What do you think about dialysis nurses?

Anna Flaxis, BSN, RN · Sep 1, 2013

Gawd, I loved the dialysis nurse I used to run into on the floor! One less thing I had to do, plus he was super knowledgeable. I loved collaborating with him. He taught me so much. He could do HD or PD or whatever, and he always treated me like a peer even though I often didn't have the slightest idea what he was doing.

Pangea Reunited, ASN, RN · Sep 1, 2013

Generally speaking, I have a pretty high opinion of them. The few who've annoyed me are the ones who call me over and over for stupid things. For example, I had one confused patient who would say she wanted to stop dialysis about every 15 minutes. Each time, the HD nurse hit the call light and each time I reoriented the patient and reminded her why she needed HD.

After the first 3 or 4 times, I started to get annoyed- especially when I went in and the HD nurse was eating a cheeseburger and fries at the patient's bedside. It's like they just didn't want to be bothered with the patient.

Fiona59 · Sep 1, 2013

Honestly? Dialysis is in a separate building and we never see the staff that work there.

nrsang97, BSN, RN · Sep 1, 2013

I worked in ICU and bedside dialysis was usually set up and maintained by the techs. Occasionally I would see the dialysis nurses. I usually found them to be helpful. I was happy to see the techs. I would have to do the hour to hour documentation, but they did everything else and came when I needed help.

lisajtrn · Sep 1, 2013

When i worked on the floor and we sent patients to the hemo unit for dialysis we sent all their meds with them. Most of the time they would come back with their meds not given. They would not give them their meals and if incontinent, were never cleaned and changed.

Now I am in ICU and it is done in their room so I look after the patients needs.

Daisy_08, BSN, RN · Sep 1, 2013

Well, they write orders on scrap paper, and when are called for a real order they never send it and then freak out it was never done. Inc pts are never changed, pts who need to be feed never are, pts who require o2 don't get it even when the supplies are sent and then it is a big mystery why they had to call a CRT.

Generally I dont have warm feelings, however when I call them they are almost always polite and seem very reasonable.

CodeteamB · Sep 1, 2013

For a long time the only interaction I had with the dialysis nurses were when they came to my monitored unit to treat patients who were too unstable to go to their unit. As far as I could tell their only responsibility for the patient was to access the catheter, push a button and then read a magazine and double-chart the hourly assessments I completed.

I figured it would be different on the actual dialysis unit, but the day I had a patient become hypoglycemic in dialysis I had to go upstairs, assess, start a new peripheral IV and treat the patient on orders from their physician!

I never had problems with patients not getting fed, and the only meds we sent with patients were those that were to be infused via the catheter at the end of the run so that was never a problem.

If this is the situation where you work OP, then I would suggest that a way to improve would be to take responsibility for the patient as a whole while they are in your care, the patient has many needs that have nothing to do with the catheter or the machine.

RNewbie · Sep 1, 2013

I've worked at hospitals that send dialysis nurses to the bedside. The pts are usually sleeping and the dialysis nurse sits in the room and watches tv. I've had several give me their cell and tell me to call if the machine alarms. The facility I worked that had an inpatient dialysis unit, the dialysis nurse did nothing besides dialysis. It was so frustrating. This hospital had paper charting and orders so it was clear when there were new orders because they would be flagged in the chart. They would always come get pts early right around shift change when things were crazy. I cant tell you how many pts I've gotten back 4 hrs later with orders still flagged and no one bothered to carry them out. If not that they could have called the floor to let us know so we could come do it, but these are things that any nurse could do. I mean things like transfusion orders. Why would you not even attempt to transfuse the pt while they are there for an order that was written hours ago? One time I had a pt that was transported around 730a. I barely laid eyes on the pt before he left and never got a chance to look at the chart. Pt comes back around noon with flagged orders in the chart written around 700a. Orders were to dc the pca. Pt was super lethargic and barely responsive. Rapid responsed the pt, he was sent to the unit. I know that was a lot but I think I have some pinned up feeling about my experiences with dialysis nurses!

NurseRies, BSN, RN · Sep 2, 2013

Thanks for all the feedback so far. I am not surprised by the comments. As a traveling dialysis nurse, I do hear a lot of the same complaints. I think it goes for any unit, you have some nurses that go above and beyond their call of duty, and others who do their job responsibility only and call it a day. One thing to consider is that many hospitals get their dialysis services by an outside company, either Fresenius or Davita. If this is the case in your hospital, most of the times, the nurses do not have access to the hospitals medication systems and are not legally allowed to do anything outside of the nephrology practice.

That was hard to get used to coming from a hospital based dialysis unit. I went to California and was not a direct employee of the hospital. They told me that the only thing I could do was hook up the patient and record vital signs. If I helped move the patient up in bed and they somehow got injured, I could be in huge trouble for practicing outside of what it covered in our contract. As a Davita nurse, I didn't even have access to the computer systems to look up labs! I had to ask the nurses for saline syringes, heparin, all kinds of things that made me feel bad.

I get a lot of snide comments from floor nurses and ICU nurses, and I am just trying to figure out what I can do! It seems that the attitude is that I just go in there, plug in a machine, hook em up, and then sit on my butt for 4 hours. I will give it to them, ICU treatments are not difficult and it is very boring, but the rules are the dialysis nurse is NEVER allowed to leave the room, and I mean NEVER. Not even to pee unless someone is watching. I also must defend that there is much more to the machine then just plugging it in and hooking them up. It takes about an hour to safely set up a treatment, and it also takes 3-6 months of training to learn the equipment.

I think that we all have to work together. I like to do things for the patient since I'm in there all morning, but at certain hospitals, I am legally not allowed to even feed them! I think sometimes people think we have the easiest job in the entire field of nursing. But I have to defend that good dialysis nurses make it look easy. You have an inexperienced or lazy dialysis nurse and you will see how messy things can get in a hurry! And regarding sending the patient back with a soiled bed, some units do not have the means, or the privacy to completely change a bed. The unit is out in the open at times and I know at one hospital I've worked at, we didn't even have blankets, let alone sheets, gowns, or anything to clean anyone up with. We are kind of given the bare minimums to function. Also, I cannot carry out physician orders that are not related to dialysis. If I saw a flagged order, I would check it to make sure it wasn't STAT, but legally, most of the time, this is out of our scope of practice. (unless your hospital runs their own dialysis unit and doesn't use the big companies to do their services). Many times, we don't even have an IV pole. It is frustrating for us knowing that the patient has needs that we cannot fix. Also, patients are technically not allowed to eat while they are having treatment. And we are instructed to only check the blood sugar if they are symptomatic. sigh.. I hope you all can understand my frustrations too.

Sometimes I don't think we understand how challenging the other job can be, and let me tell ya, I don't think I could ever be a floor nurse! I really, truly respect the floor and ICU nurses, and the LTACH nurses too. It can't be easy!

LakeEmerald · Sep 2, 2013

Thanks for opening our eyes to your perspective. We get so busy at work we just don't take time to see everyone's side. I am greatly relieved that I do not have to do dialysis work in the ER!

Bortaz, MSN, RN · Sep 2, 2013

I don't think of dialysis nurses. Ever.