What is it like working for Divata Dialysis?

imperial · Mar 6, 2005

I agree with what you are stating. It is very disappointing for one, I am sure, to receive erroneous answers from staff. What I hear alot is that nothing is done until an alarm goes off. i.e. if an Arterial Pressure is 260 the staff will not do anything until the alarm sounds. IMHO, I feel they could check to see if there is something that could be done to change the ap ..........i.e. reposition the needle. ..FMC and whoever else trains in such a short time should be ashamed of themselves. These are physicians running the companies and I can assure you that if it were their loved one they would make sure the person delivering care had more than 4 wks of training. It is just amazing to me how a physician can be over a large corporation and no regard for patient's lives, and that, imho and I mean my most humbling opining manner, is the truth of it all. Shame on them............

RRN · Mar 6, 2005

I agree with what you are stating. It is very disappointing for one, I am sure, to receive erroneous answers from staff. What I hear alot is that nothing is done until an alarm goes off. i.e. if an Arterial Pressure is 260 the staff will not do anything until the alarm sounds. IMHO, I feel they could check to see if there is something that could be done to change the ap ..........i.e. reposition the needle. ..FMC and whoever else trains in such a short time should be ashamed of themselves. These are physicians running the companies and I can assure you that if it were their loved one they would make sure the person delivering care had more than 4 wks of training. It is just amazing to me how a physician can be over a large corporation and no regard for patient's lives, and that, imho and I mean my most humbling opining manner, is the truth of it all. Shame on them............

Can you say MONEY?????? IF you can you get the grand prize.. I amazes me that when I left Fresenius in 2002 ONE MONTH into my travel contract they offered me 20% to return to a STAFF position.. Not even charge. And I didn't do it.. Actually, was pretty insulted ..Where was the money when I was there.. Then one month later they came back with 30%.. Now I was really p.o.'d.....And if staff knew what they are paying for travelers they'd be outraged.. They could get two very well paid RN's for what they pay for one traveler. When I started traveling I took a 62% increase in pay . Now you tell me why would I go back for 30%????? I say "You can pay me now (as staff) or you can pay me later...Later usually costs more".. When I do go home to Fresenius I get 10% over my base for per diem..

But I'll tell you what a traveler is. He/she is a bandaid. A traveler is put over an open cut and left there for 13 weeks. Then that bandaid is removed and the cut is oozing pus and no one knows what to do but put another bandaid (traveler) over that nasty cut and keep going for another 13 weeks.

It really is a shame you are right. I am 54 today. Unfortunately, or fortunately I don't have much longer to work. I don't think I'll see many changes in that short time.. I would love to but I won't.

imperial · Mar 6, 2005

Happy Birthday !

It is a shame and crying shame..................I am shocked that organizations i.e. the nephrology nurses assoc, as well as other dialysis organizations have not stepped up to the plate and really addressed these issues. I go to alot of other sites, etc and continue to see sites that are supported by dialysis comcpanies, so, that tells me that they can't, in reality, oppose anything with a company as it would be a direct conflict of interest.... and, as all things, people are bought off... just look at california and how their big governor vetoed the ratio bill.................a perfect example.. perfect...............he actually called the nurses association a 'special interest' group. HEWLLLLOOOOOOOOOOOOOOOO. so what is the group that influenced him to vetoe the bill of having ratios for patient safety.. oh don't get me started.............. :uhoh3:

nosonew, BSN, RN · Mar 6, 2005

Happy Birthday !
It is a shame and crying shame..................I am shocked that organizations i.e. the nephrology nurses assoc, as well as other dialysis organizations have not stepped up to the plate and really addressed these issues. I go to alot of other sites, etc and continue to see sites that are supported by dialysis comcpanies, so, that tells me that they can't, in reality, oppose anything with a company as it would be a direct conflict of interest.... and, as all things, people are bought off... just look at california and how their big governor vetoed the ratio bill.................a perfect example.. perfect...............he actually called the nurses association a 'special interest' group. HEWLLLLOOOOOOOOOOOOOOOO. so what is the group that influenced him to vetoe the bill of having ratios for patient safety.. oh don't get me started..............

Personally I think the ratio should be RN 1:6, Tech 1:4 and that shouldn't include the reuse person, secretary, etc being counted...only those people working on the floor. At my unit we have TONS of new patients and now have 13 catheter patients out of 27... just about half. When there is only one nurse to do all pre and post assessments, give meds, put all catheters on, take all catheters off, talk to doctors, deal with any emergency, it is just TOO MUCH! Nothing else gets done...no teaching, no time for hugs, no time just to chat and find out what is going on in their lives, no time to call the family for info, no time to update meds, etc, etc...

Maybe there should be criteria that the CEO's of these companies must have a close family member on dialysis...THEN we would surely see a few changes... :chuckle

imperial · Mar 6, 2005

Personally I think the ratio should be RN 1:6, Tech 1:4 and that shouldn't include the reuse person, secretary, etc being counted...only those people working on the floor. At my unit we have TONS of new patients and now have 13 catheter patients out of 27... just about half. When there is only one nurse to do all pre and post assessments, give meds, put all catheters on, take all catheters off, talk to doctors, deal with any emergency, it is just TOO MUCH! Nothing else gets done...no teaching, no time for hugs, no time just to chat and find out what is going on in their lives, no time to call the family for info, no time to update meds, etc, etc...
Maybe there should be criteria that the CEO's of these companies must have a close family member on dialysis...THEN we would surely see a few changes... :chuckle

As I have said over and over there will not be aggressive change, or any, for that matter, until, as you said, a CEO, or politician has a loved one on dialysis. And, then that person would probably be at home, on home hemo with private RN's 24/7. There is one FMC unit, of which I have visited in wanting information. They have 15 chairs and one isolation room. There are two shifts and two patients on third shift. They have one RN (clinical manager) secretary (how can ya count a secretary in staffing?) One LVN/LPN and two techs. Then usually one float from another one of the units. So, for 15 patients - 2 shifts - two patients on third shift.. there are including manager... excluding secretary.............4 staff and sometimes 5.. then sometimes there is someone in the morning and into second shift to help with cannulating.. Is this standard?

babs_rn · Mar 31, 2005

I think companies have their good and bad points and the bottom line is it depends on the individual unit and those working in that unit. All companies have great units and all have ones with deplorable conditions related to delivery of patient care.. Just take a look at any of the survey results and you will see the horror stories... those are the facilities that need to be changed. So, I ask,, from you all who certainly appear to be dedicated well educated dialysis staff, how does one change a unit that is bad to a good one. When I state bad, I am referring to mistakes made by staff due to lack of education, mistakes made in water treatment, dialysate, entering information into machine, etc. Most of these mistakes, that I have reviewed/read are related to lack of education and from staff who are not well trained. I wish all the units had staff as you all here.

I have to agree with you on that point. It is, more often than not, a matter of the individual center/clinic and the regional administration. I recently walked into a center that has had..mistakes made by staff due to lack of education, mistakes made in water treatment (also due to lack of sufficient understanding of the importance of the system), not to mention actual building/facility issues. In my 10 weeks here I have utilized the resources available, with the support of a fantastic RD, and have a heavy-duty training program going on, re-educating everyone from the basics on up. Those who are well familiar with the material can consider it a refresher, but everyone learns something (and once this is done no one can claim "I didnt' know")...building issues are being addressed though I pray for a new building when the acquisition is complete.

I won't get into the differences between DaVita's and Gambro's computer systems. I will say I prefer DaVita's and look forward to working with it again. Just more user-friendly, but then it's newer, faster, and we're all entitled to our individual preferences. Staffing-wise, I work around a lot of Gambro CDs who are working the floor full time as charge nurses...and I know my day is coming there too. DaVita FAs have to do it too when there's a crunch, and in our state an RN has to have 6 months of dialysis experience in order to be able to charge. Six of one and half a dozen of the other on that end of things, we have 26 stations and often only one RN in house and with staff call-ins, she often winds up having to take a bay too. So that's not just a DaVita thing, that's an "available staffing" thing.

For-profit companies are always going to be about the bottom line, period. The fact that they exist in healthcare is a topic for another forum.

RRN · Mar 31, 2005

I have to agree with you on that point. It is, more often than not, a matter of the individual center/clinic and the regional administration. I recently walked into a center that has had..mistakes made by staff due to lack of education, mistakes made in water treatment (also due to lack of sufficient understanding of the importance of the system), not to mention actual building/facility issues. In my 10 weeks here I have utilized the resources available, with the support of a fantastic RD, and have a heavy-duty training program going on, re-educating everyone from the basics on up. Those who are well familiar with the material can consider it a refresher, but everyone learns something (and once this is done no one can claim "I didnt' know")...building issues are being addressed though I pray for a new building when the acquisition is complete.
I won't get into the differences between DaVita's and Gambro's computer systems. I will say I prefer DaVita's and look forward to working with it again. Just more user-friendly, but then it's newer, faster, and we're all entitled to our individual preferences. Staffing-wise, I work around a lot of Gambro CDs who are working the floor full time as charge nurses...and I know my day is coming there too. DaVita FAs have to do it too when there's a crunch, and in our state an RN has to have 6 months of dialysis experience in order to be able to charge. Six of one and half a dozen of the other on that end of things, we have 26 stations and often only one RN in house and with staff call-ins, she often winds up having to take a bay too. So that's not just a DaVita thing, that's an "available staffing" thing.
For-profit companies are always going to be about the bottom line, period. The fact that they exist in healthcare is a topic for another forum.

And these big companies making a profit in the billions is certainly a topic for another time.....

jnette, ASN, EMT-I · Mar 31, 2005

Same here.. 6 mos. before charge.

And our charge nurse ALWAYS has a "side" (= 4 patients). So she counts as one of the floor staff. We usually have three on the floor.. could be one nurse and two techs, two nurses, one tech.. or three nurses.. depending.

Then we have one "water person" (previously reuse person). But we rotate, so the water person can be any one of us. The water person helps out on the floor when and where he/she can... but has his/her own duties to fulfill mostly.

So for 12 patients on each of the daily two shifts, we have three staff members on the floor (one of which is charge in addition to having four of her own patients).. a water person, and a secretary. DON/MGR on the floor when neccessary due to short staffing, vacations, etc. to fill another staffmembers shoes for that time period.

Crazy.

RRN · Mar 31, 2005

Same here.. 6 mos. before charge.
And our charge nurse ALWAYS has a "side" (= 4 patients). So she counts as one of the floor staff. We usually have three on the floor.. could be one nurse and two techs, two nurses, one tech.. or three nurses.. depending.
Then we have one "water person" (previously reuse person). But we rotate, so the water person can be any one of us. The water person helps out on the floor when and where he/she can... but has his/her own duties to fulfill mostly.
So for 12 patients on each of the daily two shifts, we have three staff members on the floor (one of which is charge in addition to having four of her own patients).. a water person, and a secretary. DON/MGR on the floor when neccessary due to short staffing, vacations, etc. to fill another staffmembers shoes for that time period.
Crazy.

Darling try doubling the patients and having one nurse to give all meds and be in charge.. And sometimes have 4 patients...

That's crazy,,,,,,,,,,,,,,,,,,,,,,,

imperial · Apr 2, 2005

Been a Davita nurse (in GA) and happily so for the past two years. Worked agency with other companies, wouldn't waste my time with them. Davita is a good company BUT it has developed more of a "bottom line" mindset the past year or so than it had when I first started. That said...staffing ratios are pretty much set by the individual state. Here in GA it's 4/1 caregiver, 10/1 Nurse (not direct, just a nurse in house per 10 chairs running) and RN in house at all times that patients are receiving care. I have floated to other Davita clinics within the state as well and have found that each center has its own individual quirks and some are great to work in, and some are just awful. Just depends --- I like the company, the benefits and profit-sharing are wonderful, and I am paid based on my years of nursing experience, not my years of dialysis experience. Unfortunately, like everywhere else in healthcare, it would appear that there are some really clueless people out there making clinical decisions (policies and procedures) based on theory and conjecture rather than on actual input from the caregivers themselves regarding what works in reality and what doesn't. But that's everywhere you go. If it's the company you want to know about, I say go for it...just make sure the center itself is a place you want to be. But as far as Davita itself as a company, let me tell ya...nowhere else in my 16 years as an RN have I been as fulfilled in my job and in my role and the support system that I receive as I have been here. Even if I am stretched too thin sometimes.
Good luck whatever you decide!
Barbara

I am aware, due to my advocate work, that there are a few units that are now going to reuse of dialyzers in the Georgia area, Savannah. I am wondering, due to many questions asked by patients, if the patients have a say in this decision. Can patients request not to do reuse? Thanks.

jnette, ASN, EMT-I · Apr 3, 2005

I am aware, due to my advocate work, that there are a few units that are now going to reuse of dialyzers in the Georgia area, Savannah. I am wondering, due to many questions asked by patients, if the patients have a say in this decision. Can patients request not to do reuse? Thanks.

Yes.. patients have the right to refuse reuse of their dialyzer. However.. speaking as one who was a PCT and then Reuse Tech for about four years before becoming an RN in this field, I can say that there is no reason whatsoever for concern about reuses. There are so many protocols, procedures, and checks in place that it is more than safe. We never had a patient to refuse reuse... ever. The only reason our company decided to do away with reuse was once again.. the bottom line. ($$)

They find it more cost efficient to use the disposable dialyzers.

RRN · Apr 3, 2005

Yes.. patients have the right to refuse reuse of their dialyzer. However.. speaking as one who was a PCT and then Reuse Tech for about four years before becoming an RN in this field, I can say that there is no reason whatsoever for concern about reuses. There are so many protocols, procedures, and checks in place that it is more than safe. We never had a patient to refuse reuse... ever. The only reason our company decided to do away with reuse was once again.. the bottom line. ($$)
They find it more cost efficient to use the disposable dialyzers.

Proprietary...

When I worked in Danbury CT the NM there did her master's thesis on reuse.

Her conclusions were that it is actually better for the patient also.

I wonder if I can find her work.. Maybe I'll do some digging..

Here's something from a quick google search:

http://www.aakp.org/AAKP/RenalifeArt/2002/freseniusdialyzers.htm