Reply With QuoteIs this in the hospital setting or Sub- acute(nursing homes)?Normally if your talking about acute ratio is 1:1 Rn's or techs.
jajs
I worked on an Acute Dialysis unit which was run by Davita..I thought that most of the staff were inexperienced to take care of the acutely ill pts..
I believe that RN's should have some acute care experience prior to working in a dialysis center..Ex. shutting off heparin drips, responding to chest pain, care of seizure acitvity and dealing with arrythmias..I also believed that some of the techs were not trained properly..Not responding appropriatly to hypotension, changing the K baths without consulting with the RN's, ETC..I Also found the hours to be extremely long..7am-11pm..Secondary to no staff.
Also the HD room had 7 beds..Our manager always thought that one RN should be in the room with 2 techs..I thought that this was unsafe.
So i left..Any other Acute places like this?
Is this in the hospital setting or Sub- acute(nursing homes)?Normally if your talking about acute ratio is 1:1 Rn's or techs.
jajs
In response to your question it was in an acute hospital setting..In the dialysis room itself our manager wanted only 1Rn and 2 techs for a seven bed unit..When I was in the ICU, it would be a 1:1 ratio.. In which techs had nothing to do with it... I didn't feel that that was safe.. Especially with patients who were so acute..Post Caths, post cardiac surgeries, pts in with chest pain, Etc.... Is any other acute place like that? Especially the hours..
There wasn't much structure or support..
I work in a acute inpatient dialysis unit in Rochester, New York. We have a minimum of 2 RN's and 1 tech in a four bed dialysis unit. One nurse for 2 acute patients. We do however, have several away treatments a day averaging around 8-9 critical patients, and also have SLED treatments. The SLED's have one RN to four patients in the ICU's. Our current census is a staggering 35 ESRD patients and 4 PD patients. Yes, I would be concerned with your situation as well. More than 2 critical patient's at a time is asking for trouble.
The acute units I've worked at were 2 pt's p/RN in the dialysis room; away pt's in ICU, CCU, etc were 1:1. I also worked at a hospital based subacute unit with vent pt's and other acutely ill pt's and they wanted me to run up to three pt's at a time - IN DIFFERENT ROOMS! And not rooms next to each other, some where down the hall. I told the physician and supervisor that I didn't think that was legal and even if it was I wouldn't do it (which I told them before I even took the job). Shortly after refusing to do pt's in different rooms (I said I'd do 2 in the same room), I was written up for wasting supplies. I took too much gauze into an isolation room for a new cath bleeding all over the place. After being "counselled" I just turned in my badge at the end of the day. So far they haven't injured anyone as far as I know. Has anyone ever heard of such ridiculous expectations?
I took a job as an acute care HD Nurse with Fresenius/Springfield.(Ma) I have plenty of acute care experience.
I attended their class religiously and ended class portion with a 97.5 average.I was terminated today for bogus reasons that I did not know enough.Duh
From the moment I stepped into their acute setting i was harassed. Oh why do people act like that?
Staffing in one unit was a total of 8 patients to 1 RN and one tech.
When going to local hospitals they had us running all over between many rooms to dialize different patients...expecting that we would start a patient and leave and go on to the next..just check back each 1/2 hour to see how they were.
I provide good safe care to MY patients..And no staffing is not safe:frustrated: :frustrated:
Re: Safe Staffing:Acute HD
Wow, reading over some of these situations is deja vu all over again.
I worked in a chronic clinic for 4 months. They didn't have enough staff to train me, so my preceptor was a tech. Now I have respect for any tech who has tecnical knowledge to pass on, but this one, the first words out of her mouth was "you nurses think you know everything, but dialysis is different". She constantly questioned my assessments and my judgement. One patient was a new PD patient with a new PD cath that was infected and needed HD until the cath was clean. The man was clearly septic, but my precptor insisted he wasn't. I went over her head, informed the charge nurse. The man was admitted after the treatment.
The formal training was ok, 2 weeks of class (no hands on, just theory) and the hands on was in my clinic. My main beef was that further on in my training I realized my precptor was really doing it "her way" not the way it should be done. Whenever I voiced my concerns that I didn't to be taught specific steps properly and needed the opportunity to do it for myself (I'm a hands on learner), I got "we have no time for that". The staffing ratio was 8 chairs, 1 LVN/RN and 1 tech. Combine all this with the fact the DHS came in on a major inspection stemming from patient complaints and deaths in the chairs, and I finally decided enough was enough.
Now in the facility I work at now, we used to have a dialysis unit for inpatients, but that was closed and the nurses run the patients individually at the bedside. The primary nurse is responsible for all the patient care. The dialysis nurse is only responsible for running the patient, taking orders from the nephrologist and serving as a resource for the primary nurse.
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