4everpurple

Yes, for us standard is 2K+ or 3K + baths. We have a non formulary order for 1K+ but it is nephrologist specific, no one in our clinic is on 0K. We are a chronic facility....

I am fairly new to dialysis, hired as a charge RN at a for-profit facility. I have worked briefly in hospital nursing (I gave it the "old college try of 1.5 years). We do not do foot checks, I have not even heard of doing them, though we assess as necessary. We have a glucose meter and standing PRN orders for IV dextrose in an emergency. Even they are for profit, I do not feel like they are pushing cost-cutting any more than the non-profit hospital I worked for. In the hospital, the nurses were rude, competitive and not even helpful. I never got to know my patients, even though i deperately wanted to. I was giving 20 meds to each of 5 different patients every shift and had to trust that the pharmacy was double checking, because I was never able to. I felt lost and small. In my dialysis facility, the number of patients does not vary much, and I already know so much about my patients. I can follow a trend in their blood work such as high potassium, talk to the doctors about it, help the patient before they have a critically high level and get a ton of support from my teammates if I need it. I know in my heart that this is where I was meant to be. It is the best decision I have made. I am sorry you feel that you are being pressured to do things to "add to the bottom line" of your company. Maybe you need to look at a different company. I feel that at my company, everybody matters and has a say in the patients' treatments, from the Administrative Assistants to the PCTS to the RNS and the Clinical Coordinator to the Facility Admin. I have a hard time seeing the down side of this. After my 2 tries in the hospital setting and a few years in pediatric home health care, this is the most rewarding of all of those experiences. I can honestly say I will never leave this field and probably not the company, either. I hope you can find happiness..... Sorry I am rambling a bit, this is my first post and I have strong feelings about this.....