So I've been a dialysis nurse for two weeks. I am a second career nurse who spent the first year of licensure as a psych nurse and then decided to make the switch to dialysis for many reasons. I am training at a Davita clinic in the Pittsburgh region right now. My training is 9 weeks in orientation and then three more weeks of independent practice with oversight until I'm on my own completely with my own assignment.
I honestly had no idea what to expect. I couldn't even shadow for the job before accepting it because of Covid. I can say I am very pleasantly surprised at how much I am enjoying it so far. Here are my thoughts:
The Good:
I was worried to begin about being trained by a PCT. In the hospital, the PCT's have far fewer responsibilities and I just couldn't see the value. NOW, I do. The PCT training me is amazing. PCT's in dialysis do so much more and have so many more responsibilities than hospital PCT's and her knowledge is vast. I understand this may vary depending on who's training you - but my preceptor is awesome at her job and she's been there 10 years. The RN preceptor has been there 9 years as well. Everyone I've met has been with Davita for a very long time, giving me a positive image of the company.
I learned to set up the machines this week and I am up to doing 3 machines in an hour and helping at turnover getting machines set up. Apparently, this is pretty fast for a brand new person. So I feel like I'm making progress. The flow of the unit is starting to make sense to me as well and I like the pace. Super busy getting everyone on the machines, then time to get caught up and talk to patients, and then it's time to take patients off and put new people on and you are super busy again. The ebb and flow is something I like.
I was concerned about PCT's pulling meds for patients, but then I realized once on the unit that it's pretty limited and very little room for error. The nurse verifies that the PCT pulled the right about of heparin before it's given. All other meds are given by the nurse. This fact seemed missed in a lot of the posts I'd read prior to starting.
I really enjoy talking to the patients and I'm excited to learn about cannulation next. Right now I am independent up to the point of putting the patient on the machine, including charting.
The Bad:
There isn't much bad. Getting up at 3am is tougher than I thought. But I work 4am -2pm right now and I like getting home in the afternoon.
The class portion is interesting to me, but tough because PCT's and nurses are trained together for the first 12 weeks. The PCT's that I'm working with are amazing because they've been there a long time and succeeded within the company. My training class is another story. Not everyone makes it. And I can tell that some won't. Coming in late, one was sleeping during class, talking back, rudeness, unprofessional. It's tough because the entry-level for the PCT is nothing. No experience needed. All training on the job. So you have people coming straight from working retail or fast food and coming into a professional environment and some just don't know how to behave. There are 8 people in my class. Three nurses, the rest PCT's and of my PCT classmates I can see two making it as they are professional and eager to learn. Lack of previous education does not make one unsuccessful as a PCT, but some of the people literally have no desire to be there except that it makes more money than other entry-level jobs. I feel like the PCT turnover has to be extremely high.
I wish nurses were trained separately but I understand why they are not. We are all learning the same things from the ground up. It's just hard being in class with others who don't care, can't keep up with what page we are on, know literally NOTHING about medical terminology and talk back to the amazing instructor we have.
The only other bad is the chairside charting system. It is SO OUTDATED and not very user friendly. They are supposed to be getting a new system which will integrate all of their systems and I think that will help a lot. Right now there are several different systems and they don't talk to each other.
Other than the class frustration, I've found my first two weeks at Davita to be really good. I'm loving the company culture and the people I've met. I can see myself here for a long time. I hope. I am pleasantly surprised at dialysis nursing. I am still on task mode but am starting to piece together why certain things are done and how that affects the patients. The rationales will come. But for now, I'm happy!
Hi guys! I just wanna ask how many days/week is the classroom training? Thank you
Seems as I recall there was usually something almost every day. Either classroom or computer. The days/times varied. Some days were full, other days were shorter. It's not like there's a set schedule you can rely on but you should get your training schedule in plenty of time to plan around it. The computer classes have people in them from all over the country so I am pretty sure the trainer works the rest of the schedule around those classes since they can't be easily rescheduled. When you start training with a preceptor your schedule will be based on that person's schedule.
I started off really liking dialysis but I'm not so sure now. Since I moved from my training clinic to my home clinic things have not gone so great. The techs basically run the show and the charge nurse is not a nice nurse and the unit is so toxic and full of cliques. The new clinical coordinator cannot make changes because the long time techs refuse to accept any new direction. The manager is lovely but cannot stand up to the techs who think they know it all. It's chaos.
I've worked there since June and I keep waiting for it to get better but it doesn't happen. I have a full pod assignment every shift, which I don't necessarily mind - but I'm not learning any of the nursing stuff. I was hired as a nurse, not a tech. I know nurses do cannulate and do jump in when short staffed, but I also thought I'd be doing more dedicated nursing than I am. I am responsible for a full pod assignment AND assessments and meds for the whole unit (along with charge who also assesses and does meds). I feel like I'm doing two jobs instead of one.
I told my manager I'd like to transfer to a new clinic and I was approved but the clinic I'd have to transfer to is 45 minutes away without traffic in the city (this clinic is 10). Plus it's their covid clinic and I just don't know if I'm up for that since I live with an immune-compromised husband.
I have tons of respect for dialysis techs and their difficult job, but at the end of the day I'm the one with the nursing license on the line when they are doing things clinically incorrect, but I'm also the one looked at like I have three heads when I say anything because they think they've been there forever and I'm new to dialysis so I can't say anything. Regardless of how long they've been there, it's my license, and doing things the wrong way for 10 years doesn't make you an expert.
Just venting I guess. I so wanted this to work out but the power struggle from the techs and the inability to really do what I was hired to do has jaded me pretty quickly.
I'm looking to maybe go back to psych nursing where I was before. I think it's more my niche than this. I love the patients in dialysis....the unit structures and power dynamics, however, are a whole other ball of wax.
I started off really liking dialysis but I'm not so sure now. Since I moved from my training clinic to my home clinic things have not gone so great. The techs basically run the show and the charge nurse is not a nice nurse and the unit is so toxic and full of cliques. The new clinical coordinator cannot make changes because the long time techs refuse to accept any new direction. The manager is lovely but cannot stand up to the techs who think they know it all. It's chaos.
I've worked there since June and I keep waiting for it to get better but it doesn't happen. I have a full pod assignment every shift, which I don't necessarily mind - but I'm not learning any of the nursing stuff. I was hired as a nurse, not a tech. I know nurses do cannulate and do jump in when short staffed, but I also thought I'd be doing more dedicated nursing than I am. I am responsible for a full pod assignment AND assessments and meds for the whole unit (along with charge who also assesses and does meds). I feel like I'm doing two jobs instead of one.
I told my manager I'd like to transfer to a new clinic and I was approved but the clinic I'd have to transfer to is 45 minutes away without traffic in the city (this clinic is 10). Plus it's their covid clinic and I just don't know if I'm up for that since I live with an immune-compromised husband.
I have tons of respect for dialysis techs and their difficult job, but at the end of the day I'm the one with the nursing license on the line when they are doing things clinically incorrect, but I'm also the one looked at like I have three heads when I say anything because they think they've been there forever and I'm new to dialysis so I can't say anything. Regardless of how long they've been there, it's my license, and doing things the wrong way for 10 years doesn't make you an expert.
Just venting I guess. I so wanted this to work out but the power struggle from the techs and the inability to really do what I was hired to do has jaded me pretty quickly.
I'm looking to maybe go back to psych nursing where I was before. I think it's more my niche than this. I love the patients in dialysis....the unit structures and power dynamics, however, are a whole other ball of wax.
Unless you have a strong clinic manager and upper management, this will happen. Kinda like CNAs or techs in acute or LTC who try to run the show. Yes, they are needed. No they aren't the boss!
Thx so much for the update. I have been reading all the posts I can find on dialysis nursing and your recent experiences and concerns are very common. The liability from stubborn techs is why I've chosen not to do dialysis myself. I'm very sorry and I hope you can hang in there until another opportunity at a different clinic opens up for you. ?
Unless you have a strong clinic manager and upper management, this will happen. Kinda like CNAs or techs in acute or LTC who try to run the show. Yes, they are needed. No they aren't the boss!
I guess I am lucky in my home clinic placement. There literally isn't a clinic manager, we have a manager from a different clinic "helping out." The charge nurse is also new to the position. What we do have is a team of techs led by an excellent long time employee who is also the clinic's only preceptor. This tech trains new staff to respect the nurse's position and also expects all other staff to do the same. Fortunately this person is a strong leader and all the staff follow that direction.
I'm sure my background in LTC doesn't hurt either. I have a long history of working effectively with stubborn CNA's!
I guess I am lucky in my home clinic placement. There literally isn't a clinic manager, we have a manager from a different clinic "helping out." The charge nurse is also new to the position. What we do have is a team of techs led by an excellent long time employee who is also the clinic's only preceptor. This tech trains new staff to respect the nurse's position and also expects all other staff to do the same. Fortunately this person is a strong leader and all the staff follow that direction.
I'm sure my background in LTC doesn't hurt either. I have a long history of working effectively with stubborn CNA's!
I think my LTC history helped as well, for the same reason.
Specializes in Dialysis (currently). Previously MedSurg.
On 10/13/2020 at 10:42 AM, Nurse Magnolia said:
I started off really liking dialysis but I'm not so sure now. Since I moved from my training clinic to my home clinic things have not gone so great. The techs basically run the show and the charge nurse is not a nice nurse and the unit is so toxic and full of cliques. The new clinical coordinator cannot make changes because the long time techs refuse to accept any new direction. The manager is lovely but cannot stand up to the techs who think they know it all. It's chaos.
I've worked there since June and I keep waiting for it to get better but it doesn't happen. I have a full pod assignment every shift, which I don't necessarily mind - but I'm not learning any of the nursing stuff. I was hired as a nurse, not a tech. I know nurses do cannulate and do jump in when short staffed, but I also thought I'd be doing more dedicated nursing than I am. I am responsible for a full pod assignment AND assessments and meds for the whole unit (along with charge who also assesses and does meds). I feel like I'm doing two jobs instead of one.
I told my manager I'd like to transfer to a new clinic and I was approved but the clinic I'd have to transfer to is 45 minutes away without traffic in the city (this clinic is 10). Plus it's their covid clinic and I just don't know if I'm up for that since I live with an immune-compromised husband.
I have tons of respect for dialysis techs and their difficult job, but at the end of the day I'm the one with the nursing license on the line when they are doing things clinically incorrect, but I'm also the one looked at like I have three heads when I say anything because they think they've been there forever and I'm new to dialysis so I can't say anything. Regardless of how long they've been there, it's my license, and doing things the wrong way for 10 years doesn't make you an expert.
Just venting I guess. I so wanted this to work out but the power struggle from the techs and the inability to really do what I was hired to do has jaded me pretty quickly.
I'm looking to maybe go back to psych nursing where I was before. I think it's more my niche than this. I love the patients in dialysis....the unit structures and power dynamics, however, are a whole other ball of wax.
Sorry to hear you aren't enjoying the job any more ? The people you work with definitely makes or breaks the experience & I feel like if you had more supportive colleagues you'd really enjoy dialysis! I've only been a dialysis nurse for a few months but loving it so far ? It was such a breath of fresh air being able to learn something TOTALLY new, be out of your comfort zone, and develop a new skill set.
I came across your original post ("Take job in dialysis or OR?") and was in the same dilemma as you a few months ago cuz I was really torn between the two as well. Even though I would have rather gone to the OR, I was offered a job in dialysis AND accepted that offer before the OR manager ever contacted me for an interview. I was desperate to leave my surgical floor (it was very stressful) and took the first offer I got, so I did the dialysis course over a course of 3 months.
So interesting to hear the similarities in the routines between our training & workplaces, as well as the differences in the roles on a typical day. What exactly are PCTs and their roles/responsibilities/tasks? We have HCAs (health care aides) where I work and from what I've been reading on these posts, it sounds like PCTs have a lot more responsibility than HCAs. We don't have PCTs here!
Also, why do the shifts start so early for you guys? Our day shifts for the nurses start at 0730h every day, and the patients arrive at 0800h for their treatments.
Hope you are able to find a job you can be happy with (whether it's dialysis, psych, or some other area)! That's the beauty of nursing tho --if you aren't happy with a certain area, you can venture a different one ?
Sorry to hear you aren't enjoying the job any more ? The people you work with definitely makes or breaks the experience & I feel like if you had more supportive colleagues you'd really enjoy dialysis! I've only been a dialysis nurse for a few months but loving it so far ? It was such a breath of fresh air being able to learn something TOTALLY new, be out of your comfort zone, and develop a new skill set.
I came across your original post ("Take job in dialysis or OR?") and was in the same dilemma as you a few months ago cuz I was really torn between the two as well. Even though I would have rather gone to the OR, I was offered a job in dialysis AND accepted that offer before the OR manager ever contacted me for an interview. I was desperate to leave my surgical floor (it was very stressful) and took the first offer I got, so I did the dialysis course over a course of 3 months.
So interesting to hear the similarities in the routines between our training & workplaces, as well as the differences in the roles on a typical day. What exactly are PCTs and their roles/responsibilities/tasks? We have HCAs (health care aides) where I work and from what I've been reading on these posts, it sounds like PCTs have a lot more responsibility than HCAs. We don't have PCTs here!
Also, why do the shifts start so early for you guys? Our day shifts for the nurses start at 0730h every day, and the patients arrive at 0800h for their treatments.
Hope you are able to find a job you can be happy with (whether it's dialysis, psych, or some other area)! That's the beauty of nursing tho --if you aren't happy with a certain area, you can venture a different one ?
Have you revisited the idea of trying the OR?
I actually got a job doing hospital dialysis. The techs have more limited roles and can't give medications or change machine settings - which I am more comfortable with. I will also get to work with acute patients as well as peritoneal dialysis. I like dialysis - I just didn't like that clinic.
This job isn't through an outpatient center - it's an actual unit in the hospital. When the clinic patients end up in the hospital, they still need dialysis so that's what this unit does. I will facilitate dialysis in the unit for patients who are well enough to come to the unit, but I will also go to the ICU and trauma units to facilitate dialysis on unstable patients who cannot be moved. In this way - it's kind of a cross between acutes and clinic but without the crazy acute hours as we are scheduled for specific patients. I'm also only working 20 hours a week. I wanted part time with Davita but they couldn't accommodate.
Specializes in Dialysis (currently). Previously MedSurg.
On 12/4/2020 at 8:36 AM, Nurse Magnolia said:
I actually got a job doing hospital dialysis. The techs have more limited roles and can't give medications or change machine settings - which I am more comfortable with. I will also get to work with acute patients as well as peritoneal dialysis. I like dialysis - I just didn't like that clinic.
This job isn't through an outpatient center - it's an actual unit in the hospital. When the clinic patients end up in the hospital, they still need dialysis so that's what this unit does. I will facilitate dialysis in the unit for patients who are well enough to come to the unit, but I will also go to the ICU and trauma units to facilitate dialysis on unstable patients who cannot be moved. In this way - it's kind of a cross between acutes and clinic but without the crazy acute hours as we are scheduled for specific patients. I'm also only working 20 hours a week. I wanted part time with Davita but they couldn't accommodate.
That's awesome! I work in a hospital dialysis too and sounds pretty much like what your unit is like. I'm glad you're in a better work environment ?
kbrn2002, ADN, RN
3,970 Posts
Seems as I recall there was usually something almost every day. Either classroom or computer. The days/times varied. Some days were full, other days were shorter. It's not like there's a set schedule you can rely on but you should get your training schedule in plenty of time to plan around it. The computer classes have people in them from all over the country so I am pretty sure the trainer works the rest of the schedule around those classes since they can't be easily rescheduled. When you start training with a preceptor your schedule will be based on that person's schedule.