MarkTX

Hey RN017! Where are you located? The daily work routine is as follows: Arrive at unit and locate the pile of papers that are orders for the day. See how many nurses are currently working in the unit and how many are doing bedside treatments Decide whether to work in the unit or bedside based on how many treatments are needed of each and how many nurses are working in those roles. Physically take the papers with the orders for the patients I plan to treat that day and begin checking labs/filling out paperwork/talking to doctors about possible changes to treatments based on changes in lab values since the orders were written. Either call a transporter to pick up the first patient or go to the storage room and grab a mobile machine. Turn on the machine and start rinsing (15 minute wait). While rinsing, set up machine for treatment and assess patient. Finish paperwork necessary before treatment. Begin treatment. During treatment: Document vitals every 15 minutes Educate patient regarding maintenance of their access, dietary modifications, treatment options, etc. Remember, some of these people have never had dialysis before. Document dressing changes/meds/I&Os etc in the computer Start looking up labs/orders for next patient After treatment: Return blood, flush catheter/hold fistula/graft until hemostatic, bandage appropriately. Call transport to pick up patient or clean machine and move it to next room. Rinse and repeat. Most acute dialysis units will not hire a nurse with no dialysis experience. Ideally they want someone who has worked in chronic dialysis and the ICU. This has become unrealistic in some areas, my own included. We recently hired a couple new grad nurses with ZERO experience, but we were desperate. I transferred from chronic dialysis and was grateful for the background knowledge. I would highly recommend at least 6 months in a chronic unit just to get really good at placing needles and understanding policies and procedures before you are in such an independent place as acute dialysis. We do 2:1 ratio in the chronic unit. We can do 3:1 if we have a tech. This varies by state and hospital policy. Bedside is 1:1 and is generally ICU or a patient with some type of isolation that they can't come to the unit (think TB or C. diff type of stuff) or if they are generally unstable and we want them close to their nurse. We don't give any meds other than those directly related to dialysis. We don't take any orders for any doctor other than a nephrologist. If a patient needs to go to the bathroom during a treatment and just can't wait, we either give them a urinal/bedpan, or end the treatment early and have their nurse pick them up. A shift can be 5 hours with just one patient or they could beg you to take a 3rd shift and you end up working close to 20 hours. You might think you will only have a 5 hour day, then at the last minute you get orders for a treatment in the ER and you're there another 5. We also have to be on call once a week. The on call person has to be available for times when there is no one available in the hospital to take a stat patient. It could be at ANY tim It pays $50 for a weekday or $75 for a weekend plus your normal pay if you get called in. Just like any part of the nursing world, where you work, who your coworkers are, and who your boss is plays a big role in how happy you will be with your job. I find myself feeling kind of burnt out and generally not very happy with where I am, but the money is good and it really is a good job if that makes sense.

lol. I didn't see the comma between nurse and administrator . Yes. I would not wish FA on anyone.

I'm sure you're right. A recurring theme from every acute nurse I spoke with was lots and and lots of hours and crazy long days. Nurses are ultimately responsible to ensure their patients get the care they need and sometimes that requires an extra long day. Anyone who can't do that needs to find a job that isn't bedside. The occasional 4th shift patient that is going to die without dialysis is expected and understandable. When it becomes a regular occurrence, that's when you need to have a conversation with your manager and be prepared to move on if that is really important to you.

So how's the first semester going? Everyone doing okay?

Sounds like some eastern governors want in on the action They'll need to change the school's name to Governor's Univerisity.

I can't imagine why their program has anything to do with the NCBON. If you were in a prelicensure program that would make perfect sense, but previously you stated you were starting a masters program with no license given. There must be more to the story.

My understanding is that a handful of units still reuse dializers. For whatever reason, EVERYONE is required to be trained regarding reuse safety and every unit has a spill kit for renalin even if they don't reuse. Don't plan on ever being in a reuse clinic/hospital, but it is possible.

I have spoken with several of the acute care nurses. The common theme I've noticed is LOTS and LOTS of hours. One nurse I spoke with said he knew another nurse who cleared $200,000 last year. Obviously the money is great, but he wasn't talking about it in a positive way. I didn't ask specifically about time off, but I think the implication is that they are short on acute care nurses right now and that always makes it difficult to get time off. They also said that for the day they are on call, the generally get called in. There is a maximum amount of PTO you can have (don't remember how much), so they will allow you to cash out once a year. The hospital is where the money is at. I was just given my new position here at the clinic and I will be making $5/hour more in the hospital. The nice thing is that if I have time and choose to pick up hours in the clinic later, it's at the higher rate of pay.

When I initially applied to DaVita I had a phone interview, a panel interview, an interview with the facility administrator, and 2 shadow days at different clinics. Their hiring process is so slow. For the transfer, I just had a telephone interview with a recruiter and a interview with the administrator. Stick with it through the process. It's a pain, but it's worth it. As for machinery, I assume you are talking about dialysis machines. I have only seen Fresenius machines in use. My clinic uses 2008k2 machines, but I've seen some newer models at newer facilities. Water systems vary from clinic to clinic. It's all some form of reverse osmosis.

I actually just graduated from school and have had my license for a few weeks. I'm scheduled to transfer in 4 weeks and was told to expect up to 8 weeks of training to include other modalities such as peritoneal dialysis and apheresis. Starting range for a new grad RN in acutes in Houston is low $30s. 3 days on, one day on call ($50/$75 on call pay for weekdays/weekends respectively), no more than 3 shifts of patients per day. Ratio is 1:1 if it's in the patient's room or 2:1 on the unit. They don't use techs except for patient transport and taking care of machines.

What is a nurse administrator? Is that like a clinical coordinator or a facility administrator?

Hi TravelLusting and NurseRies. I am a RN with DaVita in Texas. They took me on in chronic outpatient as a new grad LVN, paid for my tuition while I was transitioning to RN, built my work schedule around my school schedule, and transferred me to a much better paying acute position in the hospital upon graduation. The benefits are nice and affordable, and they give bonuses twice a year (last year was almost $4000). They give the clinics a lot of autonomy so the experience you have at one clinic could be entirely different than you would have at one just down the street. I would definitely recommend DaVita and have helped several of my classmates get jobs here as well. Once you are a fully trained employee, you can pick up hours at any DaVita clinic (a little more difficult across state lines, but doable). You can try out different units and find one that is best for you, build rapport with the staff, and transfer over when the opportunity presents itself. There are plenty of things I could complain about as well, but they aren't big and I have worked in plenty of other healthcare environments. They ALL have problems.

I was a LVN (Texas version of LPN) and just graduated last month from a transition to RN program at a local community college. The problem with WGU for you is that they give you very little, if any, credit for your LPN license that you worked so hard for (not patronizing, my LVN program was much more difficult that the RN program I just finished). Even at the community college I only saved one semester by having my LVN license. What took a traditional student 4 semesters took me 3 and my LVN program was 3 semesters so I ended up with a total of 6 vs their 4. I was FAR more prepared than most of the traditional students and was making easily twice as much money as most of them working full time during school and while I had a good RN job waiting for me, many of them will have to take entry level RN positions, etc. Who's better off? I don't know. I think I did what was best for me and my family. There is only one LPN-BSN program that I am aware of that is entirely online. It is through Indiana State Nursing: LPN / LVN to BS | DegreeLink | Indiana State University. In my opinion, you are better off finding a local night and weekend program for transition to RN. The increase in pay is significantly more for the LPN-ADN than from ADN to BSN. WGU has, from what my research has found, an amazing RN-BSN/MSN. I will be starting the RN-MSNadmin program in January! As far as babysitters go, there are a lot of resources available for you on base. I'm sure there are lots of moms who are willing to help you. Also, you can easily get the workforce scholarship (federal funds) to pay for your program allowing you to more easily afford to pay for babysitting. Even if you have to take out $15,000 in student loans I promise it will be worth it.

Thanks for your input Jess. I asked my enrollment counselor about the bachelors degree and he said the same thing you did, that they only award a certificate if you need it for employment purposes, but you technically do not get the degree until you finish the MSN. I wonder if it would be cheaper and faster to take a few more credits through WGU with the postmasters option that taking the full MSN at a different school.

Thank you for the thoughtful response Jess6. I wonder if it would be possible to enroll in the RN-MSN program with WGU then stop once you've received your bachelor's degree and get the master's somewhere else. I had a similar conversation with my enrollment counselor. He said that you must finish your MSN, but my understanding with WGU is that with some things, if you don't like what one person is telling you, just ask for someone else :) Anyone try changing to BSN after starting the RN-MSN program at WGU?