liamia

hey, how've you been? take it easy, you are only working for 1 month so it's very normal that you will still forget things. are you always rushing? my advice is don't rush, cause once you do that you will forget a lot of things. and just be patient with your trainer. usually they are really strict because if you made a mistake they will be held accountable for that. it took me 6 months before i got use to the work.

It is really challenging.. i was not prepared when i took it and i believe this job is for the tough ones because it's mentally, emotionally and physically exhausting(physically draining in the sense that you do all the physical work and be jack of all trades like doing the biomed role). RN's role in the dialysis clinic is to supervise and give meds because they have 24 patients. they also have a lot of paperwork, so you're considered lucky if your charge nurse will help you but usually they will not help you even if you're behind with other patients because their busy assessing. though if it's really an emergency like life threatening they will help you. the PCT's and LPN are the ones who do the actual dialysis and we have to do interventions once they experience hypotension, cramping, hypertension etc.. i think you can make it since you're use to a busy facility before.. :) i also just wanna share with you when i was still a trainee: so for the first 2 weeks it's all about learning and studying the basics of dialysis in the classroom. then 10 weeks will be on the floor setting up machines, preparing dialyzers, pack and heparin. Your preceptor will encourage you to set up machine in 3 minutes which is very overwhelming at first but the more u practice and the longer you do it, you will learn that it is achievable.. LOL just message me here if you have other questions and don't be discourage if at first you're having a hard time. the first 3- 6 months will really be TOUGH and hard because you are a newbie and just starting to learn techniques.. good luck! hope you will share your experience too once u start.

i feel for u dear, i noticed that too in our clinic when they hired an EXPERIENCED nurse they only trained her for 3 days and also without a preceptor which is very risky! specially in your case, you don't have a background in dialysis right? and re: your co-workers, that's really hard to deal with since your new in the facility they should be more understanding and instead of helping you, looks like they back bite you. i remember when i was new, at first some of my co-workers didn't like me specially the senior ones(PCT/LPN) but when went to work on my own(without a preceptor) i noticed they're not annoying anymore and we clicked and suddenly we get along! although there are still 2 nurses that's really annoying, even if you warm up to them they will not do the same. LOL I realized, maybe that's really the nature or culture in dialysis, THE MANAGEMENT will make it hard for the employees because it's all about the profit so they always wanna save money! but at the back of my mind i always ask myself, how can you hook a patient in less than 10 minutes if some of my patient's need a HOYER lift, i can't just rush the 350lbs patient going to his chair because he's also weak. and some patients are too slow to walk or in a wheelchair and we have to weigh them, make sure they washed hands and their access before getting their vital signs etc.. there was also a time that i have to take 5 patients instead of the regular 4 patients per PCT protocol. but we can't do anything because we are UNDERSTAFFED or we have LOW CENSUS that time so FA will make sure 1-2 staff PCT/LPN will go home early to save up money. we always have to deal with getting mandated NO 10 hour sleep and do a 16 hour shift if one of our co-workers call in sick. I totally agree with you when you said: There isn't time to assess patients, identify needs, and the come up with a plan. that's usually what HD nurses end up, not enough time to assess and take care of them because the facility wants us to finish early to save money.. tsktsk i suggest maybe try for 1 year as an HD nurse, you might get used to the culture and love it in the end(you'll never know :)).. as you've said you always want to be an HD nurse. I'm just wondering why you didn't apply as an HD nurse in the hospital? i think it's easier to be an RN there than in the clinic. because in the clinic you have 24 patients total per 8 hour shift... so it's really stressful! i think in the hospital they only have maximum 2-4 patients right? but for me once i get my RN license i really want floor nursing(i know it's hard) but it's what interests me. though i still want to be on call even as a tech or LPN just to help our clinic to give back or repay the experience i gained through them. i love my work in our dialysis clinic, i just don't like culture they made.. if only they can change the system..

i also don't have a dialysis experience before i was hired in our clinic but the 12 weeks training was really good because you still got the preceptor. but after the training and you are on your own that's where the reality sets in. you just have to be patient because there will still be patients that are rude or grumpy. i just try to understand them because i know they are sick and most of them are still depressed specially if they are new to dialysis and come to think of it, who wants to be poked 3 times a week with that large bore needle! some patients will also not trust new PCT's because they are scared you might make a mistake in poking them so they will request other PCT. the technique there is you just have to be really friendly and explain to them that you will do your best. there are times that you will feel EXHAUSTED specially during turn over of patients because everything should be fast but SURE and SAFE... but since you are new just take your time, don't rush. once you've learned everything like setting up the machine, programming it, preparing heparin etc then speed will come after. you just have to learn the basics of dialysis then you're good to go.. =)

but don't worry, i think it really depends on the clinic. if it's a large clinic then for sure you have BIOMED tech's there to do the work. also since you are just training they won't teach you yet how to shut down the clinic and do the bleaching every saturday.. lol

oh my, i don't know how to explain it cause i use to work in another country. but let me share you this: btw it depends on the dialysis clinic u are working. is it hospital or clinic? although i'm only a PCT in our dialysis clinic i have a staff nurse(medical-surgical private hospital) experience in another country. Im still waiting for my authorization to test and i hope i will get my license SOON because i think DIALYSIS is really not for me! it sounds like we have a time limit per patient, They want us to hook each patient for 5-10 minutes and then go to the next patient. it's all about rushing! now where is the patient's safety there? i cannot practice compassion or empathy because we always have to rush. lol PCT's in our dialysis clinic also act as BIOMED, we do the bicarb mixing at the back while doing patient care and shut down the clinic(rinsing the large tanks, closing it) if you have the 2pm-10:30pm shift. every saturday we also have to do the bleaching of the large tanks at the back and very tiring because i'm just alone doing the back shut down and it means I have to stay longer to make sure after i bleached the tanks, we have to rinse and make sure it's clear and free from bleach after testing it with a strip(i have to work 2pm-11:30pm if I'm doing the bleach saturday shutdown). sorry for ranting here, maybe i was just used to floor nursing in our country that's why i don't like the way of the dialysis clinics here. we use to have 14 patients per nurse back home and it's a private hospital, not even government, it was hard but i was still able to manage because there is no time limit, though we have to act fast too. i've only been working for 1 year in our clinic but somehow i got use to their technique. also the good part in our clinic are my co-workers and patients, they're all friendly and nice, i love them! but i'm still hoping i can get a hospital job someday(although i know it's more hard in the hospital) and i really think it depends on the interest where we can excel..

I agree with our colleagues here, don't give up! I think it just depends on the facility.. hope you will find a better hospital. RE: trying to switch as a HD nurse, maybe in the hospital much better as a dialysis nurse but not in a clinic. Our nurses there handle 12 patients per 4 hours, so total of 24 patients per 8 hour shift. although HD nurses in the clinic only do assessments, giving medication, (also lots of paperwork documentation) but it also can get busy for the first 2 hours specially during turn over and if one of the patient have complication then you'll be late with your next patient and the rest which is kinda frustrating because the management always want to save up money so they want a fast turn over and as much as possible no patients should be hooked up late! management is really strict with that.. I also just wanna share: Although I'm only a PCT in our dialysis clinic I have a staff nurse(medical-surgical private hospital) experience in another country. I'm still waiting for my authorization to test and I hope I will get my license SOON because I think DIALYSIS is really not for me! it sounds like we have a time limit per patient, They want us to hook each patient for 5-10 minutes and then go to the next patient. it's all about rushing! now where is the patient's safety there? I cannot practice compassion or empathy because we always have to rush. LOL PCT's in our dialysis clinic also act as BIOMED, we do the bicarb mixing at the back while doing patient care and shut down the clinic(rinsing the large tanks, closing it) if you have the 2pm-10:30pm shift. every Saturday we also have to do the bleaching of the large tanks at the back and very tiring because I'm just alone doing the back shut down and it means I have to stay longer to make sure after I bleached the tanks, we have to rinse and make sure it's clear and free from bleach after testing it with a strip(I have to work 2pm-11:30pm if I'm doing the bleach Saturday shutdown). Sorry for ranting here, maybe I was just used to floor nursing in our country that's why I don't like the way of the dialysis clinics here. we use to have 14 patients per nurse back home and it's a private hospital, not even government, it was hard but I was still able to manage because there is no time limit, though we have to act fast too. I've only been working for 1 year in our clinic but somehow I got use to their technique. also the good part in our clinic are my co-workers and patients, they're all friendly and nice, I love them! But I'm still hoping I can get a hospital job someday(although I know it's more hard in the hospital) and I really think it depends on the interest where we can excel.. ?

i can relate to your situation. although i'm only a PCT in our dialysis clinic i have a staff nurse(medical-surgical private hospital) experience in another country. Im still waiting for my authorization to test and i hope i will get my license because i think dialysis is really not for me! it sounds like we have a time limit per patient, They want us to hook each patient for 5-10 minutes and then go to the next patient. it's all about rushing! now where is the patient's safety there? i cannot practice compassion or empathy because we always have to rush. lol PCT's in our dialysis clinic also act as BIOMED, we do the bicarb mixing at the back while doing patient care and shut down the clinic(rinsing the large tanks, closing it) if you have the 2pm-10:30pm shift. every saturday we also have to do the bleaching of the large tanks at the back so we have to work 2pm-11:30pm. sorry for ranting here, maybe i was just used to floor nursing in our country that's why i don't like the way of the dialysis clinics here. we use to have 14 patients per nurse back home and it's a private hospital, not even government, it was hard but i was still able to manage because there is no time limit, though we have to act fast too. i've only been working for 1 year in our clinic but somehow i got use to their technique. also the good part in our clinic are my co-workers and patients, they're all friendly and nice, i love them! but i'm still hoping i can get a hospital job someday(although i know it's more hard in the hospital) and i really think it depends on the interest where we can excel.. :)

very busy specially during turn over. very tiring too.. if you have a lot of patience then you will survive... good luck..