How Long Does It Take?

[coldhoist]

How long does it take for you to get off your machine once the alarm goes off?  It is taking 30 minutes for me to get off and take my last BP reading. Is that about normal?

[robertscz]

no, that is absolutely insane and i would complain asap....  5 min max

[kristina]

It depends how many people are finishing their dialysis treatment when you are finishing ... for example, if there are say 5 people finishing all at the same time, each one of them may find themselves lined up in the getting-off-queue ... and it all may take a little time ... 
Good luck wishes coming your way 

[Michael Murphy]

The time it takes depends on how many people coming off at the same time.  However it you have a catheter it could be 5 minutes.  With a fistula it becomes more complex.  Needles need to be removed, sites covered with gauze and held until the bleeding is stopped.  I assume if I am off the system at 10:30 I will be out between 11:00 and 11:15.  Remember if this is rushed you run the risk of leaving blood trails on the way out.  If that happens it may be up to a additional half and hour before you escape.  The clinic I use has each tech to nurse treating 3 patients however the industry norm is 1 tech or nurse for 4 chairs.  If your center is 1 for 4 it generally will longer.

[GA_DAWG]

We are supposed to have 15 minutes between patients being put on the machines for this exact reason. It is supposed to give the techs time to remove each patient without having the airport taxi line backup. Needless to say, the techs don't like it and at every opportunity ignore it. when it results in the inevitable sound of multiple machines beeping off at the same time, they are always surprised. throw into that the inevitable patient who will suddenly decide it is a grwat time to get off early, and chaos ensues.

[Michael Murphy]

Watch arrival times while the centers try to schedule start and stop times to avoid concurrent removals there are events beyond the clinics control.  A patient is late arriving.  If a patient is late on first shift that will cascade down through the entire schedule causing each following patient in that chair to be late being put on and late being taken off.  Emergency, 2 treatments ago in the last 30 minutes of my treatment my blood pressure dropped to 80 over 45, not good it took a hour extra to get me off the machine and my chair was not available for a extra hour.  Rushing to leave, in the last 6 years I have been on dialysis at least once a week someone in a hurry decides he/she has stopped bleeding in a new record time and on the way out begins to leave a trail of blood out the door, and then back in to hold some more.  Not only does it delay the rusher but since a couple of the staff need to go clean the blood trails it effects availability to remove other patients.  Finally big emergencies about a month ago the tech putting me on tape my return line to me and my blanket, got cold pulled blanket up needle was pulled out, blood over every thing, 4 staff members became assigned to clean floor, walls, curtain, me, and machine.
Remember this is a medical procedure we are not as schedulable as a oil change accidents, bad reactions, late arrivals all happen and must be dealt with by the staff on the fly.  With all that happens I am not suprised when I am late getting off but suprised when I get off a half hour after my scheduled completion.

[GA_DAWG]

I agree about the emergencies Michael. I also think the first shift should have set get off times. If you are late, you still come off at your usual time. Clotting in the machines, failures by the machines, and bleeding are unavoidable. Those I understand causing delays, although our center has a few chairs they move patients who are bleeding into. One thing I have noticed about arrival times is we have people who show up well before their alloted time to be put on, EXPECTING to be taken early, because one tech decided not to use the schedule and just put them on last time. I have even seen people arrive exactly on time, only to discover that some tech had given their chair to a person who showed up early. As i said also, we have a small number of people who wait until others are getting off after running all their time and these people want off early. I have only seen one nurse explain to them they will have to wait until the people who ran all their time get off.

[Riki]

In my clinic, if someone asks to be taken off, it's done.  No questions asked.  Those of us who are doing our regular time and are done, must wait until a nurse is available.  We have a patient to nurse ration of 3:1, and being the evening shift, there are usually only about 8 patients, so 3 nurses plus one care worker, whose job is to set up and strip machines, look after supplies, and take care of petient's non medical needs.  On occasion, I have to wait to come off, but it's never been more than 10 minutes.  As time is running down, they try to keep track of who has the least time left and try to take them off in that order.

[Paul]

We have a patient to nurse ration of 3:1

So "Yay for Canadian medical services." I've never heard of those ratios anywhere before. I am currently dialysing in a ward for people with additional problems that make dialysis difficult, so need more staff than most places. The best we get is three nurses for fourteen patients.

If you are not careful we will all emigrate to  Canada

[GA_DAWG]

Our ratio is five patients to one tech, and ten patients to one nurse.

[Riki]

Our ratio is five patients to one tech, and ten patients to one nurse.

We don't have techs, just nurses.  Oh, and care workers, but they don't take people on and off.  They can do pretty much anything else but that, and once we are on, they aren't allowed to touch the machines.

[Michael Murphy]

In the US being asked to be removed early requires a AMA (against medical advice) form be filled out and signed by the patient.  Last month I was in a upstate New York clinic and on my last treatment I was scheduled for the 3 shift and I am a 4.5 hour patient. I would have been on till 8:30 pm  and would not be out till 9:00 pm at the soonest.  To avoid the ama route the clinic contacted my nephrologist to write a prescription for 4 hour treatment.  There is a rumor in my clinic that the transplant teams frown on too many ama to end treatments.

[GA_DAWG]

AMAs are definitely one of the things transplant facilities look at. They also ask the clinics if you are compliant as a patient. Too many AMAs is a negative towards getting a transplant.  It is no rumor.

[Simon Dog]

With a fistula it becomes more complex.

I made it real simple.   As soon as the flushback was done and the lines to the machine disconnect, I said "thanks, I'll take it from here".   Made it much easier for the tech or RN to get to the next patient.

[Riki]

AMAs are definitely one of the things transplant facilities look at. They also ask the clinics if you are compliant as a patient. Too many AMAs is a negative towards getting a transplant.  It is no rumor.

That is true here too.  They may take you off as soon as you ask, however it is documented in your chart.  Too many times, and you can be removed from the transplant list because of possible compliance issues.

I do remember one time when I was in NYC, I asked to come off about 15 minutes early because my toes started cramping.  I noticed that the person who put me on had put me in for my max, and not my actual weight, but not until after my feet started cramping. *L*  I didn't have to sign anything.  They just took me off.

[Charlie B53]

I am Guilty of arriving early, consistently.

I have a 6:40 a.m. seat time but usually arive no later than 6:20.  I also bring along a neighbour up the street who also has an early seat time about 6:45 . Since we both are the first shift it wroks out OK.  Wayne doesn't smoke so I won't smoke in my truck on the ride in, but once there I will stand out on the sidewalk and have a cigerette while Wayne always spends a few minutes in the bathroom.  Once finished I go in and set up all the qwap from my bag, blanket, pillow, computer, snacks, glasses, cup of ice.  Then I go weigh in and check with the Nurse if she is ready or should I go outside for a while again?  Half the time she lets me go outside again.

We get alone fine.













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