FransBevy

Sounds very unsafe to me.

Twins, give up the company kool-aid and re-read my post. I didn't 'refuse' to do foot checks. My patients are 'refusing' them and I am documenting that. My patients cried when I told them I was leaving dialysis and not because I was 'giving in'. They recognized that I wasn't about to compromise on real care.

Chisca, GC! You certainly called this one!

Hi, How are you, GC? I've left dialysis. I could no longer manage the workload and I respected my patients too much to subject them to my ambivalence towards the job. The profit driven add-ons were just frosting on the cake. I was giving a protein supplement over months with zero change in albumin levels! That's crazy. Twinsmom seems to be a company lackey but I'm too proud of my work to foist unnecessary tests and treatments just to drive up profit margins. i've appreciated your wise, seasoned comments and thank you.

What are the general opinions regarding UHS psych hospitals? Are they all as archaic and dollar driven as mine?

I'm an older RN who has had it up to here with the abuse that most ICHD impose on their staff. I'm done. Every day they load even more BS on to my job and since I'm old I'm savvy enough to recognize that most of what they add on is simply profit-driven baloney. 'Protein supplements' that do nothing for albumin levels? Glucose checks when we don't keep insulin on our formulary? Just for the record, since I own a blood sugar level I refuse to do glucose monitoring if a patient has brought neither insulin or glucose tabs with them. I feel embarrassed when asked to do foot checks on patients who tell me that they won't take their socks off and to quit trying to profit on their disease. I really like my patients and do everything I can do for them but since I'm reality based and pragmatic I've decided that the ladt years left to my working life will NOT be spent driving stock prices up and reality down

That toxic environment will poison your life and the clinic manager should be on it like white on rice. Talk to her and see what happens.

Why do you think dialysis is your calling? Have you spent time in a chronic dialysis facility? What don't you like about the ER? I've made the transition but I really want to hear about your expectations.

Dialysis is trying to do too much with too few nurses. I'm done. I just sent something to a resumé specialist because I can no longer keep up with the baloney.

'Getting On' was icky and squirmy and utterly, totally hilarious. They got really, really close, that's for sure!

Egads! After the day I had today I could really, easily, successfully transfer into psych... :)

I'd wear whatever makes you happy and COMFORTABLE! I have unusual coloring and my patients always compliment me when I wear black or bright red. Scrubs are cheap and even with all the bleach I still stay within my budget on work clothing. 90% of the time I'm wearing PPE gowns and stuff so I could be naked and it wouldn't matter. I'm always cold and I've found a company that makes really nice scrubs with 3/4 length sleeves which helps.

You are not a nurse. Please find another outlet.

Shock! MOI?

Jeez, I couldn't do it without my LPN's.

Westie, I did send my resumé to my niece to be buffed up but I'm an old nurse with a messed up back. This is a rough job for me. I, unfortunately, have grown to really love my patients (absolutely the downside of LTC) but the paperwork is foolish and overwhelming. We are NOT treating the patients, we're treating the lawyers and all the other leeches to the medical professions and it really is taking away from patient care. Yes, we check the boxes, but when we're looking at the boxes we're NOT looking at the patients and something will get missed. I know something has gone terribly awry when my darned Facebook page is filled with lawyer's ads for suing Fresenius and NxStage. Do we have to stay to change it?..

I can make a difference. My. Worst. Patient. Ever! said to me today, "I want to care about myself as much as you seem to give a **** about me". I totally agree. Your care is really difficult, you make it really hard for me to do my job. But, guess what, sucker? I'm not giving up. So, THERE!!! If ever I wondered about being a LTC dialysis nurse, there it was. I could quit my job tomorrow but I won't quit you. You are one valuable human being with a past I could learn from. You have lived a life that was screwed up from birth but somehow you struggle to get on. Nothing yet has gone right for you, yet, HECK! You're only 46 so there's potential for turn around. I've detected a heart so I'll assume a soul goes with it. Patient! I am a nurse and you are a human being so all I have and know and am is dedicated to keeping you alive until you wake up to your world and decide you have a rôle in it. (Note the ô in rôle, I did start out in art school!) If our patients only knew...

Westie...I'm trapped like a rat. See my other post...

I come from a surgery/ER background so I'm still getting my footing in this chronic care thing. There's a truckload of difference between the "treat 'em and street 'em" dynamic of urban hospital nursing and chronic dialysis nurse/patient relationship. It's all nursing and basic nursing principles will always apply but the intensity of the interaction has to be dialed down a notch in this setting. I'm growing to like it but sometimes it seems like transitioning from a race car driver to a taxi driver.

Check out the available health insurance coverage. That can make a huge difference!

Thank you everybody. I've told my patient no more breaks, I've stuck by it and he now shortens his treatments but what can I do? It's his life. On the idea that dialysis patients are very often there by poor lifestyle choices: I'm about 15 pounds overweight and I don't exercise. I know better but hey! my life's so hectic and crazy that I don't treat my body right. So, I'm the last person who can pass judgement on my patients. I educate and educate but at the end of the day it's a case of, 'Nurse! Heal thyself!', I'm afraid. Once again, Thanks!

My FA knows but I can see your points very clearly. What do you do about thise patients who just don't seem to get it? My patients always finish their treatments and never sign off and their numbers usually improve when I have them frequently. The other nurses don't want them, frankly, and the AMA right is pretty high with the rest of the staff. It's pretty freaking difficult. Arrgghhh! Thanks

True, Trauma, but right now the two smokers hace CVC's and I've informed them that when their fistulas mature the party will be over and I'll see about nicotine gum. Both of the current crop of difficult, recalcitrant babies are still fairly new to dialysis and one, while still young wants to sign off and has missed a week of treatments because he felt it just wasn't worth it. It's difficult.

I've 30 years of nursing experience in various specialties (surgical, ER, tele) who's been in dialysis for 2 1/2 years. It's not my dream job but I work hard to help my patients make the best out of the rotten hand they've been dealt. One thing I do an excellent job at is withholding and suspending judgement on the 'lifestyle' choices my patients make. I want them to live, I want them to feel valued, and I want them to feel that dialysis is as important as breathing. If I can keep them alive and well so that maybe, one day, they'll see the light and start taking charge of their own health I'll feel like it's been worth it. Because of this I frequently get assigned the psych or addicted patients because I love the challenge and because I can usually get through to the occasional 'outlier'. As such I occasionally will allow a patient a 'bathroom' (ahem, cough, cough) break where they'll grab a quick cigarette. I make them promise to return and they always do. I increase their UFG to accomodate the extra blood return and I've yet to have a patient not return. My manager knows what I'm doing and we both agree that complete dialysis is the ultimate goal. The problem I'm having is with the other nurses and techs who openly disapprove of my 'spoiling' and 'giving in' to my patients. They're always going on about what my patients are 'getting away with' and how I'm letting them run the show. They're the most harsh, judgemental crowd I've ever worked with. I'm an experienced RN who's worked with all types for years. I know I'm being a bit manipulated but so what? My patients always improve their URR's and THEY SHOW UP!!! So what do I say to these nosy Parkers who always have to have an opinion on how I treat my patients? I'm tired of them.

The pay stinks in Boston. I don't know how I'm managing.