I can only hope that centers, corporations, and units will be inspired to improve their methods on how new technicians are brought into the dialysis units.
1. Improper Training/Preceptor. Correct training is very important. Learning how to do things the correct way the first few months of becoming a new tech is very crucial. I have seen technicians and nurses who were never trained right in the beginning stages of starting their new role within the dialysis clinic. As a result, those individuals would get written up, and reprimanded often because of the frequent mistakes they would make. This is no joke. I have seen people quit because they see that they can't handle the pressure to do a job they were not properly trained to do. The pressure can come from the patients getting furious and rejecting them, and teammates snares, as well as management complaints.
Example: You shadow a preceptor who only shows you shortcuts, instead of clinical protocols and policy. Or you were only able to shadow someone for one week or two weeks and that is it. If the state health department was to come to your unit and watch you, would they see you making serious mistakes or following the clinical state mandates?
Tips: If you find you are not learning like you should, talk to your manager about shadowing a few individuals and OBSERVE. You should look at how different techs set up their section, their machine, and handle their patients. If you see a tech that is getting compliments and praises from their patients/teammates and doing things the right way, this is someone you need to be looking at. Ask to watch policy and procedure DVD's that each company has to help you get everything down pact. Also ALWAYS listen to the patients' complaints and do your best to help them.
2. Getting their own assignment too soon and are some times alone when handling patients. Up to 3-4 and sometimes 5 patients some new technicians told me they have received after a week of being on the floor. A sole assignment is when a technician will be alone with several patients for one, two, or three shifts, and is responsible for monitoring them, putting them on the machine, taking them off and cleaning the machine afterward.
Every individual has their own rate of learning and comprehending the course of the job as a dialysis technician. However at least 2-3 months are needed for a new dialysis technician to really get good at learning about the unit, the policies, and procedures as well as putting on and taking off patients appropriately. I find clinics that rush their new technicians out on the floor quick within a week or a month DO NOT CARE ABOUT THEIR PATIENTS. When clinics do this, SERIOUS MISTAKES will HAPPEN. Patients need technicians as well as nurses that really know what they are doing, these are their LIVES and many of these patients have CHILDREN and RELATIVES depending on them to survive.
Example: I remember having to even tell a nurse while I worked in an far per-diem unit, how to put on an individual who had a catheter access without me touching the patient. If I wasn't there who knows what would've happened to that patient. She should've been shadowing a nurse but they were short of staff, she was the only one there and she was rushed out on the floor too soon and these were the results. Was I in the wrong for telling her what to do? No....but some will say yes.... but if I didn't her patients would've suffered greatly.
Tips: Explain to your manager that you don't feel comfortable being given a sole assignment so early without any help. Tell the manager that you are still LEARNING and you don't want to be LIABLE if a bad mistake happens due to you still getting the hook of things. If the manager pairs you with someone experienced then go for it, but if not, I don't encourage you to be in a pod/section all by yourself. Be prepared for patient complaints and anger. Never be afraid to ask other teammates for help and advice as well.
3. Limited Support from Management and Peers.
Some technicians who experience issues on the floor, sometimes turn to management for support, and can't find it because their manager has bad attitudes, or are in on the latest drama and politics. Some managers don't properly resolve the issues that the technician is experiencing with a patient or another staff, and therefore sweeps it under the rug. The gossip, drama, and pressure is usually on from other "experienced" teammates making that new tech to feel vulnerable and out of place. Sometimes a new tech could be receiving extreme, inappropriate backlash from the patient and doesn't know what to do other than tell management.
Example: Tech A goes to Mr. manager B's office and asks if he can talk to patient C about ceasing the cursing and disrespect towards them. Or Tech A tells Mr. manager B that they are overwhelmed and need to still shadow someone or if they can work with someone until they are comfortable being alone. Manager B ignores them and tells them " Tech A you are ok, it is not a hard assignment I gave you, try your best, I can't pair you with anyone because I am short of staff"....(manager B sips his steaming hot coffee and fiddles his overgrown beard)..
Tips: If management doesn't have your back period.... only trouble I see, sorry. My only advice is to make sure you get certified within the time-frame you are at that unit and find another clinic and transfer. Never leave a unit unless you get your foot in the door elsewhere.
4. Dialysis School training vs. On the clinic floor training differences (techs were not expecting turn-over to be so hectic/death rate/ other factors). Dialysis schools deal with basic and advanced studies regarding dialysis and sometimes have their students practice on dummy arms and other means. This is different from actually sticking a person and hearing them scream and feel uncomfortable. Dialysis schools can never really prepare a person for (TURN-OVER). Turn-over is when your 1st, 2nd or 3rd shift patients are coming off the dialysis machines and you have to clean the machines and set up for your next shift patients to get on. Everyone has their own "turn-over" style and this is hard to just learn it without experiencing it and creating your own way of handling it. Some people can't handle the death rate appropriately and some learn to cope. I was one who was caught by surprise when my patients began to pass away, but I had to learn how to cope the best way I could. This doesn't mean that I don't cry, I still do and sometimes go to the funeral.
Example: For instance, you have 4 patients on the machine and turn-over is about to take place. Meaning 1 patient is supposed to come off in your section first. However your 2 patients who are 1st shift patients asking you to come off at the same time. What would you do? Or let's say you have one patient out of the four that you have, start passing out in the midst of the turn-over rush, what do you do?
Tips: Watch my upcoming video on dealing with turn-over issues properly. Also observe how your peers set up their section and do the same and even more. Create pre and post packs and get your circuit lines, dialyzers and saline bags. You don't need to be running to cabinets or drawers when turn-over has started unless you need an additional urgent supply for a patient who is experiencing an emergency.
5. Severe Drama on the floor with dialysis teammates/management/patients.
Every job has that one person they may not like or who is causing issues for them in one way or another. To be honest with you I've had several individuals over the years who made my dialysis experience as a technician a living nightmare. However I have had to really pray and God granted me some serious grace to forgive them and be at peace. Severe politics and drama is not good in any case, but I have seen technicians quit because of it. I even wanted to quit because of it. This toxic situation was spilling over into the patients, and that was not good. Once patients get involved in the drama you are having with another teammate, you can forget it. Some patients spread that little gossip to other patients in the waiting room, and the whole situation blows up into something unpleasant by the time it gets back to the person who it is about. This is no joke!!!!!!!!!!!!!!!!!
Example: Tech A SUSPECTED that Tech Z was trying to get all the attention from another Tech named Tech T. So Tech A tells one of her patients a lie about Tech Z (to create hate towards her). Tech A told her patient that Tech Z is a evil tech who moves slow and shouldn't let that tech touch her arm. The patient goes out into the patient lounge and tell other patients what Tech A said and now Tech Z is having issues putting on her patients because "they HEARD" some stuff. Now the tension starts between the two techs plus the patients are involved from the "I HEARD" gossip.
Tips: Try to strive for peace, talk directly to that teammate ALONE. Pull them off the floor if a issue starts. Never get loud with another tech on the floor in front of the patient. In some companies and units, you can get written up or suspended, and possibly fired. Sort out your issue with any person face to face. I found the most positive results by doing it that way. Shoot down any rumors and assure the patient that what they heard is a rumor and that you are a professional that seeks to make sure they have A GOOD TREATMENT.
6. Consistent Unfairness regarding scheduling/ratio of patients. I have been through instances where because I was new to a situation, I was a target for work overload. People began to manipulate me into handling their duties and trying to make me think that it was my ACTUAL JOB. I was slyly given additional patients that were other technicians during 3rd shift and didn't notice because I was naive. Only as I became familiar with scheduling and assignments was I able to understand who's who and who is not. You should never be a slave to anyone ... only follow your job description. I have witnessed new technicians becoming very frustrated with being forced by senior techs and even some nurses to do things they are not supposed to do "all in the name of being new". Some technicians experience unfairness but are too scared to speak up because they fear for their jobs and negative backlash from the threefold cord in the unit (management, patients, and co-workers). Example: Newbie Tech H is supposed to have 4 patients for each shift 1st, 2nd, & 3rd. Sometimes the third shift has a low ratio of patients who are scheduled to come in. However there are three techs left in the unit and they each have one patient. Tech H did have only 2 patients for 3rd shift but something was done without her knowing and she ended up with two additional patients thinking they were hers because she was given them(told to put them on). However she put them on the machine but was puzzled as to why she has four and those three techs have one patient. This continued to happen time after time and Newbie Tech H complained but those who made the schedule always had an excuse as to why. This is baloney~ Tips: In the process of learning XY & Z. I encourage you to stand up for yourself in a positive way. Don't allow anyone to talk down to you or disrespect you because you are new. Learn which patients are yours and who is not. If there is a new admission find out if you would have to take that person in your section. Ask questions. If you are called names and laughed at for standing up for yourself, don't pay the jokers no mind. You know at the end of the day they will still have to RESPECT you. Reflection: I remember this one tech came into the unit with a certain respect for herself and she demanded respect in a very calm and peaceful manner. She wouldn't allow anyone to disrespect/overload her with unfair assignments and she went about doing her job. She is still there....why? Because at the end of the day, her day is what she makes it. She made it great by speaking up and standing up for herself.
Thee end~ Hope this blog helps~
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I founded a total of 5 dialysis groups on Facebook but I am currently in 3 of those groups.
1. DIALYSIS NURSES ROCK PERIOD https://www.facebook.com/groups/WEDNRP/
2. POWER DIALYSIS TECH & STAFF GROUP (Now renamed and headed by Dwelyn)
3. CCHT/BONENT GROUP