How do you rate the knowledge and skill of your centers staff?

[bioya]

I would like to know how your center rates? I am former DaVita and I know we had a good clinic when we were Gambro, but DaVita has runied us. Just curious.

[ohhmygolly]

being a chief tech with 3 units --- unit # 1 has a staff that has 10 to 15 years at every postion
unit # 2 has about 2 years at every postion and a c.m. that has been a c.m. for 13 years
unit # 3 has about 1 year at every postion  and no c.m.
rate unit #1 has good leadership on the pct and c.m. side the staff understand the teamwork that is so important in dialysis the s.w has been there for 13 years --- everyone happy everyone helps each other rate 98 out of 100
unit #2  has very strong leadership from the c.m and c.n. teamwork is getting better rate 80 out of 100
unit # 3 is a unit the pct's have taken over there is very little teamwork and no leadership from a c.m also has a new m.d. i think they will come around in time but for now rate 40 out of 100
you will find the personality of every dialysis unit to be differant so they are very hard to rate

[Hawkeye]

I'm an Equipment Technician , and at my clinic the morning shift staff is pretty good.  There are a few slackers and trouble makers, but that happens when you have high staff turnover rates.  The evening shift are a bunch of morons though, and it doesn't help that the clinic punishes trouble patients by moving them to the 3rd shift.  The 2 shifts of staff kinda balance each other out.  I won't even start with my thoughts on the PD department here.  A previous rant from me I believe will explain it.  Either way I don't think the PD patients get the quality care they should, and I find that fact to be rather sad.

[hyperlite]

Here in Ontario we don't have "techs"...we have Nurses who do everything...and they all have a university degree (4 year) They all know a lot about dialysis

[Bajanne]

We don't have techs in the Caribbean either.  We just have registered nurses. Some have 4 year degrees, some don't.  But those who don't definitely have the experience.
To us, a tech is the guy who flits around making sure that our generator, water lines, etc. are doing well, but we have no real contact with him in terms of dialysis.

[kitkatz]

In our unit in California, we have techs and nurses.  Techs do the brunt of the work with patients from needle sticks to machine button pushing to computer entries..  They only thing they cannot do is give meds.  The nurses give the meds and do medical checks on patients.  The nurses in the unit used to have it easy. All they had to do was push meds, not now, the new bosses make them get on the floor and do patient care, too.  First time I saw this a few weeks ago I was surprised and pleased.  I always thought the nurses should be doing patient care instead of just supervising.  Otherwise how do they know when we are really sick.

Katherine

[goofynina]

that is hard to say,  some "workers" nurses included, are very nice and caring, but sometimes they seem like their porch light isnt on,  some are hard workers that take their work seriously and walk around with a serious look all the time, then you get the ones that like to just talk and talk about anything and everything (i think to get out of work) lol,  overall, i think i would rate it  Good

[Rerun]

In our unit in California, we have techs and nurses.  Techs do the brunt of the work with patients from needle sticks to machine button pushing to computer entries..  They only thing they cannot do is give meds.  The nurses give the meds and do medical checks on patients.  The nurses in the unit used to have it easy. All they had to do was push meds, not now, the new bosses make them get on the floor and do patient care, too.  First time I saw this a few months ago I was surprised and pleased.  I always thought the nurses should be doing patient care instead of just supervising.  Otherwise how do they know when we are really sick.

Katherine

Our nurses do the catheters and techs do the fistulas.  I think it would be the opposite.  The catheters look easy to hook up.

[kitkatz]

I rated my unit's knowledge as good, because some of them really know their stuff. The problem is some of them cannot tell it to a patient so it makes any sense.  I heard a tech talking to a patient last night, a new patient, giving him only bits and pieces of what he needed to know.  She kept telling him to ask the doctor, or dietitian, or someone else.  She has a heavy accent and it is hard to understand her sometimes.  I have to ask her often to repeat herself to me.  She probably thinks I am rude.  There are others who know dialysis very well and can answer almost any question you throw at them.  However turn over is great at our unit and we frequently see new employees, then they are gone.  Also the twelve hour shifts just wears people out.  I know a four hour shift for me ON dialysis wears me out!

Katherine

[kitkatz]

Also I think there is a law about techs not touching anything that has to do with the catheters, since they lead to the heart or a large blood vessel in the body.  Nurses have to do it.  Even the LVNs have to be at a trusted level in order to touch the catheters. 

[Hawkeye]

Also I think there is a law about techs not touching anything that has to do with the catheters, since they lead to the heart or a large blood vessel in the body.  Nurses have to do it.  Even the LVNs have to be at a trusted level in order to touch the catheters. 

There are no rules like this at Fresenius.  Any technician or nurse can do a cath, they just have to follow the strict cath policies and procedures.  Every little step is shown to them before they can start and they have refresher courses given by clinical educators every so often too.

[angieskidney]

Here in Ontario we don't have "techs"...we have Nurses who do everything...and they all have a university degree (4 year) They all know a lot about dialysis

We have one nurse who was in PD but switched to HD around the same time I got switched from PD to HD last summer so it seemed like she followed me. She didn't learn HD in school but had to be taught on the job and often had to ask another nurse for help on things and couldn't answer my questions regarding HD and questions about my catheter and upcoming fistula worries.

She is a good nurse don't get me wrong. But I have noticed that you get different answers depending on who you ask. All the nurses seem to think or know different things from each other.

It is hard to get real answers.

And there is a guy we call a tech (I am in Ontario as well) but all he does is work on the broken dialysis machines and when the water main broke he had to come in as an emergency call becuase all the Hemo machines started alarming that there was no water while we were all attached to it.

[Bajanne]

That is the kind of tech we have too, and we had an alarm one evening concerning water too.  The machines just yelled and yelled!  The nurses were skating about the place to get the tech to fix it all.  Added some excitement to the dialysis session!

[angieskidney]

That is the kind of tech we have too, and we had an alarm one evening concerning water too.  The machines just yelled and yelled!  The nurses were skating about the place to get the tech to fix it all.  Added some excitement to the dialysis session!

Ya the nruses seemed to not know what to do tho or how to handle it. They started telling everyone to "runback" (or washback I think it is called in other places) but I held off which was good because I saw the nurse looked unsure and after an hour of our machines on pause we were able to resume since the tech came in and fixed it.

[kevno]

Most of the older Nurses are very skilled at there job. They have trained on all the different departments. Pd, Transplant/surgery and Haemo. On the unit we have a lot of nurses who are being trained for a new unit in another Hospital. This unit opens in April next year. So that is going to be nearly a year to train, for the different types of dialysis.

[BigSky]

Here they use RN's and LPN's.  Techs break down the machine and clean it and handle the cleaning of the reuse dialyzers.

Most all nurses here learn on the job.  A number of the nurses have been on the job for many years.  Very few nurses here are not able to do the job once trained.  From what I have heard from behind the scenes though is that those that do the job poorly are ridden by the older nurses until either the new one shape up or quits.  The nurses are pretty protective of the patients here.

Personally in my unit I cannot say enough good things about them.

[angieskidney]

Here they use RN's and LPN's.  Techs break down the machine and clean it and handle the cleaning of the reuse dialyzers.

Most all nurses here learn on the job.  A number of the nurses have been on the job for many years.  Very few nurses here are not able to do the job once trained.  From what I have heard from behind the scenes though is that those that do the job poorly are ridden by the older nurses until either the new one shape up or quits.  The nurses are pretty protective of the patients here.

Personally in my unit I cannot say enough good things about them.

In my unit they are more protective of the fellow nurses. You can't really complain about any nurse as they will just defend each other. But the unit itself is not bad. Not a lot of the nurses can answer my questions tho

[deej]

In my unit, we have techs and nurses and one doctor. The techs do all the work. They connect us, clean the machines, clean the reused dialyzers, take care of the alarms, everything. They even wipe down the chairs after use. By law here, there must be 1 tech for every 4 patients, 1 nurse for every 20 patients plus 1 doctor. We get connected early (morning shift) but they can´t start the machine until the doctor is in the building. Sometimes we would like to strangle the late doctors  .  We have a big turnover of techs (low pay) but the doctors are very good. The nurses don´t deal with the patients very much. If we get sick, we call a tech who calls a nurse who calls the doctor.

[angieskidney]

In my unit is it just nurses that do everything. The doctors are just the Nephrologists which only come around once a month and a tech who works on the machines to keep them in working order. Also we don't reuse the dialyzers here

[prayingfortime]

I guess this would be a good place to put what I have been wanting and needing to say.  I am a Registered Nurse with LOTS of experience. None of it in dialysis. The clinic where I work has techs but we do team nursing. The state that I work in  says there must be one registered nurse for every 10 nurses present.  I do not think so much of myself that I don't know that a trained monkey could push drugs and listen to lungs, but other than that we all do the same job.  It's just the law that mandates my presence.

I started working after a month's worth of worthless training about a month ago.  I am a nice person and I am good to my patients. I want to do what they want done, do what is right,  and I want to do it to the best of my ability.  I filled a position  that had been open for several months.  The choice was not between me and "the nurse (or tech) that the patient wanted". It was between me and no nurse.
You cannot have the same nurse and/or tech all the timie because people take days off and they take vacations.  The people that are there are there to work.  But they have to learn.  Not one soul on this earth was born a dialysis nurse.  An experienced nurse doesn't come out of a box that way.

If I take time to think it doesn't mean I am going to do something wrong, it means I am thinking about how to do it right. 

I will stick your arm the way it works best.  Tell me, I will listen. Help me. I need you too.  This is how I feed my family.  I want you to like me, but more than that I want to be successful at wanting you to want me to be your nurse.  I can't do it without you.

[Ang]

in  my  unit  the  skill  and  knowledge  is  good  i  gues  but  what  goes  hand  in  hand  with  that  is  how  you  treat/react  to  your  patients.

[karen547]

For the most part, I think the staff does an ok job- we have a lot of techs which are BETTER than the nurses! I think we also need to mention their people skills as well- which lets face it,
some just don't have! I am glad that for the most part I have nice techs and nurses but a couple are meeeeaaaannn!

[kitkatz]

For goodness sake please do not treat me like I am five years old.  Also do not expect me the patient to know your job. I do not.  Do you see me telling my 6th graders to check up on me in my teaching methods?  No!  I come into the center and I get into the chair and I wait on you and the computer to know what to do. You check the baths, and the needles and the temp and everything.  After all they pay you all the big bucks to DO that particular job. I am paying you through MY government taxes to do the job of trying to keep me ALIVE!   Please be observant when you put me onto the machine.  My LIFE is here in that machine!

[prayingfortime]

Yes, it is your life. An No, I will not treat you like a child.  I hope you get what you want from your dialysis staff.

And yes they are your tax dollars, and mine.  My goal as a dialysis nurse is to do my job well.  I can't make the needles not hurt, but I can always strive to do the best I can to make your time go as well as possible.

It is refreshing, however, to meet you.  You must be the teacher that knew on her first day of teaching how to do everything without thinking, how to meet the needs of every child, how to assess the learning capability of each student without thinking.

I strive to be respectful, respectable, and respected.  If you think about that, can you ask for more?

[kitkatz]

You must be the teacher that knew on her first day of teaching how to do everything without thinking, how to meet the needs of every child, how to assess the learning capability of each student without thinking.

Excuse me! I never said a word about your profession having to know everything the first time they meet me.  Just have some respect for the patient you are dealing with and their own knowledge.

Of course no teacher knows everything about every student, however I have a modicum of respect for my students as human beings and try to treat them with the respect due to them as my students and as learners.  Remember it is often not what you taught,m but how you treated the student that they will always remember.   It is the same in any other profession!