what are they training these techs?

[sullidog]

We have a new tech at our center, he didn't even know what a stenosis was when I brought it up, where in the world are they training these techs? My oppinion is, if you don't know dialysis terminaology you don't need to be in dialysis! I wanted to ask him if he knew what a thrill was, wonder if he knew that?
That same tech doesn't know how to stick me either!

[Sydnee]

Well if other states have the same rules as WY they have no training walking through the door the first day. When Ed first started dialysis I started looking for work and FMC had job opening for dialysis tech the only thing that was required to apply was a high school diploma or GED. I was turned down for the job because I had a friend or relative going to that clinic. (I thought that would make me more suited for the job)

The job here pays several dollars more than McDonalds so you know it attracts lots of people.   

[Sax-O-Trix]

Non-RN "Techs" cannulate patients?  That doesn't make sense when one has to be an RN (in NY anyway) to insert an I.V.  You'd think you'd have to be at least an RN to stick people with 15 gauge needles for dialysis!

[Sydnee]

Not in WY so it might be a state regulated thing. Ed asked his favorite tech to make sure. There is no training pre employment needed and YES they are the ones who cannulate. After I found that out I was even more insistent the Ed only let techs he knew poke his new fistula. At least with home hemo you know the person playing with the needles doesn't have training. In center you assume they are trained.

[PatDowns]

Non-RN "Techs" cannulate patients?  That doesn't make sense when one has to be an RN (in NY anyway) to insert an I.V.  You'd think you'd have to be at least an RN to stick people with 15 gauge needles for dialysis!

RN's are not required to draw blood and needles are used.  Dialysis techs and phlebotomists are considered in the same category since neither "push" medications (in most states).  However, new federal laws require that all dialysis techs must be certified for minimum proficiency and knowledge within 18 months of starting to work in dialysis....

ESRD Federal Regulations
 The new ESRD Rules & Regulations approved by the Centers for Medicare & Medicaid Services (CMS) have been submitted to the Office of the Federal Register for publication and have recently been published with comments in the Federal Register (4-15-08). It is currently a 116-page document (see CMS ESRD Final Rules). The rules that apply to certification start on page 20425.

Policy & Timeline
 Here is the exact wording related to the timeline for Dialysis Technicians to have certification: Patient care dialysis technicians (must) be certified under a state certification program or a national commercially available certification program as follows:

1.For newly-employed patient care technicians — (certified) within 18 months of being hired as a dialysis patient care technician.If a newly hired PCT stops working before they have 18 months of experience, they can start working at another facility but the experience from their first job will be added to their new job. For example: A PCT works in Facility "A" for 7 months. Then, he/she has to move to another state. Once Facility "B" hires this person, he/she will have 11 months to become certified.

2.For patient care technicians employed on or before October 14, 2008 — (certified) within 18 months after such date." (This means that you will have until April 14, 2010 to be certified.)

From: Board of Nephrology Examiners Nursing and Technology (BONENT) web site -

http://www.bonent.org/cht.php?TBRa=btrrlr2_0&Ra=btrrlr2_2&TBRb=vbrrlr2

[Big E]

Thanks for the info, Pat. This is good to know.

At my clinic they seem to have lots of trainees coming and going. I can't really object because they have to learn somehow, right? Since I'm doing pretty well on dialysis and don't have any co-morbidities, they probably figure I'm a good person to train on.

What I do object to is how little dialysis techs are paid, as if this were a low-skill occupation. If a job doesn't pay well there's bound to be a lot of employee turnover. The CEOs, executives and shareholders of for-profit dialysis companies skim so much off the top for themselves that should be going to the techs, nurses, etc. who do the actual health care.

[SugarBear]

Non-RN "Techs" cannulate patients?  That doesn't make sense when one has to be an RN (in NY anyway) to insert an I.V.  You'd think you'd have to be at least an RN to stick people with 15 gauge needles for dialysis!

I'm not sure where you got this info, but in NY most cannulations are done by PCT (techs).  Nurses deal with the catheter patients always and then cannulate other patients as their shift schedule permits.

[sullidog]

In my FMC unit they let techs do all the work unless they are short of help, regardless I only let someone stick me who has a lot of experience since I'm a hard stick.

[Sax-O-Trix]

I think I should apply for a part- time job as a tech, that way when the time comes for me to be on dialysis, I will be proficient at cannulating and should be able to self-cannulate.  Yikes! 

I really thought techs were RN's.  I had to have a chest cath after my transplant due to complications that required Plasmapherisis (the closest experience I have had to dialysis) and the same RN/PA/NP always did the procedure.  Floor nurses suck at blood draws and I.V.'s.  I always ask for a phlebotomy tech for blood draws and the I.V. Swat Team for I.V's.  I try not to be a pin cushion and am a royal pain in the arse about who sticks me.

Thanks for bringing this issue to my attention!  I had no clue.