Okay, so today I ended up having a day off; I was scheduled in our shitty schedule, but since Tuesdays and Thursdays are "low census days" typically (most dialysis is scheduled Monday, Wednesday and Friday), I had those two days off.
So that tops my list of gripes-- their inept attempts to come up with a schedule that will cut back on the overtime. It made my schedule a living hell the last two months and burned off whatever goodwill I had. The asinine staff meeting just infuriated us even more. Among the other gripes I have:
-- Their training program sucked. As a former educator, I give it a D+. The classroom material was uninspired, one of the instructors was one of the worst teachers I've ever dealt with. Some of the nurse preceptors I worked with were great, but couldn't do nearly as good a job as they might have, because instead of working with one nurse through the whole training, we worked with one on one day and another and another... There was a lot of stuff we never went over because they had no way of knowing whether it had been covered or not
--Massive disorganization. I know that acute care dialysis is bound to have a little chaos because you don't know how many patients you'll have from day to day, but at least one of the coordinators, the people who actually tell us which patient to dialyze at which hospital, has no idea what she's doing
--The paperwork. The paperwork is disorganized, chaotic and in many cases completely redundant. We put the start and stop times of treatment on no fewer than four different sheets. The machine logs-- the logs of tests of the water, disinfection, etc. of the dialysis machines-- were apparently designed by a drunk person. There is no rhyme or reason to them. They also moved recently from a timesheet we turn in once a week to a hyperdetailed timesheet we turn in every day. And of course they issued this timesheet with no instructions on how to fill it out properly.
-- Too many chiefs, not enough Indians. I think there is about one administrator for every four nurses. And all of those administrators except the two who actually do some work, the coordinators, are standing around trying to figure out how to make us more productive. Here's how to make the unit profitable: fire the head of the unit, "Lumbergh" and the person who is on "light duty" from injuring herself doing something stupid, and is now charged with "auditing" the other nurses, trying to catch them doing something wrong. She's a tech-- not even an RN. She has no business auditing RN's.
But with the bad, comes the good. The peeps-- the people I work with. I'll tell a little about some of them.
One of my favorite co-workers is Patrick. He's young-- about 25. His family moved from the Phillipines when he was about 13, so he's grown up in two worlds. He's very quiet, but when he opens his mouth, he shows a wide breadth of knowledge. He's also been one of the people who has helped me a lot. It could be very humiliating having to ask a kid half my age about how to do my job, but he has always been respectful, never showing a bit of condescension.
Another favorite is Saint. He's lived up to his name a couple of times, including yesterday, when I had a patient accidentally pull a needle out. I had to keep pressure in order to keep the patient from bleeding, and asked another nurse to see if someone was available to help me. It turned out he was right around the corner; he quickly and quietly helped me with the patient and the machine, and calmed me down afterward. He's helped me out in a couple of other situations. He's also Filipino (there are a lot of Filipinos in the unit). He's another guy who's always ready to help without making me feel stupid.
Ramon is a guy I always get a kick out of working with. I thought he was latino when I first met him, but he's also Filipino. Picture a Filipino guy who looks latino, but acts like a combination of Warren Beatty and Bill Murray. He's got two families, one with the ex-wife and one with the current one. He's by all accounts a great dad. He's also my hero in that he's openly contemptuous of the managers.
Yesterday, he and Manny, another guy who is openly contemptuous of the management were scheduled in the "acute room" together. The reason became obvious; the unit manager who is a nurse, and pretty competent, and the woman who's on "light duty" spent the day in the acute room with them auditing them. It was farcical. Ramon and Manny weren't intimidated in the least.
A couple of weeks ago, I was working at one of my hospitals and I had to find Fernando, one of the veterans, to get a key. The hospital has only one key for the dialysis storage room, and so if a second (or third) nurse is called to that hospital, he or she has to find the other nurse. This is usually no problem-- we have a list with all of one another's cell numbers on it.
I went to the room Fernando was working in and had a chance, for the first time, to chat with him. It turns out that he's a tech-- not an RN. He told me that until pretty recently, the unit was a great one to work for-- until they brought in "Lumbergh." He has been doing dialysis for about 20 years, he told me. He added that he was stuck there; not being an RN, he can't go anywhere but the other big dialysis corporation. If he were an RN, like me, he told me, he'd be looking for another job.
I've taken his advice under strong advisement.
There are other folks I work with who, for the time being, are making a situation that is becoming increasingly uncomfortable and stressful tolerable. Between that and knowing I'm helping folks, I think I can tough this out for a while. I'll write more about my terrific co-workers soon.