zimm4er

you were right to not want to do this. Dialysis is a speciality just like Surgical nursing. I would not feel comfortable in your world. The jug a liquid is acid, it can have different potassium. Then you add the packets to change the bath to what the doctor ordered. The packets come in different Potassium amounts. Unless you are in dialysis this is too much too be doing on the fly.

If you are used to sticking that is the main point. Your preceptor should have you sticking "easy" people to get you confidence up. Don't think about the needle size, you are not the onw getting stuck. Pt's that have been stuck a lot don't really feel it as much as you and I would. Just remember to rotate your sites--I work in acutes now and how I hate to see people come in with four holes in their access. Go slow to start with. You will be sticking the same people every other day--so you will get to know their access well. This is your first week??? Be ready for the feelings of I know nothing, but you do--You are a Nurse. Good Luck :yeah::yeah:

Ditto to tish. I do not come in unless I am called by my nephrologist. If I did they would give me hell.

I agree with the respect. Often it is the old nonlicesed vs licensed butting heads. In nursing often the nonlicensed person has been there so long they really do know a lot, and often tey teach you the ropes. Of course they usually are not able to think holistically regarding the patient.

Dialysis is a real specialty. I worked renal transplant-urology-gi for 10 years before I went to dialysis. It made my assessment skills stellar. Also, helped me learn to formulate plan of cares and what to call a doctor for. I am a firm believer inthat when I call my doc that I know what I want. I am just a firm believer in getting some basic med surg after school to refine your skills and what you have been taught. just my 2 cents

I totally agree with the above post. Hemodialysis is much more than it looks. To truely be good takes lots of "practice." AN ICU patient is not where they should ne practicing. The one thing you brought up is the ICU staff at my hospital would not be willing, and would scream out of their scope of practice. After 5 years of sled most nurses are able to troubleshoot mostly on their own. As you know there are those on bost ends of the spectrum--those that are great and I call sled savvy and those that can't even return the blood or do hardly any troubleshooting and think you are their dog. Your administrators are also not thinking about the $$$$--why give away part of your job that brings in lot's of revenue. Two big issues that usually get admin --pt safety and revenue. will stick with sleds and hemodialysis. thank you very muvh

The hospital based acute unit I work at has been Davita. RAI got the contract for the next year. What can I expect. Mainl;y I just want my same staff ratios, same pay, Pto , and then I would like a retirement plan with matching. Thanks for all you input I know I will recieve.

our call back is determined by the md. We do get the cvvhd calls, but we always know who has to be reset up if they clot off before 1000 pom or who can wait to the next day. This can vary from md to md. We have two different services, and they function very differently. Our main problem is doing late treatments because they got a new line and Interventionals always seems to put our pt 's on last. :banghead:

we use the fresinus K machine with a micro chip. We turn the blood flow to 200, and the dialysate flow to 200 also. We run replacemnt fluids of Ns at 200 ml /hour into the art/venous chambers. Nothing to weigh, measure or calibrate. We just use our standard nicarb, adjust the bicarb on the machine to the drs orders. Usually we use a 4k, 2.5 ca bath with 1meq mg. We use this on adults and babies. We get excellent clearance and all the ICU nurses are responsible for are writing numbers down every hour, and changing the replacement bags as needed. They are taught how to troubleshoot some, and return if the system is clotting. We reset up as needed. I really do like this method --it works well for the pt and is low maintance for the Icu nurse,

I also work for davita, but I was "bought out" from a private pay hospital system. So I am not sure what is old policy vs. true davita policy. We get $3.00 per hour just to carry the beeper. Then every time you get called in--wheter it be for some stupid ten minoute machine kicking--gurantee 3hours pay. If it is longer then the three hours you get time and 1/2 for how ever many hour. So in theory I could get called back in 5 times --get 15 hours of pay and only really spend 10 hours there--of course this is a FANTASY also. Sounds like they are trying to screw you though.

I work in davita acutes--I like my job. Lots of variety. and autonomy. If I have questions regarding my patient or want to change my orders, I talk to my nephrologist within minutes. The hours are long, when you include call and call back. This all depends upon the physician groupo you work for. Some will call you for stupid things like a K of 6.0, ainstead of giving them Kayelate. I don't particularly like my boss or the company, but I am not sure there is any for profit company that is truely good to work for.

we lock all our dialysis lines with 5000units/ml heparin--whatever the loading volume is

:angryfire My unit was sold to Davita about 18 months ago, it has not been a happy transition, to say the least. Now the davita buying gambro comes up--I am okay with that. Now the Fed Trade Comm. says in my city Davita needs to sell two units--either a gambro or a davita. So who does davita decide to sell, of course my units, instead of any of the gambro units. I am so angry, we get dragged thru the mud, have to learn davita ways. Every week it is something new or we are gettting to many hours. We have been given more and more responsiblities--ie acute pd plus their call. Then they take overtime away unless you work over 40 hours. I am a part-time person, so I can work till 1100 at noc and not get overtime---that is a kick in the butt. I went to a staff meeting last week and it was just all negative stuff. What happened to the village and we are one big family. Although nobody here likes davita---who do we want to buy us. It could be worse, I've heard fresenius or rcg.