rogue_maverick

I'm now planning my exit from dialysis nursing (or perhaps clinical setting at the least). I'm currently working on my MBA (multi-sector healthcare) and after I get my degree, I will bid goodbye to my comfort zone for half a decade. Time for a fresh start and new challenges. I wonder how it feels to be your own boss. :)

@ ceridwyn Of course we do. But the situation nursing in the Philippines is different from that of first world countries. This is the sad reality that Philippine nurses have to go through right after earning the license to practice the profession. So much professional registered nurses, yet not enough healthcare facilities to accomodate them for employment and career growth. And to have a goal of being able to work in hospitals overseas for a better life, employers look at experience. They would definitely hire those with the appropriate clinical experience since they are confident that the professional they are hiring really knows how to get the job done. And how get that valuable experience? it all goes back on being able land a job and start one's career as soon as after nurse registration. If being permanently employed as a full time staff is not possible, then in the meantime (though it may not be ideal) it is a wise move to have those trainings, such as in dialysis, so as not to be idle and better yet gain clinical experience as time passes by. And those trainings in return are venues for possible employment as full time staff in the near future.

In my opinion, the NKTI and Fresenius Medical Care offers the best combination of theory-clinical practice in renal nursing. Why? Because they have a broader scope of training, which includes PD and KT. Prior to the establishment of nephro synergies (the training department of Nephro Group), the training was 90% skills and 10% theory, and there was no formal manner and venue for the theory part. It was mainly on the spot lecture on the principles of hemodialysis. (this was what I went through when I trained with nephro.) Now that nephro synergies is existing, what they did was actually very good since there is now formal educational structure for the training. The drawback though, is cost. What they are asking for now is way way higher than before. (I actually got my training for free.) As what JLlandero mentioned, there is a very good chance to get employed with nephrogroup after the training, since the company is currently in an aggressive state in opening a lot of branches nationwide. Just show your worth right from day one. (I started my career with the company, and like you guys, was a former trainee. i got hired by them even before my training ended due to a timely situation of being understaffed in one of their branches. Then when they opened a new branch, I was one of pioneer staff that started it from scratch. Also, I personally know the Training Director of Nephrogroup as she was my former superior where I last worked.)

Sad to say, but yes. Just look at how many free-standing dialysis unit have opened up in the last 2 years in Metro Manila alone. There's actually an interplay between supply and demand not only concerning the increasing number of patients, but also the massively huge amount of entry level nurses seeking employment. Hospitals are so saturated now with a lot of applications, so nurses turn to other health care facilities, like dialysis centers, for clinical training and employment. Renal facilities take advantage of the oversupply of nurses by providing dialysis nursing training, which at the same time is a big help in their staffing needs. Not that all trainees are being hired immediately after the program, but to have several trainees per shift is such an ease in the daily working efficiency of the renal unit. Just imagine if you have a 16-bed dialysis center, with a ratio of 1 nurse to 4 patients. That will require 4 full time staff nurses per patient shift. But with trainees, lets say 4 per shift, these 4 extra manpower are actually a big help in patient transition, especially if these are already "senior" trainees whom you can allow to work without much supervision. So it's just like that, business people see opportunity and offer a win-win deal. Novice nurses learn dialysis nursing, and renal centers earn from them, with the added benefit of having enough nurses on their units.

Make the most of your training JLLandero.

Precisely. Then at least aspiring renal nurses would be more willing to shell out let's say at 25K or 35k pesos, but exposure would include acute and chronic hemodialysis, PD and CRRT. (Even I would be interested in that.). In short, it would be a COMPLETE renal nursing program. And it would be very good if the curriculum is standardized across all institutions offering renal nursing programs.

Very well said dodoy. High five!

What? 35K? I wasn't aware it was that expensive. Well, that is an amount that you just can't disregard. But it is still your call. Try also inquiring at NKTI. They have a dialysis nursing training that's quite cheaper for the same length of training, at around 26k. The demand for renal nurses are so actually high, especially in Europe and the Caribbean. Where I am working right now, we are understaffed. Sadly, they don't hire much renal nurses from the Philippines due to: 1) issues in recognizing of renal nursing certification. (They don't recognize our RENAP accreditation, I got hired because of my length of experience in dialysis.) 2) very high cost of bringing in expats, example. plane tickets (costs around $2000 for a flight from Manila to Amsterdam, just imagine how much would that cost for let's say, 10 nurses to come all at the same time), accomodation, attractive compensation packages. Another point to consider is, in these countries, renal nursing is a specialization requiring further university education after BSN. The program takes 1 year 8 months to complete, with clinical rotations to CAPD, acute and chronic hemodialysis, CRRT (ICU dialysis), plasmapheresis, and kidney transplant surgery, etc. exposures. So for them, when you call yourself a renal nurse, your should have at least been exposed for a certain number of months in these areas. What we have in the Philippines is only exposure to hemodialysis, and usually at a chronic setting. That's why they don't recognize our RENAP accreditation because we usually get training and experience only in hemodialysis. (Lucky for those working in tertiary hospitals who have CAPD and CRRT treatments modalities).

I have no exact figure, but what I heard, it will be more or less 20k.

Training concerns from metro manila branches of nephrogroup dialysis centers will be handled by one department, nephro synergies. Please do some back reading on this thread, I have provided the link and info regarding orientation schedule and curriculum in the last 3-4 posts. As for absorbing the trainees after the programs, that I have no information yet. You may attend the orientation as posted and you can direct your inquiries to them. Good luck!

But as a renal nurse trained in and who have worked longer in the Philippines than abroad, I still follow the KDOQI guidelines more than the KDIGO.

KDOQI is more followed in the US and countries adapting the US system in terms of renal healthcare delivery, i.e. the Philippines. In Europe (and current and former colonies of European countries) we follow the guidelines of KDIGO (Kidney Disease Improving Global Outcomes) and ERBP (European Renal Best Practice). There are only slight differences in certain guidelines, like for example dialyzer REUSE is a NO in Europe, and the maximum UF rate is computed according the body weight, but in general there more similarities. Here's the website for further reading. Kidney Disease: Improving Global Outcomes (KDIGO)

Nephrogroup Hemodialysis Nursing Curriculum Module 1: Lecture 15 days (5 days a week or 3 weeks) All the relevant theory will be gone over in detail. This will also include simulations Module 2: Monitoring, Observation, and Priming: 15 days (5 days a week or 3 weeks) Exams and quizzes will be administered. Preceptors will be present at all times on the floor. The head nurse or senior staff nurse will be the Clinical Instructors. They will give 15 minute lectures or guidelines before the beginning of every floor session. Module 3: Cannulation and Termination: 30 days ( 6 days a week or 5 weeks) The students will be given several requirements to complete on this term. (Completion Form) This is the most crucial period of their training. Module 4: Skills Mastery 1 (1 month) • A required module for mastery of clinical skills. • After this month, a Certificate of Completion will be given for Dialysis Nurse Training. • Nurses will be given a free RENAP exam review course Module 5: Skills Mastery 2 (Module a, b c) (3 months) • The additional training months are to mainly to assist the nurses in completing the 6 -month apprenticeship requirement of RENAP for accreditation. An evaluation form will have to be made for this purpose. All students who finish the course can register for free in the RENAP reviews. Dialysis Theory Evaluation This is a 2-day course where the students will be evaluated in terms of theoretical knowledge of dialysis. If the student has had previous training or classes, their mastery will show and they can proceed to the next module. This is like an APE (advanced placement exam).

DIALYSIS NURSE TRAINING Orientation Mezzanine, 169 EAST GATE CENTER EDSA, MANDALUYONG (after VRPMMC hospital --formerly Polymedic) Wed 16 May -- 3 to 5 Fri 18 May --- 3 to 5 Sat 19 May --- 10 to 12 Limited slots available! Please email [email protected] to register.

On a similar note, how do you deal with eagerly competitive colleagues? Like the ones who feel and act like they are the charge nurses, to the point that they compete or go against the charge nurse's style of management?