registered nurse - dialysis

patient care technician

registered nurse

nephrologist

director

U.S. Renal Care

A typical day would be difficult to describe, as no day is like another. A "perfect" day could be rather enjoyable, but minimally, once a week the clinical staff would be required to work understaffed. Whether it be an employee call in, or scheduled without a full staff, this was a common occurrence. On these days, either the senior most PCT or the Charge RN would be responsible for taking on a second patient load, without compensation for the extra work. It was common to have a day with 26 patients and 3 staff member(we work in a more rural area). On days that a staff member called in, it was a requirement for one of the present staff members to then cover the remainder of the non-present staff member's shift, after their shift was over. This was not optional and would be met with threats of disciplinary action. Management was rarely present at the facility, there were times where I would not see my Facility Administrator for two months. That being said, the Charge RN had to make many clinical decisions in their absence. 

The culture was very divided, with clinical staff and nonclinical staff habitually at odd. Many policies were enforced against clinical staff, that nonclinical (biomed, unit clerk, social workers, dieticians, and administrators) were not required to follow. For myself, the arbitrary treatment of the clinical staff was the most difficult aspect of the job. 

Although dialysis is a very purposeful and rewarding field to work in, it can be difficult, as you get very close with those you care for. When an individual passes away it can be a hardship to overcome.   

If the position you are interested in is non-clinical, I believe this could be a very delightful place to work. You can expect a healthy work life balance with great benefits.  From my experience as a clinical staff member, it sadly was far from. My work life balance was nonexistent, with the majority of PTO requests being denied or having days of previously approved PTO revoked. Typically PTO requests were not accepted between the months of June thru mid August, and again mid-November thru the first of the year.

My direct manager was good to work for but that was it…I basically had two bosses including the FA and no one else will ever be held accountable for anything except the biomed and every staff member will call you at anytime for anything no matter who is scheduled to be on call there that lazy to find out who is on call and instead will just call the person that works the clinic even though on call rotates. PCT”s are far more valuable to the company than you will ever be, bad behavior by not doing a good job will be rewarded to the clinical staff by passing the duties off to you the Biomed and every guy in a management position is to chicken you know what to speak up about it. Staff makes a ton of mistakes and is never held accountable for any of it but somehow that also becomes your responsibility to fix as well. Pay is ok ✅ having the illusion of autonomy is decent but is negated by being bugged 24/7 about inventory or whatever whims they feel are warranted which is basically everything. It’s not the worst company but the industry in itself just could be a lot better and the culture really could too, completely one sided IMO…for a educated Biomed I would recommend another field let the guys who work they’re way up as PCT”s do this job because you need a degree in psychology and minor in insane asylums to truly keep your stuff together in a mad house for a incenter chronic kidney disease clinic plus you wind up doing a bunch of grunt work…a waste of time especially when fixing equipment is your passion because here your really just a babysitter who fixes things occasionally depending on the age of your clinics. Sinking submarine always even when things seem smooth just give it a minute they will find a way to sink the ship and you will have to fix it again and again and again. Best advice is to choose another way unless you’re a mentally strong person or if your a yes man all the time then you may love this job 

This is a very taxing job on your body and mental health.

You have a HUGE responsibility when working here, so say goodbye to your social life.

Something they don't tell you is that you are not just working at one clinic but multiple clinics. You are basically a Central Supply Tech on wheels. You will spend 90% of your time restocking PALLETS of heavy supplies, and you will properly be doing these for multiple clinics as a lot of biomeds call off on delivery days. There is only 1 biomed per clinic so if one gets sick, you have to be the acting biomed for their clinic till they choose to comeback. 

There isn't much biomedical stuff todo here other than fixing Dialysis machines. The Dialysis machines will breakdown a lot due to using USED parts, not NEW but used. I never understood the companies logic because I changed a pump 3x which is the equivalent to a 1x new pump. Everything else is handyman type of jobs like fixing door, sinks, chairs, and your occasional light bulb replacement. For the pay it isn't so bad, think of it as a overpaid CST/Handyman. 

Once you are on call you will be called most of the time at 3am for things that aren't emergencies. I've lost so much sleep over this because I was so paranoid that I would miss a real emergency call.  

This isn't a last stop type of job, I would use this as learning experience to sling shot into something better. If you do choose to work here just learn as much as you can, because this place will test you. Make good connections with your FA's and ABMs as they will always get your back if you are in good terms with them. They know the game so they do their best to help you out.

What is the best part of working at the company?
I like the company, but leadership needs work. If you are not in the clicks, you will be targeted. No support unless you do exactly what the upper management wants. You have to compromise your values to stay in the clicks. You will not be supported if you stand out in the crowd per se. I would not recommend working for Texas gulf coast region if U S Renal care. Upper management lies and have no integrity. If you stand up for yourself you will get treated unfairly. HR is not up to par, they are not for the employees. Very unprofessional behavior was noted with upper management. Very disappointing. I would recommend if you need long term growth and professional advancement you seek employment somewhere else. Give your time and effort where it will be appreciated. 

What is the most stressful part about working at the company?
No support. Favoritism and unprofessional behavior in upper management. Egocentric leadership. Unmanageable floor staff who gets no consequences for the bad behavior. You report bad behavior and FA gets targeted. False accusations are made up. Overall, absolutely toxic environment to work in. 

What is the work environment and culture like at the company?
Gossip, toxic, unprofessional behavior, lying. Stressful, no support at all. 

What is a typical day like for you at the company?
Very stressful. Managing bad nurses itself is stressful. Dealing with people with no integrity. Unprofessional behavior between staff and management has to intervene due to bad behavior on the floor. Constant i services and write ups. Too much expectations without no support.

This company pays decent and has good policy but not aware of what goes on in each clinic. I worked in Dallas County as a Socialworker, where patients right wasnt been respected by multiple doctors. Non- English-speaking patients are treated like they are invisible. Doctors refusing to use language line, staff or family members. When doctors come to do clinc visits,  it almost looks like they are running a marathon on the floor. Doctors only come once a month to visit patients and less than five minutes they are done visting 12 patients 🤔. That is nothing comparing to the unethical action doctors are taking about kidney transplant. Dallas County is ruined by doctors from Dallas renal Group(DRG) and patients are being forced to be referred only two hospitals in the county. I left the company for this specific reason. Patients would get a lecture from doctors for being referred or listed with hospitals other than Medical city or Methodist. Some of the doctors would do anything to influence patients to get them listed with medical city or methodist, even when patients are saying "no". As a social worker trying to advocate for patients right was stressful with a group of physicians that have more power. If you are a compassionate social worker, please don't apply to this company, you will burnout just by physicians politics! When I shared my concers with my FA, I was told " to shout my mouse " and slammed the door on me. The work environment is unhealthy and stressful!. 

The management is horrible. The pay and appreciation for the techs is sad. Very underpaid and are doing the most work. You will have to learn the ins and outs of the water room and it is very strict, on top of logging that detailed information in a very timed manner on top of that, work early and long hours, disinfect machines, set up machines, program machines, transport patients to their chairs and get everything they want and need, connect them to the machine via AVF/avg  or catheter, start them, get them comfortable, record vitals and document every half hour, disconnect them and document some more, transport them out, clean machine, and do it all over again, and at the end of the day disinfect, and you have to do all of that QUICKLY along with 4 other patients at the same time! Starting pay is low, and after getting BONENT certified which they require after, you get a dollar more than the starting people do. Insane. The nurses are no help, and disrespect patients especially ones that require more help cause of their disabilities and needing more assistance due to being in a wheelchair and such, the ones with bed bugs get overlooked and sometimes not assessed because they don’t want to be near them. certain circumstances techs need help and nurses refuse because it’s not their job. When bringing up issues of management to higher ups they disregard everything. Working here was the most draining and undervalued time of my life. The patients you will grow to love and you will have a love for the work , but when it comes to the job physically mentally and financially, they don’t appreciate the techs nearly as much as they should. 

As a receptionist for a neuphrologist I was the Medical Assistant. I had many tasks to complete at once and each one was crucial. I had to post like 15 labs per day which I had to copy accurately because it depends the risk of people’s lives. I had people calling like once every 10 minutes, then people checking in every 30 min. Once in I had to make a copy of their insurance and look for their folders then put the papers properly so the doctor can see them. Also every morning I had a stack of papers and I looked for their folders that had people’s prescriptons and give them to my manager to fill in the rest. After that people would check out every 30 min and I had to make them another appointment and give them their cards also charged them. New patients I filled in half the data and made two copies of insurance and I’d. After I’m done with that I have lunch. Then when I’m done with lunch I have to put into the system and call each patient for tm to remind them they have appointments tm and if they done their labs. Once that I print their super bills. I find their folders and put a sticky note if they’re ready for tm. Then I fax over patient information that needs to be faxed. Mind you patients are signing in and I’m checking them out while I get phone calls every ten minutes. Sometimes there’s Representatives and I ask them to take a seat. My last hour and I have all patients ready and give the pile of medications to my manager.

USRC is a pretty good company to work for. They have a very good benefits package. The work setting is your typical clinic like setting. Work schedules were very flexible. The supervisor would let you set you own schedule just as long as you get your work done. PTO was very generously given. You would get 8 hours of time off per pay period (every two weeks). Medical and Dental benefits were very competitive.  Annual merit raises are mediocre at best. Typical annual rais is 3%. The only issue that I see with working as a renal social worker either in this company or in any company is the high case loads. A social worker would have anywhere from 90 to 130 patients in their case load...sometimes more, depending where you work. Your main job is to provide social services to patients that need some type of help. The other work load is doing administrative work (reports, crown web, PART, QAPI, etc.) that also takes up a lot of your time. It got to the point where I had to work weekends and late days in order to stay a float. Eventually this wore on me and I had to resign as my health began to deteriorate. The way I see it, this company is a very good company to work for, but mentally prepare yourself to eventually work long hours in order to stay afloat of your work duties.

There is no competent management. 
The "training is a joke". 
Patients are routinely ignored while alarms for blood pressure go off.
Charge nurse is to busy stuffing her face with food and cussing out other staff to attend to patients. Charge nurse has no idea how to open/read email or input correct patient data into the EMR and fails to document patient incident reports.....
Blood cultures drawn on 5-6/30 patients and yet NO DOCUMENTATION of this high rate of infections in the EMR for these patients as revealed in chart audits (nurse fails to observe proper PPE)........
Medications are out of date, as discovered by state surveyors.
Techs are scheduled for long hours without breaks so the FA (facility admin) can hide in their office and play on their cell phone.
The regional director is a big FAT joke (literally), she flits around in violation of corporate PPE policies on the patient care floor talking about her drunken parties with friends and her experiences with patients who have died in her presence (YIKES).......so many obvious CMS violations every visit........and she wastes time micromanaging how the secretary files rather than getting much needed office equipment (fax/copier) approved....
I think this information will be shared with the state to help avert MORE patient deaths in York, PA.

If you want to work more than 60 hours a week with stressful environment including to deal with your boss and patients attitude this is the place to be. 
Very bad management, you dont get paid enough, work long, i mean super long hours, from 4am till 8 till 10 pm or midnight. Depends on your staffing which is always short!
You will be required to work almost every day and if you call in, they need an appropriate reason why, like your personal life. They wont believe you and will not respect your privacy. Will intervene with your available hours. The management does not appreciate your hard work and effort to please your patient and instead write you up for the littlest things. Will not acknowledge your suggestion and complaints. 
Your boss or facility administrator that does not even care to ask how the floor has been going, but will stay in their office the whole day and will not even help in case of shortages. 
Will audit you to death and lecture you with all the errors that you made and will not commend you for your improvement. Very stingy with pay raise and will always state your mistakes during evaluation more than your improvements. So you end up getting the lowest annual pay raise.  

So if you want to be burnt out in a span of 2 months after your 6-8 weeks training as pct. then you should try!

Top Job Titles	Average Salary
Registered nurse - dialysis 20 salaries reported	$39.40 per hour
Patient care technician 1 salary reported	$26.34 per hour
Registered nurse 1 salary reported	$49.94 per hour
Nephrologist 7 salaries reported	$265,000 per year
Director 4 salaries reported	$152,750 per year

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