Acute or Chronic Dialysis Nursing?

FransBevy · Jan 9, 2012

No, the entire facility has 26 chairs with 2 RN's. The jury is still out as far as making a career out of it. I love the patients but it's not a fun place.

talaxandra · Jan 9, 2012

That doesn't sound safe. I work on a renal (and other specialties) ward, not HD, so our patients go to another unit for acute dialysis. They seem to have a 1:2 ratio, and we don't have aides or techs of any kind (though that's set to change). I'm not sure what the numbers are like in the chronic dialysis satellites but can't imagine they're anothing higher than 1:4.

Guttercat, ASN, RN · Jan 10, 2012

We RN's each get a 3 patient assignment and oversee 12 patients in all. Each PCT gets 3-4 patients. I'm finding it still overwhelming so we'll see.

A PCT in charge of 3-4 patients at a time is a dying model.

An RN overseeing 12 patients at a time, is also a dying model. Exceptions occur in units with less than 16 stations.

An FMC RN I know, is frequently the only RN in charge of a 16 station unit.

To thrive in Acutes, you've got to like running your own show, making a plan for the day and seeing how close you can come to "making it work."

In Chronics the repetitive, "Habitrail existence" (think hamsters) of running in the same wheel day in and out, yet still never seeming to see daylight, is tiresome to me. Madly flinging EPO at patients in between phone calls and 20 page annual reviews, left me numb.

IME, Acutes are like combining ER and ICU: fast-paced (yet sometimes slow and dull), a self-directed atmosphere, interesting treatment decisions, close working relationships with multiple staff and docs from different departments, and actual time to interact with patients and effect change is highly rewarding.

Best wishes FransB. I think your goal of giving it a little time, is the correct one.

talaxandra · Jan 10, 2012

Guttercat, is that figure (1 RN:16 patients plus tech/s) the case for acute as well as chronic? And how many techs would you expect?

FransBevy · Jan 11, 2012

Thanks so much, GC and everyone. We'll all keep in touch (I'm sure) and let's just hope every decision we make is best for our patients and ourselves)

Guttercat, ASN, RN · Jan 12, 2012

Guttercat, is that figure (1 RN:16 patients plus tech/s) the case for acute as well as chronic? And how many techs would you expect?

talax, it really seems to depend upon numerous factors including the company and size of the unit and patient volume.

Anecdotally speaking, our unit is (relatively) very well-staffed, w/ 2 RN's on duty for 20 stations. At the end of the day, the first-out RN goes home when the patient load is decreased to about 10. Plus we have in-house back-up in our Clinician and Unit manager, both RN's themselves.

Our acutes is one RN, with two patients max at a time, and no techs. If the poo hits the fan in Acutes, our clinician is the bomb at finding and sending up help.

Everyone has varied, but set hours/shifts. When it's time to go home, it's time to go home. Yes, we run, and it's very hard work with all of the headaches, but we have very low staff turnover. Most of the RN's have been there ten or more years. Some of the techs 10-15 years.

Some acute programs depending on patient volume in the hospital will staff more RN's and/or techs. For instance, if they are running four or more inpatients at a time, there will usually be at least one other RN or possibly a tech.

Of course we are (for a few more weeks anyway) a non-profit, hospital-owned entity.

That's about to change.

There is one for-profit, that at one time was offering $$bonuses to techs who would take five or more patients.

Gold standard these days, is one tech to four patients, I believe.

Again, it depends upon the size of the unit, the unit manager, the company, and patient volume all of which, is never a static data-point.