TNValley

1 RN to 15 patients. Alabama. If there are more than 15 patients at a time there must be 2 RN's. I'm fortunate to work nocturnal, so it's 15 patients (more stable than your usual dayshift patients) and 2 CCHT's with years and years of experience. Dayshift at my clinic runs 15 patients, 1 RN, 3 CCHT's because of turnover/1st-->2nd patient shift change. That 3rd tech is really really important to have to survive shift change because it almost never happens without some kind of problem.

Welcome to wonderland. No, I have no idea just how deep the rabbit hole goes, but congrats on jumping in with us! It's always a good idea to ask your CCHT's about your patients' histories of tolerating treatments. Sometimes the patients won't trust a "newbie" with some critical info, yet they'll openly share it with the staff they've been around for a while. -Nurse-itis- has no place in a chronic dialysis unit; the more you involve everyone, the better off you'll all be. Be brave!

The good news is as a new graduate you can be hired into dialysis. The better news is as a new RN and new to dialysis it will most likely be a good while before you're left on your own. Have a look at the Acute dialysis posts. There's lots of pro's and con's.

Most of the nephrologists and vascular surgeons I know would raise an eyebrow and give that head-tilt-silent-it-just-dropped-60-degrees-in-here stare to using a CVC for anything but dialysis treatments. Some wouldn't have a problem with it as a last resort to save a patient's life.

Working as a CNA in LTC put me through nursing school without a student loan. I was offered a job (ugh, med cart) after I finished school and got licensed, but six months of passing meds to 30-40 residents about drove me insane. Working LTC did help my transition into dialysis, though. Having a group of patients that you get to know really well in both LTC and dialysis has been very rewarding. I've always been in "The Rest of Them" category. Acute Care requires some serious mental gymnastics and decisiveness.

Yikes! Now that is just sad. Our government booted Gambro out of the country, right? That was the company I started working for back in '02. After the Gambro (and those nice benefits _silent tear_) departure the clinic/clinics I worked in were bought out by DaVita. I may be wrong, but as far as I know Gambro is no longer allowed to provide dialysis services in the USA.

I enjoy my job. I even enjoy, as do most of us, years later recalling those days of pure horror where the thought of taking hostages almost became a reality. p.s. bad dialysis days are bad, really really bad, but surviving them is great, really really great

Go for it! You might love it. I'd definitely ask about the clinic's "scores" (how they stack up to the local competition) before I accepted a job just anywhere, though. I see a disturbing better reimbursement to "better score" clinics developing in the US.

Once you've heard that "whistling" of a failing access you'll never forget it. Access Flow monitoring should be mandatory for all AVF/AVG patients.

Range for North Alabama is from $22/hr for new hires with no experience to $34/hr for 10+ years of experience. That's base pay, not including weekend/evening/nocturnal diff's.

I must've been sleeping under a rock? How'd I miss this? Anyways, I thought I'd share: Medicare Dialysis Facility Compare Facility Search I also saw a good article from Dialysis Patient Citizens and the National Kidney Foundation responding to the star ratings, especially the one and two star ratings. I'm not certain how I feel about this. Sure there are pro's and con's, but what do y'all think? ...update. I checked the clinics in my area. The information is outdated. According to what the CMS is ranking the facilities on some of them should gain or lose a star. For example, there's one clinic in my area that has an 84% kt/v rating listed at the website, but I know that clinic is actually at 100%. A lot of the info is only collected quarterly.

Aww, sorry I missed out on this one. "That doc you paged two hours ago is on line #2."

No no no Anna S, not the "T" word There was a big push in 2014 to eliminate agency/temp workers in clinics everywhere. As for "Traveling" staff, that means float, right? All new hires as of last fall are float staff. Yes, you've got your home clinic, but the new normal is that you'll be floating to any facility in your area that's short (shorter) staffed than your home clinic. There was an "area schedule" that was in effect in the TN Valley last summer due to several clinics having open positions. This was in effect for RN's and CCHT's. It was good to get out into some of the other clinics that were needing help, but it's not something I'd want to do all the time. Speaking of surveys, corporate sent out a brief employee engagement survey last fall. I keep asking/looking for results, but my clinic manager says there haven't been any released yet.

I got into HD in 2002 around the time when the duopoly was gaining momentum. Like you've described I was fortunate to have been in the right place at the right time to get decent raises/offers. The gorillas blaming "The Bundle" for everything is getting old. I've noticed how the gorillas have changed over the years; they're acute/chronic hd's and then add pharmacies, and now they've started opening their own walk-in clinics. Lean? Efficient? I'm not too concerned about the veteran vs. new grad RN's in chronic hd. The new grads have to have a veteran RN "cover" them for several months before they can be left on their own. Even after then the "rookies" still freak out and panic when patients go bad or code. Which, in my opinion, isn't necessarily a bad thing because it keeps them from getting too comfortable and casual. The rookies are also terribly inefficient. A lot of people just don't stay in it long enough to get over the learning curve, the responsibility curve, the patient demands curve, the daily staffing ratio curve, the productivity (efficiency) curve, etc. etc. you get my point. There's a DMZ here in the TN Valley area; the two gorillas mostly stay on their side of the interstate.

Yep, 1:15 for 'Bama. I see this magical 1:12 number being floated around, but it's just a fairy tale around here. Although, there are some 10 and 12 chair clinics. I worked a 10 chair clinic in TN once upon a time, it was almost like being on vacation at work compared 1:15. I kissed turnover/change out/pt shift change/etc. goodbye and have been happily working 1:15 nocturnal for the past three years. Before I got to transfer to nocturnal I was working 1:15 on days, two shifts of patients Mon-Sat.