Tech vs. Nurse War

Hellllllo Nurse, BSN, RN · Sep 27, 2007

I started dialysis in TX, and imo, the bad attitude of dialysis techs re: nurses is very common in TX, especially in FMC units. I became a traveler and found it is not that way in a lot of other states.

You earned the title nurse, and please refer to yourself proudly as a nurse. Techs are techs. They earned that title and should use it proudly. Poorly defined and poorly delineated role of nurses and techs is a big problem in TX.

adnrmoney · Sep 27, 2007

Am also a new Rn in training at one of the FMC facilities in Az, my frist days of preceptorship, my preceptor who also is a tech, within 10 mintues of starting, asked me if i have a proplem being precepted by him, and i asked why, he said that i told me to put my hand anatomically on the side but i did not do it.i replied well, well we all have a way we carry our body as long as my hand beind behind my back does not interfer with my job , i do not see why i have to stand or look in a certain way to learn the machine. with this guy it is constant harrasment.

But look past it and learn all you can. just know that you may be recented because you are going to be their boss. They may be trying to bring you to their level . just hang in there. Remember why you are doing this.

DeLana_RN, BSN, RN · Sep 28, 2007

Nephro RN,

I'm sorry you are experiencing this, but unfortunately this is a HUGE problem in chronic/outpt dialysis. Why? More so than in other areas of nursing, the perceived roles and responsibilities of nurses and techs/PCTs are very, very blurred. Of course, PCTs (with the exception of student nurses, but those don't normally cause a problem) have no idea what additional responsibilities nurses have. On the other hand, PCTs know that nurses make much more $. Therefore, the "same job, more money" perception will lead to resentment (yes, there are exceptions - excellent PCTs with great attitudes who are never subordinate - but I've encountered very few in chronics). Sad, but true.

Usually, nurses and PCTs are even trained together. Personally, I think it's a very bad idea for a subordinate to train a nurse, even in the more technical aspects of the job (not because PCTs are not competent at their jobs - in some areas, such as cannulation, they are often better because they get more practice). Only nurses should train nurses! How will the PCT later respect a nurse that s/he got to "evaluate" (and obviously, in your case, told lies about?!) Bad, bad idea.

It seems obvious that your are dealing with resentment/envy/attitude issues here. If I were you, I would speak to the FA in private to see if you can work with your nurse preceptor from now on. There is nothing that a PCT can teach you that a nurse cannot. Explain why - you don't have the "RN attitude" (LOL, that's a favorite one) but if the PCTs think so, then it's not a good idea to continue the training relationship. If you have any problems with the FA - and/or the PCTs - think long and hard whether you want to continue working there. Yes, it will probably get better once you're no longer being precepted, but dialysis has a long learning curve and other workers can truly make your life miserable if there are unresolved "issues".

I'd better get off my soapbox now (you can tell, this is one of my pet peeves although I'm no longer in chronics and we have no PCTs in acutes). I hope you can get this resolved. Despite some problems, dialysis is a very rewarding nursing specialty - you will get to know and have meaningful relationships with your patients.

Best of luck to you!

DeLana

GeauxNursing · Sep 28, 2007

I'm sorry that you are experiencing this "tech attitude". i am a tech, and I would be ashamed of myself if I treated my nurses this way. I do know the "tech attitude" exists, though. You must be at a Davita clinic. why they have techs preceptoring nurses, i have no idea. When I graduate with my LVn (15 more months!) I will expect to be trained by a nurse! I wonder how it will go with me when that happens, will I experience from the techs because I will have "switched teams"? This sounds silly, I know, but I fear that at least one person will be resentful, due to pay increase, added prestige, you know.

best of luck to you!

Redman · Sep 28, 2007

I am currently working at an FMC unit in Tx and when I first started I had some of those same issues. It just took time for the PCT and even the other nurses to trust my decision making abilities and skills as a nurse. When I was in training I tried to absorb as much as I could and ask a ton of questions. I asked questions at times I already new the answer to just so my PCT trainer would feel that I was more interested in the knowledge and skills she had to offer me.

That being said after I finished my training and began my training with the other nurses I made sure that I helped out as much as possible pitching in and helping set up machines and other things that some nurse tend to put completely in the "Tech" realm of responsibility. I currently have a wonderful working relationship with 90% of the tech and nursing staff. I have been here 3 yrs and act as Charge Nurse on weekends and during the week for vacation times and such and have almost no problems.

Anyway moral of the story is chip in and work with your techs they will work with you and you always get better results if your willing to be nice and try and treat them how you want to be treated.

DeLana_RN, BSN, RN · Sep 29, 2007

I'm sorry that you are experiencing this "tech attitude". i am a tech, and I would be ashamed of myself if I treated my nurses this way. I do know the "tech attitude" exists, though. You must be at a Davita clinic. why they have techs preceptoring nurses, i have no idea. When I graduate with my LVn (15 more months!) I will expect to be trained by a nurse! I wonder how it will go with me when that happens, will I experience from the techs because I will have "switched teams"? This sounds silly, I know, but I fear that at least one person will be resentful, due to pay increase, added prestige, you know.
best of luck to you!

You will undoubtedly be trained by a nurse, since you already know dialysis. Those units that have PCT preceptors use them only to teach basics - machines, on/off procedure, monitoring and cannulation (plus whatever else they are allowed to do by state law). And don't get me wrong, I don't see anything wrong with a tech helping to teach a nurse these skills - but for obvious reasons (the same ones you are concerned about regarding your future role as a nurse - respect, resentment, etc.) - I don't think they should be able to evaluate a nurse's performance, or be the primary preceptor - even for a short while.

From your posts, you seem to be a very conscientious tech with a good work ethic. Best of luck to you!

DeLana

BellaCerraRN · Sep 29, 2007

Thank you all for your words of wisdom and support, especially from the techs. I was worried about getting lambasted here too about having "the nurse attitude".

Today things went a little smoother. When I got to work this morning I just went in and it was all business, I made sure I said "teammate" all the time instead of tech or nurse.

When we had a break I went to the 2 I think I offended most and just shot straight from the hip. First I apologized for any hurt feelings or offenses and told them that I truly ment none and just asked them to be patient and forthright with me. That the needed to understand that I am fresh out of school so I'm fluent in "nurse" speak but maybe no so much in their language and reminded them how much we get the rules of delegation pounded into us so I'm really just trying to figure the whole mess out. This went over very well and there were hugs all around (not literally).

The rest of the day went great, I stuck to my preceptors tail all day and instead of asking her "can I go do this or that" I asked her what she'd like me to do next. It didn't take long before she was losening the apron strings and giving me a lot of stuff to do and many pats on the back. At the end of the day I asked her if today had been a better day and she said absolutely, I told her I was glad to be her teammate and for the first time, she told me "have a wonderful weekend".

So... we'll see where I go from here.

Thanks again!

DeLana_RN, BSN, RN · Sep 29, 2007

Nephro RN,

I'm glad things went better for you today, however I'm just a little concerned. It sounds like certain techs are trying to fluster you and "bring you down to their level"; this is typically the reason the "RN attitude" is brought up (have I heard that one before :roll - a favorite nurse "put down" - and believe me, I have never acted superior toward PCTs - having been a nursing home CNA, why would I?!)

Just be careful, the day will come when you will have to delegate to techs and "act superior" (which is what bad techs would call it when asked to do their job). Good techs with good attitudes, of course, are never a problem - but they wouldn't accuse a nurse of having the "RN attitude" in the first place. I really don't think you offended anyone - it's just a popular way of manipulating a new nurse.

Continue what you did today, but don't apologize anymore for something you didn't do Also, no need to avoid the terms "nurse" and "tech" in conversation, sometimes you have to use them (e.g., "Is float staffer X a tech or a nurse?" You need to know!)

Best of luck to you, keep us posted.

DeLana

penem10 · Oct 1, 2007

I have heard of this situation, although I have never dealt with it before. The solution was to approach your co-workers with the attitude that you are all there for the patients. It is not a competition between tech and nurse. Bottom line, the patients suffer when this ocurrs. Approach the techs with this and you hopefully will see things change.

More and more unlicensed personnel are taking over the units nationwide. This is not an attack on techs, there are awesome ones out there. I just believe a RN needs to be assessing the patients, accessing their grafts/fistulas and really knowing what is going with that patient on a daily basis. This is not possible when your 1 RN is struggling to keep informed on 10-15 patients at a time.

IMHO

Penem10

Nursie2k7 · Oct 13, 2007

hi i am a new lpn in dialysis (inpatient at a hopsital) and our techs are pretty great but they can get their attitudes and treat the rn's and lpn's bad some days....coming for a floor where i had to do rotating shifts deal with constant codes and have 9 patients i was very surprised when my manager said that she can't keep nurses i mean who wouldn't want to work straight days every other saturday and no major holidays without taking a pay cut......well after a month of working with a few techs with attitudes i understood....we have some great techs but we also have some lazy ones and the whole thing is as a nurse we can work every body system while their license just keeps them in dialysis (so i think)...well i told my manager that the techs treat the new nurses bad and they probably just transfer to a different unit...and in an hospital setting only nurses can do the assessments pass the meds and deal with complications so some days you can be working your tail off and they will just sit there and talk on the phone or browse the internet and you look and there is still a ton of labs that need to be done things that are within their scope and if you ask them to do it it's like now you have an attitude... but my kids love seeing me and i don't miss working the floor so if they are trying to run me off eventually they will get tired of it......

enough said for a first post

DeLana_RN, BSN, RN · Oct 13, 2007

hi i am a new lpn in dialysis (inpatient at a hopsital) and our techs are pretty great but they can get their attitudes and treat the rn's and lpn's bad some days....coming for a floor where i had to do rotating shifts deal with constant codes and have 9 patients i was very surprised when my manager said that she can't keep nurses i mean who wouldn't want to work straight days every other saturday and no major holidays without taking a pay cut......well after a month of working with a few techs with attitudes i understood....we have some great techs but we also have some lazy ones and the whole thing is as a nurse we can work every body system while their license just keeps them in dialysis (so i think)...well i told my manager that the techs treat the new nurses bad and they probably just transfer to a different unit...and in an hospital setting only nurses can do the assessments pass the meds and deal with complications so some days you can be working your tail off and they will just sit there and talk on the phone or browse the internet and you look and there is still a ton of labs that need to be done things that are within their scope and if you ask them to do it it's like now you have an attitude... but my kids love seeing me and i don't miss working the floor so if they are trying to run me off eventually they will get tired of it......
enough said for a first post

welcome to this board, and welcome to dialysis! i work in an inpatient unit as well; however, we have no techs (they used to have one who was laid off when they had to cut costs years ago; apparently, she was good and had a great attitude and everyone hated to see her go). most of us are rns; one reason for that is, lpns can only take pd call, and call is of course a fact of life in acutes.

i have to admit that one of the reasons i was attracted to acutes is the absence of techs; i had quite enough of the battles and bad attitudes in the clinic. yes, there are some wonderful techs, no question about it; however, there are also some very difficult ones - passive-aggressive, undermining the nurses - and the blurred roles in outpatient dialysis seems to encourage this kind of behavior and attitude (obviously, being able to give some meds and do other things unheard of in acute care makes some techs believe that they do exactly the same as the nurses, but are paid less). btw, techs do not have a license - and they don't really work under yours (the employer is responsible that they are competent and properly trained, and in some states also certified. your license is only at risk if you delegate tasks to them that they are not qualified or allowed to do.)

what is your manager's attitude about the lazy/insubordinate techs' behavior? how do the other nurses handle this?

i wish you well, inpatient/acutes is (imo) the best area of dialysis. hang in there, and don't let anyone run you off.

delana :welcome: