They mention training of technicians but no mention of training for nurses in dialysis. Believe me dialysis is only mentioned in nursing school there is no training for it so it is not fair to assume a nurse knows what she is doing unless she has had additional training. After working as a certified technician for over 20 years I have worked with a lot of excellent technicians and many that are just the opposite. The same applies to nurses. Don’t be fooled by RN or BSN after a name.
Have had this discussion many times before, and from my experience as a patient, I can immediately tell how good one is at doing dialysis be they nurse or tech. There are certain qualites one must possess, and not all do, irregardless of educational level. But if a nurse has these qualities and nursing ed. too, I give her/him more credit, unless a tech has studied independently and understands the patients’ physiology.
The Northwest Kidney Center started a unique program three years ago after a couple anonymous donations. Each semester the school of nursing at Seattle University and the University if Washington send their students to spend a week in the dialysis units to meet patients and spend time learning about dialysis. This program has been a big success benefiting the Kidney Centers by getting more young nurses interested in a career in dialysis and the two schools by increasing their students practical knowledge and experience.
The program has now been expanded to Seattle area Medic One units. A couple of times a year the Medic One first responders spend the day learning about dialysis and the unique needs of dialysis consumers. As someone who dialyzes at home I personally benefit because should I ever need to call 911 the people who respond will have some knowledge of dialysis (and they wont put a blood pressure cuff on my fistula arm).
The draft Conditions for Coverage (rules governing dialysis clinics), state these criteria for nurses and patient care technicians in dialysis. It could be 3 years before the rules are finalized and their wording depends on comments Medicare receives – 5/5/05 at 5 p.m. is the deadline for comments.
Nurse manager:
– Full time employee of the facility
– Registered nurse who meets state practice requirements
– At least 12 months of experince in a clinical setting and an additional 6 months providing nursing care to dialysis patients
Self-care training nurse
– Registered nurse who meets state practice requirements
– At least 12 months of experince in a clinical setting and an additional 3 months experience in the modality for which the nurse will provide training
Charge nurse for each shift
– Registered nurse or practical nurse who meets state practice requirements
– At least 12 months of experince in a clinical setting and an additional 3 months experience providing care to patients on dialysis
Staff nurse
– -- Registered nurse or practical nurse who meets state practice requirements
Patient care dialysis technician
– Meet state requirements for education, training, credentialing, competency, standards of practice, certification, and licensure in the state in which he or she is employed as a dialysis technician; [NOTE: most states do not regulate dialysis technicians]
– Have a high school diploma or equivalency;
– Have 3 months of experience following a training program approved by the medical director and clinic governing body under direct supervision of an RN, focused on operation of dialysis equipment, providing direct patient care, communication and interpersonal skills including patient sensitivity and care of difficult patients.
The rules under which dialysis clinics have been operating since 1976 say that the nurse in charge of the clinic must meet the requirements above or have 18 months of experience working with patients on dialysis. They say nothing about qualifications of technicians except that the medical director is responsible for being sure that nurses and technicians are adequately trained.
By the way, the current rules under which clinics are currently operating require only that one licensed staff (MD, RN, or LPN) be present in the clinic while patients are dialyzing. Further, the staff/patient ratio is supposed to be appropriate to the level of dialysis care being given and an adequate number of personnel are readily available to meet medical and non-medical needs.
Personally, if I was a patient, I’d want to know all I could about my care so I could do self-care in a clinic or, better yet, dialysis at home so I wouldn’t have to worry about the staff or their qualifications.