Techs - Job Standards and Behavior

[Black]

Once you get past the first few pages you'll see what the clinic techs are supposed to be doing and how they're supposed to act.  If I were an in-center patient I'd be leaving copies of this all over the center and/or mailing copies to the director and the social worker.

http://www.meiresearch.org/CoreCurriculum/CC2006m1.pdf

[Rerun]

I guess having contests on who can shoot their gloves into the garbage from across the room was left out of the conduct section!   

[Epoman]

I guess having contests on who can shoot their gloves into the garbage from across the room was left out of the conduct section!   

I used to hate seeing them do that.  You know germs went flying around as they shot them.

[Bajanne]

Thanks for sharing that article with us, Lorelle.  Very eye-opening!

[Black]

Thanks for sharing that article with us, Lorelle.  Very eye-opening!

You are most welcome and, yes, it is  eye-opening!

I was shocked that the standards were so detailed and that the expectations were for very professional behavior and a high degree of education, especially after reading some of the posts here.  I wondered if some of the techs I was reading about have ever read it or anything even close to it.  If so, they either didn't comprehend or disregarded what they read.

[DeLana]

I probably shouldn't comment here, and my apology if I offend any techs here (this is not directed at all of them, as you will see)... but I have to say that's the major reason why I'm not returning to in-center dialysis:  the techs.   Not only are the standards inconsistent - in some states they don't even have to have CNA (basic nursing assistant) training to be hired as a dialysis tech who can do so much more than a typical CNA - and only a few states require certification as a dialysis tech (that should be the minimum!!!)

But what really bothered me the most from the viewpoint of a nurse:  in many states they do things that they have no business doing (OK, this is my personal opinion.  The large for-profit dialysis companies, trying to save on salaries, see it differently of course and sadly so do many state Boards of Nursing - BON).  They didn't go to nursing school, so why are they pushing heparin or accessing central lines (perm caths), which is allowed in some states*.  For the convenience of the companies, of course, who prefer to hire fewer nurses.   One big problem with this:  some techs begin to think they are nurses (I've heard them tell patients that, and who would ever know since they usually don't wear their required name tag) and as a result can have a really bad attitude and become difficult to work with.  Not all of them, of course, I've known some wonderful techs; however, enough to spoil it for me at least.

If they adhered to the standards described in this piece, it would be a much better environment for everyone involved:  patients, staff, and families as well.

Just my 

DeLana   

*If this is the case in your state, don't be worried.  Techs who give meds are well-trained and closely supervised.  My point is just the following: the lines between nurses and techs are so blurred that it makes it a difficult work environment where respect can be lacking.

P.S.  My next job will be in hospital inpatient/acute dialysis, an all-nurse environment.

[Black]

Great post DeLana

...P.S.  My next job will be in hospital inpatient/acute dialysis, an all-nurse environment.

I know that is good for you, but it is a great loss for the clinic patients.  It is sad when the best trained and most caring are driven out by the untrained and unprofessional.

[DeLana]

I appreciate it,  Lorelle 

As I'm sure you know, a clinic is as good or bad as its leadership - facility administrator (FA) or the next higher level, regional director (RD). If the FA has good leadership skills, there should be no problems between nurses and techs because disrespect, insubordination and other problem behaviors and attitudes would never be tolerated.  Too often, however, this is not the case.  When our clinics got an evil RD (no exaggeration - she told us it was her way or the highway, and gave us additional duties when we were already overworked) they lost many RNs.  However, I'm an eternal optimist - and I don't burn bridges.  I left on good terms with my FA, and hear that some positive changes are happening (more LPNs being hired, fewer techs; this eases the RN's workload).  RDs do come and go   

Meanwhile, I'm looking forward to a new environment (hospital) and learning new things (such as PD).  Plus, I'll finally have the time to actually talk to a patient and do one of my favorite things, patient teaching.  Maybe I'll be able to ease a new dialysis patient's fears - typically, they have never visited the clinic they'll be assigned to prior to starting dialysis - and answer their questions, with a bonus of knowing what really goes on in the clinics (many hospital nurses have never worked outpatient and just don't know).

DeLana 

 

[Inara]

I probably shouldn't comment here, and my apology if I offend any techs here (this is not directed at all of them, as you will see)... but I have to say that's the major reason why I'm not returning to in-center dialysis:  the techs.   

I don't mean to offend, either, but I've got to agree with you, Delana.  I've worked with some very dangerous techs, too (but mostly good ones).  The key thing missing that infuriates me is that most of them do not understand or respect the fact that the nurse will be held responsible for their actions.  They are working under MY nursing license....and I intend on keeping it.

[Joe Paul]

I probably shouldn't comment here, and my apology if I offend any techs here (this is not directed at all of them, as you will see)... but I have to say that's the major reason why I'm not returning to in-center dialysis:  the techs.   

I don't mean to offend, either, but I've got to agree with you, Delana.  I've worked with some very dangerous techs, too (but mostly good ones).  The key thing missing that infuriates me is that most of them do not understand or respect the fact that the nurse will be held responsible for their actions.  They are working under MY nursing license....and I intend on keeping it.

I did not know the nurse is responsible for a techs actions..

[Zach]

It is sad when the best trained and most caring are driven out by the untrained and unprofessional.

This is so true.     

[bdpoe]

 but I have to say that's the major reason why I'm not returning to in-center dialysis:  the techs.   Not only are the standards inconsistent - in some states they don't even have to have CNA (basic nursing assistant) training to be hired as a dialysis tech who can do so much more than a typical CNA - and only a few states require certification as a dialysis tech (that should be the minimum!!!)

My understanding is that in Florida they do not have to be CNAs and while they are supposed to be supervised by
a nurse, it seems that the nurses are too busy to see what the techs are doing. Being in the same unit isn't supervison to me.

...bdpoe

[Black]

..but I have to say that's the major reason why I'm not returning to in-center dialysis:  the techs.   Not only are the standards inconsistent - in some states they don't even have to have CNA (basic nursing assistant) training to be hired as a dialysis tech who can do so much more than a typical CNA - and only a few states require certification as a dialysis tech (that should be the minimum!!!)...

My understanding is that in Florida they do not have to be CNAs and while they are supposed to be supervised by
a nurse, it seems that the nurses are too busy to see what the techs are doing. Being in the same unit isn't supervison to me.

...bdpoe

Exactly right!!

[livecam]

What really impressed me about the job functions performed by both nurses and techs in dialysis units was that although they perform much of the same work, the nurses require years of instruction but the techs all seem to learn on the job.

There are some very competent techs out there and on-the-job training is not a bad thing.  In what I do most of my training has come from actually doing the work in order to learn it.  The difference here is that if I screw something up I can go back and fix it without doing any harm. When a fistula is involved with a patient there isn't much room for mistakes.

There were techs that scared me like the gangish guy that had been doing reuse and slogging bicarbonate around until he was promoted.  Learning is one thing but I didn't let it happen with my equipment.

You can protect yourself by paying attention to who is good and asking for those people.  If someone you aren't comfortable with comes around to put you on etc. you can ask for someone else.

[kitkatz]

No new people touch me unless it is for non important stuff!  And I tell them to get away from me if they are new unless someone else in with    them.

[Rerun]

When you are a new patient you are screwed!  Let's train on the new girl. 

When I visit a clinic the FIRST question I ask is "how long have you been doing this."  I don't know what answer I'm looking for.....20 years is nice.

[sophiasmom]

In my unit, techs just learn like a month of school at a dialysis unit, then they train with
another tech who's been around for a while.  A few weeks, then there on there own.  Scary!
6 months on the job and they can do catheters. They all push heparin, but not the other meds.

To be honest, and no offense to most nurses, there are some techs whom I trust more than some nurses.
I trust people by how they act and put me on, whether tech or nurse.

New to dialysis techs and nurses are scary.   I've had great nurses, great techs and bad both.

I truly love some of these workers, and some I wish they would just work somewhere else.

    
 
Chris in MA

[CCHT_8o8]

They should've put "Tagalog as a first language" as a requirement at my clinic... 

[okarol]

Most states do not require an individual to have a certificate or license to provide dialysis care as a dialysis technician.

[bdpoe]

Excellent postings on this topic. In center hemo dialysis is tough enough. it is to my absolute horor
that facilities and employees aren't held to a higher standard.

This needs to be adressed to the legislators, both state and federal,
This needs to be championed as a priority issue by all kidney organizations and publications.
Medicare, Medicaid and Social Security need to hear about this from everyone.

We all need to make our demands and complaints heard.