osprey

just a short rant; all I want is any report from the floor before they get to me; they complain that we never phone or write report, yet it's ok for them. The other night we got a pt from the floor with a pressure of 69/40; problems breathing; she finally went to ICU from us; the floor finally got back to us with report to say that 3 hours earlier on rounds she was fine; pressure about 104/50. So we are looking at the same thing; we are thinking of a fill in the blanks form that we send to the floor pre, and they have to fill it in and return it with the pt AS WELL AS as verbal report before they leave the floor. Then at least the doctors don't think thay went sour in dialysis.

I agree with the above person. We are fortunate with our LTC pts as before they start hemo; the social workers from the hospital and the facility speak and get alot of the things settled ( like advanced directives ) and the dietician also has spoken with the facility. We encourage them to send in the list of meds being taken every month, this way we know what they are on and they know if we need a new med started or stopped. or held pre hemo. ( like antihypertensives,nitro patches). We also do any bloodwork for them and send them the results, this way less chance of them trying to use a fistula arm by accident.

we isolate them totally; gowns,gloves, masks, the whole deal; we don't bleach between them, but the room is crashed between them; even if its VRE to the next VRE pt. as they can be in varying degrees of getting better. Maybe this is different as I work in a hospital. The clinics around us don't have isolation rooms so if any of their pts get something infectious then they have to come back to their home base till they are clear of any infections. [

I work in an 18 bed unit; both chronic and acute pts. in a hospital. We have both outpatients( not stable enough for the clinics ) and pts from the inpt. population. Our ratio is usually 1 RN to two pts; perhaps 3pts if all are very stable. We have three shifts of pts; the first shift on by 0700 and the last going on about 1800;then some overnight pts and of course the ever present acutes who pop up out of nowhere and need emergency hemo. We have nurses who do 8 hr shift (7-3 or 3-11 and 12hr shifts 07-19 / 19-07) The team leader has no pt assignment on the day shift and more often than not has one on the 3-11 shift. Our usual amount of off units is 2 -3 per day; except the last few weeks we have been up to 9/day. ICU and CSU mainly; with a few od's just to make sure that we could do hemoperfusion. Our orientation is 6 weeks long; class room only for the first week, then both(classs and practical) the next week and then mainly with a perceptor for the last 3 weeks.By the time you are out of orientation, you can do most things, including all trouble shooting, pts and machines and do the 2 pt assignments. We tell them that you won't feel like you really know anything for at least 6 months and feel comfortable in a year. They usually don't do charge for a year and then will also be trained to do the offunits. We also have techs; they do primarily set up off unit machines, but will help in unit to set up machines for the change over times if we are busy; but we do everything; set up, put on, assess, hourly rounds, meds, rounds with MD's, problem solve etc. If its there, we do it. The clinics here have a 1:3 ratio and the pts there have to be really stable or they go back to the home base (hospital) until more stable. Its really great to read these comments and questions from the forums; I'm glad that I found it.

Thanks for the info': how much is nothing to write home about; I am at the top of the scale here at 33.75 Can/hr with 6 weeks paid holidays; how does that compare to florida?

I would really like to get a job in south florida in hemodialysis; I am a canadian with my certificate in nephrology and 13 years experience in acute and chronic pts. Can anybody suggest who I contact for the paperwork. How are the conditions, pay scales etc. Thanks for any help