I'm not sure what you took offense at and really don't appreciate being called a Nazi. I intended my posting to offer suggestions to a nurse who apparently felt uncomfortable taking on more responsibility than he/she felt competent to handle. If you read the initial post, he/she described himself/herself as a "staff nurse" who set up B Braun machines. He/she asked for a step-by-step manual for putting on and taking off patients. In every dialysis clinic where I've worked, staff nurses put patients on and take patients off. I've never worked in a clinic where a nurse just passed meds. If this person was a charge nurse, as you suggest, he/she would need to be licensed, experienced in dialysis, and know how to do everything related to patient care in the dialysis clinic including taking orders from physicians and handling any emergency that might arise.
The ESRD regulations require that the governing body of a dialysis clinic assure that all staff meet the qualifications for the job and have orientation to the functions that they are to perform and an opportunity for continuing education. The goal is to assure that staff are competent to provide quality care to patients. If a clinic hires unqualified staff and doesn't provide the training they need to operate the equipment and care for patients, that facility is at risk of being cited by Medicare and having to develop a plan of correction to resolve the deficiency or lose Medicare funding and be closed.
Finally, if you'd read my last sentence, you would have seen that I thanked the nurse for taking his/her job seriously and wanting to learn. It is a huge responsibility to care for people who are on dialysis and some people do not take it as seriously as I believe they should.