As a former dialysis nurse, I can tell you this. Our medical director doesn't care how much time you have at ltc per patient, nor will they foot the bill for supplies. I was the only nurse in the building, and could not leave the floor to pee myself, never mind assit a patient that requires a lot of assistance to the restroom. We barely had enough staff to keep the patients dialysis going. Patients are constantly coming off and on the machines and their vitals and condition are rounded on constantly. We didn't have wipes, we did not have briefs, we did not have a change of clothes to change the patient into. We don't keep insulin or pain medicine in the dialysis center. We were bare bones, an OUTPATIENT clinic. We did however, take patients off of the treatment, which required rinsing the, back and giving them a lot of extra fluid, if they had to use the restroom and were able to. Dialysis patients can bleed out in under 3 minutes if a needle slips. They can code at the drop of a hat. All staff needs to be watching the patients for their entire treatment. We don't have extra staff to cover the ltcs lack of staffing. You can't send a can, so who is supposed to make up for that?
I can tell you it was a regular occurrence for our patients to come sitting in their own mess from ltc for thei treatment, can't you toilet them before you send me out? Maybe feed them if you know they will be gone for 4 hours? They were often given meds they were not supposed to have prior to dialysis making their bp unsustainable for treatment. Every time i called i ogt a different nurse, never the same one twice. It got to the point where I would call ahead 3 times a week to ask the ltc to please feed and toilet before sending the patient and reviewing all the meds to hold because they could never get it right. If you think dialysis is so easy and we are all just lazy kicking back, I suggest you give it a try. Maybe ask to shadow a day or so. If you understood what was going on. during the dialysis treatment you might have a better idea of why the patient can't be taken off cleaned and bathed any old time. It goes both ways and bth sides need to work together.
Just Like you say Money isn't a good reason, right back at the ltc and lack of staffing. We are all fighting the same battle here, let's work together instead of blaming the other.