In-Clinic Tech's

[Simon Dog]

That's an incredible NT ratio.   Here in the US I see more like 8:1, with 4:1 for the techs.

As to lazy RNs - ergophobia is a disease that knows no boundary of profession, race or background, except perhaps Asians and Indians (I've never seen a lazy Asian or Indian (spot, not feather) ).

[OlManRivah]

LOL

I've already been told Do NOT Touch the machines. They won't even let me turn my chair so I can LOOK at it.

I always carry my little hand held mirror.  It's purpose is to view the machine.  Works great!     

[Michael Murphy]

I have never seen a nurse sit at the station and ignore a alarm.  However now and then I have seen a nurse jump up and run to a patient who was starting to get in trouble.  One of the most frightening things I have ever seen is the guy next to me was starting to drift off with low blood sugar when one of the nurses jumped up ran to a cabinet and ran to the patient with the biggest dam syringe I have ever seen. I just layer there thinking omg they are going to stick that guy with a elephant needle. Turned out she stuck it in his tubing and the effect was unreal. From pale and pasty to roses cheeks in seconds.

[GA_DAWG]

We have a really good and talented group of techs. I know they care about the patients because I have seen how hard they work to give us the best care they can. I have also seen them cry after a patient has an incident, though they try to hide it. I have tried at different times to explain to them we (the patients) all know there is a risk to what we do, but we also know the results of not getting the treatments. I do know they are denied by law being able to discuss other patients, so I usually do not ask a lot of questions. Besides, it is usually not long before another patient hears any news.

[Charlie B53]

With the number of alarms that regularly sound off, it's a wonder the Techs get a half second to breath.  But I have noticed that the Tech's in my Clinic seem to KNOW which patient and which alarm is more critical.  My machine makes noise regularly, it's no big deal, the Tech comes over, pushes a button and all is well again.  Many times it is like that with a number of patients and the Tech doesn't seem to be in any hurry. 

However.................

There are those patients that when an alarm goes off the Tech is there IMMEDIATELY.  It's like the Tech KNOWS which patient and which alarm requires an immediate response.

Experience, there is no other explanation.  These people know their business.

[kitkatz]

My chronic Low BP freaks the techs and nurses out.  The one that have been with me longest tend to not freak do much, but check in on me to see if I feel okay.
The new ones tend to hover.

[kickingandscreaming]

Low BP always sounded good to me-- as someone who naturally runs high.  It wasn't until my BP was lowered too much by a new drug that I learned how awful low BP can  be.  I was dizzy all the time and fainted multiple times.  So it can be a big deal.  With an adjustment of the dose, my BP moved into good territory.  Thank heavens.

[kitkatz]

Unfortunately my BP is what it is.  Midodrine does not work for me.  Just gives me a huge headache but no BP changes.
So we get to watch the crazy BP each time I go into dialysis. Seems to go in cycles, too, but no one has caught the cycles yet.
I just went through two months of higher BP that I have had, and now it is back down.

[Charlie B53]

I still so new to all this.  I have only been at my one clinic.  If you don't count the VA Hospital and the University Hospital across the street from the VA.  So what I have seen/experienced in my Clinic I would mistakenly ASSUME is much the same at all clinics.  WRONG, as usual.

My Fresenius clinic has
2 Nurses
4 Techs
1 Floater Tech
1 Secretary
21 Chairs

The big room is divided but a low divider wall with a sink on each side.  This makes it seem like two treatment areas.  Each area has 5 Chairs/Machines down the outer wall and 5 down the 'inside divider wall.

There is one more Chair in the 'Clean Room' in one corner.

One Nurse tries to stay at the desk/monitor while the other one roams. Only one Tech is allowed to take a break at any time so there is always at least three.  With the roaming Nurse there is always two persons in each treatment area.

Wentzville was a corn field 20 years ago when we moved here. About 60 miles West of St Louois about the only thing around there besides corn/farmers is the GM plalnt making pickup trucks.  With the housing boom a LOT of corn fields have been developed and whole neighborhoods sprang up.  Major freeway exchange widened and over a mile of mini mall businesses, Home Depot, Lowes, and all the rest of 'Society'.

I'm glad we live another 20 miles/3 towns farther West away from all the todo, noise, and crowding.

But I am surprised to learn that my clinic is rather large as compared to many of yours.

[Simon Dog]

But I am surprised to learn that my clinic is rather large as compared to many of yours.

I use the Burlington, WA DaVita clinic when visiting that area.   Nice people, lots of personal attention - 1 RN, 1 Tech, 4 chairs. (actually 5 chairs if you count the one in the isolation room, but there was no machine with that chair the last time I was there).

[Charlie B53]

I've got a couple cuisins near Burlington.

I really miss living just North of Seattle.  As much as it's grown, now if I was to return I'd have to go farther North a bit past Everett, or out on one of the Islands.

Too many people.  Makes me crazy(ier).

[iolaire]

But I am surprised to learn that my clinic is rather large as compared to many of yours.

I use the Burlington, WA DaVita clinic when visiting that area.   Nice people, lots of personal attention - 1 RN, 1 Tech, 4 chairs. (actually 5 chairs if you count the one in the isolation room, but there was no machine with that chair the last time I was there).

I was there as well two years ago when visiting my brother outside of Bellingham.

[Simon Dog]

But I am surprised to learn that my clinic is rather large as compared to many of yours.

I use the Burlington, WA DaVita clinic when visiting that area.   Nice people, lots of personal attention - 1 RN, 1 Tech, 4 chairs. (actually 5 chairs if you count the one in the isolation room, but there was no machine with that chair the last time I was there).

I was there as well two years ago when visiting my brother outside of Bellingham.

Really?   I though that clinic only opened up a bit over a year ago.    Was the clinic you used a very small one behind a Taco Bell on the main drag in Burlington down the street and on the other side from the Burlington mall?

[iolaire]

But I am surprised to learn that my clinic is rather large as compared to many of yours.

I use the Burlington, WA DaVita clinic when visiting that area.   Nice people, lots of personal attention - 1 RN, 1 Tech, 4 chairs. (actually 5 chairs if you count the one in the isolation room, but there was no machine with that chair the last time I was there).

I was there as well two years ago when visiting my brother outside of Bellingham.

Really?   I though that clinic only opened up a bit over a year ago.    Was the clinic you used a very small one behind a Taco Bell on the main drag in Burlington down the street and on the other side from the Burlington mall?

yes four chairs, we were there Nov 2015, it felt new back then, but that could have just been because it was built for 20-30 chairs and only had a few installed. DaVita Cascade Dialysis

[Simon Dog]

yes four chairs, we were there Nov 2015, it felt new back then, but that could have just been because it was built for 20-30 chairs and only had a few installed. DaVita Cascade Dialysis

That's exactly the place I referred to - Nov 15 is less than two years ago.    I only counted enough plumbed chair slots and space for a total of 9 chairs - 4 additional in the main area plus the isolation room.   Nice people.

4 chairs makes for a great ratio - one RN and one tech for 4 patients.

[Riki]

My chronic Low BP freaks the techs and nurses out.  The one that have been with me longest tend to not freak do much, but check in on me to see if I feel okay.
The new ones tend to hover.

I have that problem too, to a point where the doctor had to put an order on my chart to no do anything unless I'm having symptom.  Their policy is to put the machine in minimum, so it's not pulling fluid, for a few minutes to get the pressure back up, but it doesn't do anything for me except have me leave a little heavier than I wanted.  I have to tell the new nurses sometimes that the order is there, because they automatically start pushing buttons on the machine when my bp goes below 100 (they really only look at the top number, can't remember if it's systolic or diastolic *L*).  I say something like "It's only 97, I'm good." and they say, "but we have to do something, that's low." and I say, "not for me."  It takes a few minutes of arguing and shuffling through the chart to find the order before they finally agree with me.

As for my unit, it is the largest one in my province.  It has 16 chairs, with room for 2 more.  I highly doubt that room will ever be used for patients, though.  It's used now for training and to set up and prime machines while connected to the water system, so they can swap machines out, making turn around times easier.  The unit is kind of split in two, as there are two nurses' stations.  One side has 5 chairs, plus the 2 isolation rooms, and the rest are on the other side.  When I'm on in the evening, there are usually only 7-9 patients on. We have a nurse to patient ratio of 1:3, so we have 3 nurses and 1 DSW, which is just a resident care worker, or what was once known as a nursing assistant, but have specialized in dialysis.  They can set up, strip, and wash machines, do blood pressures and take temperatures, take care of all the supplies (ordering, organizing, putting together "packs" of supplies for different things, like putting people on, taking them off, dressings, setting up the machine), and they do things like get pillows and blankets, make tea and coffee, plug devices in when they start to lose power, pick up my phone off the floor when I've dropped it.. *L*  They're great folks

[GA_DAWG]

We have 30 seats with 6 techs, 3 nurses when full. If anything we have a nurse problem. It is not that they do not do their job, but that some of them give the techs no help. Our two best nurses quit to take other jobs because they were tired of the director giving them the shaft on shifts. They could do anything in the clinic, listened to patients, and ALWAYS helped when asked. We have great techs, but sometimes they need a hand, like when a patient cannot hold their sites but there also are other patients coming off the machines.

[Simon Dog]

I say something like "It's only 97, I'm good." and they say, "but we have to do something, that's low."

I do home hemo, but in center when traveling.  I always tell the tech/RN "don't even thing about a saline bolus unless I go below 80 systolic" and have never had any pushback.

[Riki]

I say something like "It's only 97, I'm good." and they say, "but we have to do something, that's low."

I do home hemo, but in center when traveling.  I always tell the tech/RN "don't even thing about a saline bolus unless I go below 80 systolic" and have never had any pushback.

I've never had a problem while traveling, except for the last time I was in New York.  When I went in for the first treatment, they asked me what my max goal was, so I told them.  No big deal, I needed to get some of it off.  The next time I went in, I didn't have the same amount on, but no one said anything to me, even after I weighed in.  They automatically put me on at my max.  I didn't notice it until I had about half an hour left, and I was starting to feel light headed.  I asked to come off early, before they totally drained me.

[GA_DAWG]

I occasionally see a tech tied up with a patient and unable to immediately answer an alarm. Usually, she winds up yelling at a nurse to get the alarm as they sit at the desk. We have really good techs, some nurses, not so much. I see techs often ready to take a patient off and have to call a nurse to give the patient the rst of their iron or calcium. I hear them call over and over "Catheter ready."

[kitkatz]

The new nurse we have had finally gotten into the run of things.  She runs a tight ship, but has time to talk to patients about life and treatments.
She even had my chair moved from the back corner up the front where she is so an eye can be kept on my whacko blood pressure more often.
I like her.  It took us awhile to get to know each other.