Solutions for Acutes?

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Specializes in Med/Surg, Tele, Dialysis, Hospice.

Our acutes department is really struggling. I don't know how many RNs have been hired, trained, and then quit, just in the past year or two, but it's at least eight. We are swamped with treatments and we are all going in to work everyday expecting nothing less than a twelve to fourteen hour day--and that's if we hustle and skip lunch. Then there's the on call. Work fourteen+ hours only to know that you could get called right back as soon as you get home...or before you even get home.

Does anyone here work for an acutes department that figured out a way to retain nurses and have as normal as possible work days, as in, eight to ten hours? Does anyone work in an acutes department where the on call problem has been eliminated, and if so, how did you do it? Almost every nurse that gets hired in our department hates the on call, and probably 75% of them quit because of it. Is there a solution? Anything? I am not that young anymore, and I just don't think that I can take working 50-60 hours a week anymore. I hate to throw in the towel like the others, but what can be done?

Any suggestions or shared experiences would be very welcome!

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Specializes in Dialysis.

If you find an answer I'd love to hear it. My former ICU colleagues are experiencing the same turnover so I don't think it's just dialysis. We recently had to swallow a cut in the on call pay and a cut in the weekend differential.

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Are there enough patients to justify two shifts? I know large inpatient units often run round the clock, and schedule shifts similar to the outpatient unit.

The other option would be to hire a couple of per diem on-call nurses, but I doubt tptb would go for that.

In our old system, all the nurses (including outpatient) took turns taking call (6pm-6am).

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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.

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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.

I'm so sorry to hear this. :(

Renal used to be such a great field in nursing.

The (dialysis) times they are a' changing....

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Specializes in Med/Surg, Tele, Dialysis, Hospice.
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.

I just applied for a position with the hospice company that I used to work for, and if they call, bye bye, dialysis. I can't take it anymore.

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Dang. Losing both Westie and Frans from the dialysis ranks--and at the same time-- makes me sad. :(

You both have impressed me as very talented and conscientious over the years. My best to both of you as you go forward. I can't say I blame you for striking out. The dialysis field has changed drastically.

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Specializes in Med/Surg, Tele, Dialysis, Hospice.

Thanks, Guttercat, you are very kind.

I am very conscientious, maybe that's why I can't justify being forced to work 17-18 hr. days and running patients when I'm so tired that I'm bleary eyed. One little mistake, like forgetting to clamp a CVC port, or forgetting to do my last 2 hr. water check on the RO...or whatever, just because I'm so fatigued that my brain is fuzzy, and I could bring great harm, if not death, to a patient, not to mention lose my license and my ability to make a living. It's just not worth it. If any of us complain about the long hours and fatigue, our manager acts like we're being wimps. Seriously...how many people do you know who would willingly work 17 hours straight without complaining or searching for a different job?

Anyway, thanks again. I really hate to give up on something that I worked so hard to learn, so I may just try to cut back to fewer days a week in acute dialysis if the hospice job doesn't pan out. Time will tell. I'm not quite desperate enough to go back to working the floor on a busy hospital unit...yet.

Frans, I'm also sorry to see that you are throwing in the towel, but I really do understand why. I remember how excited you were about making a difference in the lives of your chronic patients, but unfortunately, it sounds like the corporate culture of dialysis and the daily, grinding routine of doing the work of at least two nurses has had the same effect on both of us. Best to you as you seek something more conducive to a better quality of life.

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Westie, I've had those nights of getting called in as soon as my head hits the pillow (after a 16 hour day of flat-out running), where simply finding the on-button on the machine takes a great deal of mental concentration. Absurd, isn't it?

I know very well what that is like. I think marathon days like that are to be expected, and might be even good for you on occasion--gets the juices flowing and keeps us sharp. But it is unsustainable over time.

I was very fortunate in my last position that I had a clinical manager that did her best to assure that we had enough rest.

I finally got to the point where taking call on my days off was the best solution over the long term. I didn't mind being called in so much if I had not been working all day.

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Specializes in Dialysis.

Shouldn't this thread be in the Collective Bargaining/ Nursing Union sub forum? ;)[h=2][/h]

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Specializes in Nephrology, Dialysis, Plasmapheresis.

I believe I have the answer. No more corporations running our specialty...

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I left dialysis full time because of the crazy hours. It wasn't just that we worked 60-70 hour weeks but then we would work some 30 hour weeks. I hated that too because I didn't want to use all my vacation time to make up the hours. I still work PRN in an acute unit and they are about to trial a second shift that comes in at 10am and works until 10 pm.

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