CocoaGirl

I had my CNN for several years, but decided it was too time consuming & expensive to maintain the 60 CEU's. There is no reimbursment from my employer for seminars, journals etc. & It is hard to find free CEU'S related to nephrology. There is no pay incentive to be certified other than "personal satisfaction". Before we were acquired by FMC all of the RN's were CNN certified & we would rotate each year who got to attend the ANNA conference....all expenses paid. Ahh those were the days

I feel that the staff RN(s) get the short end of the stick, so to speak, especially if you are the only nurse beside the clinical mgr. The RN is required to fill in for the PCT when they are off, but if the CM can't fill in for you then you can't have off. I was once informed that I couldn't have my vacation time off, that had been approved months in advance, because of a meeting that she had to attend. Well guess what....I went on my vacation as planned. Staffing coverage is NOT my responsibility. Staffing is cut so short that it is a chronic problem with this company. I do not believe there is a written policy about this matter.

If you are employed by FMC you are not allowed to transfuse in the outpatient clinic. This is a HUGE issue for our patients because they have to go to the lab to have a T&CM drawn (another needle stick). The patient will have to go the next day to infusion services have an IV started (yet another needle stick) & sit for 4 - 6 hours to receive the blood. Why? because of reimbursement issues. We used to draw the T&CM during dialysis, send the specimen to the lab & if no issues with blood availability we would transfuse that day during treatment or during the next treatment. The hospital would bring us the blood & it was so simple for the patient.

I have always been curious WHY FMC is not considered a Monopoly in the industry. FMC has the market in its back pocket since it manufactures their own machines, dialyzers, saline. They own Phoslo, Venofer & want us to push our patients to utilize the FMC pharmacy for their meds. The company acquires hundreds of independant dialysis facilities & now they are jumping into the vascular access business.

I can't say you will be on your feet all day, but it will be 95% of the time (unless you are lucky to get a pee break or a lunch). The RN does pre & post nursing assessments on all patients, administers all meds, sets up & tears down machines. Not to mention taking your own assignment of patients to start treatment on, monitor during tx & take them off. Most of the time you are the ONLY RN or licensed staff in the building. We have to do ALL the nursing paperwork, med reviews, diabetic foot checks, lab reviews, physician orders, order supplies & meds. UGH I'm tired just thinking about all I have to do.

I have been through a Fresenius acquisition, our unit was private & was bought out by FMC. It was a nightmare and still is, be prepared that staff who quit will not be replaced. Almost all of our support staff were let go: HR, unit clerk, receptionist etc. You will work short staffed, have LOTS of extra duties to take on and have limited support from upper management. The PCT's have had to pick up ALL of the water system testing & checks, mixing bicarb, doing pt labs, filing, chart audits, faxing (all the secretarial duties), stocking supplies, putting away the huge pallets of supplies when the truck comes etc. This is in ADDITION to taking a full pt assignment. Our unit has 3 techs & only one nurse. Sadly, you will learn very quickly that profit comes before patients & patient care.

Telling someone their patient is "Tachy". That usually gets a look or two.

FMC is famous for not being totally up front with potential employees about hours, traveling & training. Only certain facilities are training facilities & if you are hired for a different facility you WILL have to travel to the training facility for some of your orientation. Ten hour shifts often turn into 14+ hour shifts because a third shift gets added. Sorry, but this is reality at FMC.

Yep......the extra day(s) off is so not worth it because of the ridiculous hours that we work. I would really love to do the ten hour shifts I was hired for.

Sounds like we work for the same company. I know what you mean about having two 30 min breaks deducted when you don't even get to take one break. These hours are killer, I couldn't do two days in a row.

We work 13-15 hour shifts Mon, Wed & Fri. The days are very long, non-stop & there is no such thing as a 30 minute lunch break. (Even though the company knows we can't take longer than 10 mins) we still get 30 mins deducted. I could not do this job if I didn't have the next day off to recouperate.

The foot rests were removed last week & the patients do NOT like it at all. Our patients can't push themselves back in their chairs, their legs dangle and it is just uncomfortable for them. Each patient was given a memo that was written by corporate about the reasoning behind the removal of the foot rests & we have encouraged each of them to call the listed number to complain. What about the "patient rights" that CMS has indicated in the conditions for coverage?

The footrests in our area will be removed by technical ASAP according to the latest memo. Each unit will have to purchase "portable" foot stools for staff to tote around for each pt to use to get into their chair. I don't believe that they will be used for pts to rest their feet on since we will only be getting one or two of them for the whole unit. The entire issue makes zero sense & corporate just need let the footrests alone. I'm not privy to all the details of the accident that occurred to make this come about, but my guess would be that if there had been adequate staff (that was not rushed) the incident may have been prevented.

Are there any infection control recommendations for caring for a C-Diff positive patient in the chronic setting? Our unit has an alert & oriented nursing home resident who is obese & requires a hoyer lift to transfer into & out of the dialysis chair. Due to the hoyer lift size it will not fit into the patient bathroom. The resident is incontinent of foul, liquid stool that soils through their adult brief & clothing almost every treatment day. The patient is colonized with c-diff and has had treatment multiple times. We have been instructed by the area manager (non-medical) & the clinical manager that this patient will be changed in the chair by the staff when this occurs. There is no isolation room, this is an open unit with patients only a few feet away. (of course we put up privacy curtains during the changing process). Sometimes the stool ends up all over the hoyer sling & hemo chair. It is gross & smells up the whole unit, but what really concerns me is the risk to other patients. The alcohol based hand sanitizers are NOT effective against the clostridium spores. It takes a minimum of 3 staff members to do this changing process due to the size & immobility of the patient. (we only have 4 staff in the unit, period). We suggested that if the patient is incontinent to send them back to the nursing home and dialyze the next day at another unit since we are only a 3 day a week clinic. The patient would have an 45 minute drive back to the nursing home & have another 45 minute drive back to our unit. I feel like the clinical manager is not taking the risk to staff or the other patients seriously. Any suggestions??????

Management did away with our pillows & cases (our pillows were only 1 yr old & in excellent shape). The clinical manager put out a memo to each pt about the pillows being an "infection control issue" and they are to now provide their own pillows from home. We have had several patients ask how bringing stuff from home will improve infection control. The staff were specifically warned not to mention to the patients that the reason was the cost for the disposable pillow cases. So now not only do we work with bare bones staffing but now we have to deal with patients bringing in black garbage bags full of their belongings into the treatment area. I'm not joking about the garbage bags, some bring in two pillows (one for their head & one for their arm), one sometimes two blankets, their snacks, ice, headphones etc. I agree that bringing things from home is just gross (some of our patients hygiene is just not good). FMC is all profit driven, management could care less about patient comfort or safety, their actions toward patients speak volumes.