. We got new DON and so far she fired one nurse, cause she did not like her, she tried to set her up but the nurses good documentation helped her. but she was still fired. Then DON snapped at SW and she quit, never to return. SW had been there for 18 years. Then the ADON quit due to DON doing things that were not ethical regarding firing employees. Your choice to stay or go, but good luck and watch your back.

I was just hired to start work in chronic dialysis facility. I shadowed an RN there this week and I think I will like it but wow it looks overwhelming! I start the 11th and will be precepted by a tech. Their techs look to be verrrrry good and know a lot. Wish me luck! Thanks:)

Glad you enjoy your LTC job. It sounds like a fabulous place to work. CMT's and wound nurses and unit clerks too! And only 10 residents. Majority of LTC is the nurse does it all and have 25-42 residents, so if you like LTC you better stay at that facility. You realllllllly lucked out on that facility. Good Luck!!!