I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: Neo on October 14, 2009, 12:20:40 AM
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I just wonder why they cant hire someone who is qualified first of all. I mean I have to think with all the money they are getting from diaysis has gotta pay for some better more competent and knowledgeable staff. It really seems that I cacn only find a select few members of any dialysis facility that seem to actually be qualified and care. :banghead;
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I had a chat with one of the head nurses at my center about that. She said some good techs and nurses get an attitude of 'don't take no shit from the patient'. Many patients resent being there and don't always cooperate with the techs. I think most people who work in health care do care about the people they work with. As for being able to stick someone right the first time, my veins roll around some, so I think it isn't easy to get it right all the time. The techs also do not have the authority to change your treatment, they need approval from the dr. or head nurse.
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I cannot believe how many idiots I come across at the differrent dialysis centers. Seems like we could corral them and keep them at just a few and we could go to the other facilities.
The techs don't get paid that much and there is no medical school required. There is no school period required. It is on the job training and then a test. BFD!
The nurses have to be registered, but some are just lucky to get a job at all. I swear!
GREED is why we get shitty help. This is a medicare program and a big money maker and the CEO's are not going to waste their money on help.
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I was only on hemo for 6 months, and I discovered that the techies all seem to be deaf. I once called the front desk and asked them to send a tech to turn off my alarm which had been ringing for over 20 minutes. Yet, the techies were all standing around, laughing, joking, talking on the phone, etc.
for someone who hates all that noise, this was beyond annoying; this was cruel and unusual punishment!
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Well, a tech I know really takes the cake. I dialyse at home and have a tech come to help. The regular guy is really good. But he sent a replacement one day. Once, after treatment had started, the machine started giving alarms. Instead of pressing the Reset button, this butthead pressed the Prime button. :oops;
That was it. For the next half hour or so, there was panic. Eventually, he shut the machine and started from scratch.
Kamal
http://kamaldshah.com
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Medical care is a business like any other. There is no money in the dialysis procedure itself. Everyone loses money doing it. So the do what they can to limit their losses like any business does. Pay a low wage and take whomever applies.
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Im lucky only in terms of they stick me fine and I usually never get missed or infiltrated because my fistula(knock on wood) has never had any problem in the 5 years Ive been on dialysis at all. The only language I hear half the time is Spanish,(all the techs but one speak Spanish) and first of all this is nothing against Latin Americans, I have tons of friends and I actually like some of the techs but I feel kind of disrespected and uncomfortable when I'm getting put on the machine and the 2 or 3 techs are there talking in Spanish and It just seems disrespectful cuz what if they are saying something about me which I suspect they may do sometimes... And when we come to dialysis we have a right to have an attitude sometimes, it sucks to go 3 times a a week and sometimes we are sick, and how do you feel when your sick? MISERABLE! I wish they would pay the techs more because if they had higher salaries they could hire better quality more educated people. Being a Tech is not like working at McDonalds it is almost more important than Nurses are because they do almost all your care except your I.V meds. I also worked as a Tech in the hospital so I know what low salaries they can offer, but I did notice that the dialysis units pad way lower than my local hospital when I was working. Is this similar to your experiene? Is this everywhere?
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Depends on where you are, and who sets their pay. I have seen tech's as low as 9./hour, and up. My payrate for my techs was between 15.-18./hour. They are ALL certified, and have been for a long time. I hand picked them, and they are AWESOME. I have seen soem who are awful at some clinics though.
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The answer is to learn to stick yourself, and to understand how the machine works. I stick myself, even in center, (You can do that, you know!) and when the machine beeps, I look at what's going on, and make my own adjustments.
Don't whine about the help. Take care of your own shit.
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The answer is to learn to stick yourself, and to understand how the machine works. I stick myself, even in center, (You can do that, you know!) and when the machine beeps, I look at what's going on, and make my own adjustments.
Don't whine about the help. Take care of your own shit.
Excellent point! Ask for the best sticker in the house, and have them train you. It's your arem, and your life.
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The answer is to learn to stick yourself, and to understand how the machine works. I stick myself, even in center, (You can do that, you know!) and when the machine beeps, I look at what's going on, and make my own adjustments.
Don't whine about the help. Take care of your own shit.
Just a thought but some of us CANT ! because we are either new to hemo or have lines in ! So we have to put up with the crap ! While im not new to dialysis , i am new to hemo and the other day my arterial line started alarming , now i dont know what to do yet , so one of the unqualified young girls (assistants not nurses) came over and pressed the over- ride , im mean WTF? I said you go get me a nurse ! So some of us have to put up with shit !
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The answer is to learn to stick yourself, and to understand how the machine works. I stick myself, even in center, (You can do that, you know!) and when the machine beeps, I look at what's going on, and make my own adjustments.
Don't whine about the help. Take care of your own shit.
First of all not everyone cant stick themselves, and im quite independent in fact i am finishing nursing school, and i know exactly how the machine works. But why should I or anyone have to worry about the competency of the staff?!! I mean are you mental?! would u rather your unit have qualified people who know what they are doin0g especially since i do NOCTURNAL(BECAUSE I TAKE CONTROL OF MY TREATMENT AND STAY ON 8 HOURS INSTEAD OF 4 BECAUSE I KNOW MY SH*TL.),SO I SLEEP FOR 6 HOURS ON THE MACHINE. I sure would hope that the people know what they're doing when I'm asleep. NICE IGNORANT STATEMENT.Hey everybody he just solved all our problems, and to think,ALL THIS TIME WE WERE JUST BEING TO WHINY AND NOT 'TAKING CARE OF OUR SH*T."
Fixed Quote - Rerun, Moderator
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You just gotta laugh at ignorance... I specifically didnt say I had any problem with my fistula being missed which i wrote earlier. Andfor you info this website is partly up for us to BITCH about things that need to be changed in Dialysis. I set my machine i inject my own heparin and meds. But obviously on nocturnal you sleep and you need trustworthy people in case something goes wrong when you NOT able to control the situation. Ive spent enough time wasting words on someone who wont care what anyone writes anyway.. All can do is state facts and than laugh at such ignorance and listen to the 98% of people on here that make sense. :rofl;
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I know that my tech makes just over $10/hr so the money isn't there. He isn't imcompentent though, I got pretty lucky with my unit everyone there is great
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With the economy there should be "over" qualified people standing at the door trying to get on but no we still go the the Union Gospel Mission and hire "Program" people. They know how to stick! They have been doing it on the street for years!
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You just gotta laugh at ignorance... I specifically didnt say I had any problem with my fistula being missed which i wrote earlier. Andfor you info this website is partly up for us to BITCH about things that need to be changed in Dialysis. I set my machine i inject my own heparin and meds. But obviously on nocturnal you sleep and you need trustworthy people in case something goes wrong when you NOT able to control the situation. Ive spent enough time wasting words on someone who wont care what anyone writes anyway.. All can do is state facts and than laugh at such ignorance and listen to the 98% of people on here that make sense. :rofl;
Keep leaning on people you are convinced are incompetent(and hey- I believe you), and one day you will end up dead. Suck it up cream puff, and deal with the reality that you can take more control.. If you don't it's on you. I Am on nocturnal as well, and still take care of my own alarms.
I realize that some are new to it and I will say the same thing, learn as much as you can, demand better training, and learn to start sticking yourself.
The mortality rate in center is 20% annually. You can beat those odds, but you won't is you expect other people to beat them for you.
Neo- it's not a slam. You are right we should be able to expect competent staff. We can't. Ever. We won't. Ever. At worst they will inject us with bleach or sterilization fluid, at best we can expect random mistakes and oversight. If we as dialyzors keep expecting professional caregivers to care as much as we need them to, we are making ourselves vulnerable.
Bitch away. Just do something about it. I want to have you shouting at me 20 years from now.
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You just gotta laugh at ignorance... I specifically didnt say I had any problem with my fistula being missed which i wrote earlier. Andfor you info this website is partly up for us to BITCH about things that need to be changed in Dialysis. I set my machine i inject my own heparin and meds. But obviously on nocturnal you sleep and you need trustworthy people in case something goes wrong when you NOT able to control the situation. Ive spent enough time wasting words on someone who wont care what anyone writes anyway.. All can do is state facts and than laugh at such ignorance and listen to the 98% of people on here that
make sense. :rofl;
:clap;
EDITED:Fixed quote tag error-kitkatz,Moderator
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I am not on D yet but I know I wouldn't want a trainee or a junior attending to me without an exprienced person around.
I mean you pay for a service...... You should get service. You should not be doing anything by yourself. If you fall asleep you should be able to do so without worrying :"who is going to watch my machine?"
That is rediculous. We , the pasients should not be doing it .... as we did not have the training that they had. Sometimes I think we know more than them, but still.
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Well, if your plan is to get offended by the overall incompetence and lack of careof dialysis technicians rather than taking responsibility for your own care, all I can say is, good luck with that. Let me know how it works out for you.
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EVERYBODY on this post is right. Each patient should learn as much as possible, be responisble for as much as possible, and DEMAND that those being paid to care for them be as competent as possible. It's not too much to ask on all sides. It is your life, and yes people are paid to be doing this job. Some do it VERY well, as I've said so many times. SOme are careless, tired, lazy, or just undertrained. It's sad, but true. Same for patients. SOem are wonderful, knowledgable and resposible. SOme are careless,tired,lazy or undertrained.
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EVERYBODY on this post is right. Each patient should learn as much as possible, be responisble for as much as possible, and DEMAND that those being paid to care for them be as competent as possible. It's not too much to ask on all sides. It is your life, and yes people are paid to be doing this job. Some do it VERY well, as I've said so many times. SOme are careless, tired, lazy, or just undertrained. It's sad, but true. Same for patients. SOem are wonderful, knowledgable and resposible. SOme are careless,tired,lazy or undertrained.
Im NOT allowed to do anything myself while i have a tunnel line in and sadly we dont pay for it over here , we have the NHS , we get what/who we are given , take it or leave it , no choice ! I have no choice but to put my life in these peoples hands and believe me i dont like it one bit !
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I am hesitant to put my two cents in since everything seems a little heated, but I have to agree that for what our insurance companies end up paying, we deserve competant care. I am fairly comfortable with the staff where I dialyzed, but not at all satisfied with the amenities offered. I understand that may not be a huge priority, but I do spend alot of my time in the center and I wish they would put out a little more effort in making that time more comfortable.
And that can mean spending money, like making sure each chair has a television so no one has to share, or just common courtesy, like staff lowering their voices when someone is sleeping. I will never be able to stick myself, sorry but I am a wimp, and some of the staff scare me. One nurse (with 30 or 40 years of experience) took two hours one day sticking me repeatedly. I finally walked out without dialysis that Saturday. I now place a time limit and a "stick" limit. Exceed it and I walk out. Rarely happens and I am always very patient, but even I have my limits. I will even overcome my shyness and say thats enough go get help.
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I agree that we deserve competent care, but i also realize that we will never get competent care. We can accept that or not.
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After reading these posts I feel very lucky to have received the care I have during both stretches of time that I was on hemo. Here in Canada, only nurses do the sticking and I have found most (there is no such thing as a perfect world, in any field of human endeavour, no matter how important the job may be) of the nurses I've dealt with to be caring and professional. I have had to make time upon occasion to talk over issues that bothered me with individual staff members and I have always approached these occasions with the mindset that WE ARE A TEAM. I know things about this particular body that they don't and they have professional experience and training that I don't. My goal and I want it to be theirs too, is to learn from each other. I want to pick their brains and understand everything I possibly can about my illness and the treatment. I insist on sticking myself because I trust myself the most and I can ensure consistency, thereby hopefully prolonging the useful life of my fistula. Money can't buy that.
We don't pay out of pocket here, but we most certainly pay for our health care via our taxes and I'm committed to doing my part to making sure that these precious resources are used as wisely as possible. Many studies suggest or clearly demonstrate that patients who become active in their own care do better than those who are more passive recipients of whatever is dished out. I'm personally not genetically predisposed to passivity so my goal has always been to be as nurse-free as humanly possible. I'm glad they're there if I drop a pencil or something but I like the feeling of mastery and independence that comes from doing things myself. Even when dialyzing at the hospital initially, I asked to do the hourly checks myself although of course the nurse had to check it over and sign off on it. Some were grumpy and not keen but I just keep joking with them and pestering them and explaining that I'm an incurable need-to-know-how type and if they let me I'll make sure I'm their easiest patient as long as I'm not in a coma or otherwise incapable. I also ask questions about everything they touch, why are you doing that, what does that mean, how do you evaluate that etc. That helps me do my own assessments of a nurses' strengths.
I'll just end by saying that I am much the same with regard to my doctors. For me this has nothing to do with how much money someone is making to do their job, or how competent they ought to be, it has more to do with the fact that an extra pair of eyes and another brain checking everything can only result in better overall care. I take my nurse (and doctor) training responsibilities very seriously and overall I've found my dialysis unit personnel to be both pleasant and competent.
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Hey Wallyz... Are you the new Davita Spokesperson? They would love to have you.
THE NEW DAVITA SLOGAN:" Come to Davita and Suck it up and do everything yourself, what, did you expect us to know something?" :rofl;
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Hopefully, with the new national requirement that all patient care technicians be certified by April 2010, we might find fewer incompetence among the rank and file.
8)
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Hopefully, with the new national requirement that all patient care technicians be certified by April 2010, we might find fewer incompetence among the rank and file.
8)
Yea we can only hope, at least its a start.. If the patients become more vocal things will change.. I just feel awful for the many other people who aren't as educated who get mistreated, and im sure everyone on here has seen many people taken advantage of at these places, because they didn't speak up or know they could. Its a huge problem..
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Hey Wallyz... Are you the new Davita Spokesperson? They would love to have you.
THE NEW DAVITA SLOGAN:" Come to Davita and Suck it up and do everything yourself, what, did you expect us to know something?" :rofl;
I don't get get you neo. Here you are, acknowledging that that the largest provider has a lot of less than competent people, and you are still on me for wanting to do things my self? Unless you have a plan for educating and weeding out bad techs, you don't have any way to make the situation better.
If you don't want the situation any better, so that you have something to bitch about, that's fine. For everyone who wants a solution, they need to be the solution.
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Neo , when i started Hemo (after doing pd for nearly 5 years) i was being treated like a numpty and i spoke up, only to be warned be careful what i ask for ! Yeah honestly !
Wallyz , while we would all like to be in charge of our own destiny , some of us CANNOT . Why cant you just accept this ? I did nearly 5 years of home dialysis pd ,but since starting on hemo all my rights have been stripped away, im not allowed to touch anything . Do you know how frustrating that is ? Im neither stupid or ignorant , its a case of RULES are RULES . So its not as black and white as take care of your own shit as you so eloquently put it !
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Kicky, I get it hat people are trying to disempower and intimidate you, and I am angry and frustrated for you. I do believe that you can work your way out of the bind you are in. I just don't want you to give up on controlling your own health and your own body.
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Wallyz , i fight all the time but believe me they dont like it ! They treat like you get kidney failure and brain failure all in the same go !!! :stressed;
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My hospital sends out a questionnaire from time-to-time to monitor patient satisfaction. With a pre-paid envelope, it's anonymous.
Asks you to rate very poor/poor/satisfactory/good/verygood. Issues include confidence in nurse, doctor, explanations, courtesy, waiting time etc.
And boxes for suggestions.
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Ah ,we get a handheld contraption every other day to press buttons on like that, as the hospital are not meeting targets/standards ! I wonder why ?
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Its true there are some incompetent techs, but not all are this way. I believe the medical field takes a very special person to do it. There are plenty of kind, patient, caring people in the medical field and these are the people who do the job becuase they love it, they love helping and caring for others. And then there are those people in the medical field who simply do the job cuz its a paycheck, these people should not be in the medical field. I must admit I myself could not do it, I cant stand bllod and that kind of stuff and I have absolutely NO patience. I also know that here in Indiana anyone can be a tech, and I think this is very wrong. My best friend, though I love her dearly, never knew a thing about the medical filed in her life and she just walked into a center here in Indiana and got a job. She said all she had to do was kinda job shadow the other techs for 3 weeks and take a couple written tests and then after just 3 short weeks of "training" she got to stick her first patient. I mean she does her job well and she loves her patients but as a dislysis patient myself I dont want someone sticking me that has never worked in the medical field before and simply learned by watching other techs for 3 short weeks.
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I just wonder why they cant hire someone who is qualified first of all. I mean I have to think with all the money they are getting from diaysis has gotta pay for some better more competent and knowledgeable staff. It really seems that I cacn only find a select few members of any dialysis facility that seem to actually be qualified and care. :banghead;
It's funny you say this. This is exactly how I feel. Most of the techs at my center are complete morons. Well that's not fair to the techs because honestly I feel the same way about the nurses and all but 2 of the doctors.
Nurses right off the bat, are all foreign. Which I have no problems with. I myself am from a family of immigrants. The problem is they don't speak English well enough to handle some of my concerns. One example of something that happened last week. I was starting to feel cramps coming on and I asked the nurse for saline. She pointed at the saline and said "yes saline" and walked away. Instead of getting frustrated though I couldn't help it giggle. The guy next to me laughed and shook his head.
The doctors are not much better. Like I said with the exception of 2 of them who are always on the ball. They are obviously very knowledgeable and there isn't a question I can ask them to which they will not have an answer for.
/end rant :rant;
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I agree that we deserve competent care, but i also realize that we will never get competent care. We can accept that or not.
I would suggest never accepting anything less than perfection.
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I just wonder why they cant hire someone who is qualified first of all.
In this economy, they should be able to.
We've got a 9.7% unemployment rate.
No one is irreplaceable.
And there would probably be fifty applicants for each tech position.
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Are you kidding? It's a rare person who can handle the emotional load of watching people die, plus needles, plus being around smelly sick people.
(not you guys, but you know the folks I'm talkign about)
I would suggest never accepting anything less than perfection.
One example of something that happened last week. I was starting to feel cramps coming on and I asked the nurse for saline. She pointed at the saline and said "yes saline" and walked away. Instead of getting frustrated though I couldn't help it giggle.
Reconcile those for me, please.
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Every patient has their own unique needs, and every patient has their own priorities.
I still have a hemo catheter. (Fistula operations have failed so far.)
So for me, the absolute top priority is keeping that catheter site clean and free of contamination.
I won't mind if a nurse forgets to give me my Venofer (iron) or Zemplar (Vitamin D) infusions once or twice. Missing a dose won't kill me. Even a problem wih the machine that shortens my dialysis session once or twice won't kill me.
But contaminating my catheter site could kill me. And I have put my foot down on that issue: The techs are going to be as careful about my catheter site as I am myself.
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What state are you in? Can the Techs put a catheter on? They can't in most states. Can't touch it at all in Texas.
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http://ihatedialysis.com/forum/index.php?topic=15497.0 What requirements does your state have for training and certification of techs?
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The center I use has improved immensely since Marshall,the director,left. All the techs are in better spirits and the nurses seem to smile more.
All our techs are certified. They are there if the machine buzzes ,they ask if they can do anything for us.
I think a lot has to do with the rapore they have with the doctors. Dr Cosintino and Dr Emily are great.
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What state are you in? Can the Techs put a catheter on? They can't in most states. Can't touch it at all in Texas.
Same here in California. Thank god!
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Most of the techs at my dialysis center ARE competent, and even caring.
We do have a few bad apples, about which I've posted before.
However, at my dialysis center which is part of a major hospital in Massachusetts, the morale of the staff has suffered, as management eliminated the company matching part of their 403(b) investment plans, as cutbacks during this bad economy. (A 403(b) plan is for not-for-profit organizations what a 401(k) plan is for profit-making companies. It works similarly.)
If management is going to treat the staff like crap, the staff is going to figure that doing an excellent job isn't going to be rewarded anyway, so why bother.
An even worse management decision by the hospital was to eliminate separate sick days for the staff, and combine sick days and vacation days into one "time bank." As a result, a nurse or tech who calls in sick for a day, gets one less day of vacation time. This is a disincentive to calling in sick, and an incentive for a nurse or tech to come to work sick with a cold--and spread it to the patients.
For a hospital to penalize their staff for calling in sick with some infection is absolutely, criminally, STUPID. They should provide a financial incentive for a staff member to stay home and not spread their cold or flu to others. Instead, the "time bank" creates a disincentive.
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Most of the techs at my dialysis center ARE competent, and even caring.
We do have a few bad apples, about which I've posted before.
However, at my dialysis center which is part of a major hospital in Massachusetts, the morale of the staff has suffered, as management eliminated the company matching part of their 403(b) investment plans, as cutbacks during this bad economy. (A 403(b) plan is for not-for-profit organizations what a 401(k) plan is for profit-making companies. It works similarly.)
If management is going to treat the staff like crap, the staff is going to figure that doing an excellent job isn't going to be rewarded anyway, so why bother.
An even worse management decision by the hospital was to eliminate separate sick days for the staff, and combine sick days and vacation days into one "time bank." As a result, a nurse or tech who calls in sick for a day, gets one less day of vacation time. This is a disincentive to calling in sick, and an incentive for a nurse or tech to come to work sick with a cold--and spread it to the patients.
For a hospital to penalize their staff for calling in sick with some infection is absolutely, criminally, STUPID. They should provide a financial incentive for a staff member to stay home and not spread their cold or flu to others. Instead, the "time bank" creates a disincentive.
That's great man. Good to hear. I think my problem may be regional. Most of the techs and nurses at my center immigrants and have obviously not been here long. Also, since they are mostly all from the same country they have no problems communicating with themselves. However, when I need something I am limited to 1 or 2 nurses and a couple of techs.
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I agree with you. When i was on hemo, for a short time. My machine would go off and they would teach me to shut off the alarms because the techs got tired of coming over to me every two seconds (my percath was verry sensitive), and i got yelled at once for touching it. Heck, i got yelled at for wanting the machine to face me, well atleast so that i can look at it.
Lisa
The answer is to learn to stick yourself, and to understand how the machine works. I stick myself, even in center, (You can do that, you know!) and when the machine beeps, I look at what's going on, and make my own adjustments.
Don't whine about the help. Take care of your own shit.
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At my center they're not incompetent. As far as canulating and stringing the machine, they're so trained, that they could do their job in the dark. The nurses are the ones that aren't necessarily incompetent, but slow and un-confident.
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What is it with techs not wanting to turn the machine so you can see it?
My biggest problem is one tech absolutely refusing to put the bleach rag they throw onto the bottom of the machine for cleanup after the patient is off the machine into a sealed bag. It is a harsh chemical and it makes me wheeze and for some damned reason she thinks I am asking to be treated special or something. The truth is, bleach is a harsh chemical and those rags shouldn't be left to fume up the place near any patient. We have had words and I have complained about her twice now. If it happens again, I will tell them if she can't get it through her head that bleach and i don't mix, then she can take care of other patients.
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Very seldom do have an alarm. If it happens it's in the first 5 min or so and my tech knows she has to flip the aterial needle. I wanted to see the machine so I knew what my blood pressure was. when I asked the tech she said she would have to clear it with the Office manager. That didn't work. Her answer was "Fresenius procedure." My Neph is head honcho. When I asked him he said no problem, he wished more patients cared about their own treatment. My machine is always at an angle now. We just have to learn to keep speaking up. If at first you don't succeed, try try try again.
Pam