UF Profiling & Sodium Modelling

[nu2dialysis]

Hi! I have been a PCT for almost 3 years now. Started with Da Vita in Michigan and moved to NY where I'm now working for a privately owned clinic. I learned that there are different state laws that we have to follow here (like PCTs cannot draw their own heparins, can't put catheter patients on and we actually have stools that we could sit on!). I was told that PCTs cannot use UF profiling and sodium modelling without doc's orders. But they're really never around and our RN's are not very aggressive as far as setting UF goals for fluid overloaded patients. Most of our patients run for 3.5 to 4.5 hours with only 4 kilos as max goal even if they have gained 8-9 kilos. I was taught that I could use UF profiling and sodium modelling together to remove fluid in the old clinic I used to work for. Most of the patients back then would run for 3 hours and we could pull even up to 5 kilos at a time. So I'm left debating goals with our RN's and I don't want to seem like a know it all when I know I still have a whole lot to learn. Should I go by UF goal or UFR as far as setting their goals on the machine? Also I have found out that there are certain PCTs that have been with this company for a long long time that would mess around with their machines (when there's really nothing wrong with the machine) so that they wouldn't have as many patients at a given time (our ratio is 4:1 which of course sometimes turns out as 6:1 esp if your partner is lazy). My hubby thinks I should look for another company to work for but am now afraid that all companies here in NY would have be the same? Any comments?

[NephroTorch]

Of course fluid restrictions is tantamount to the treatment of our patients (given). I really wouldn't use sodium modelling for my patients because it leaves the patient thirsy post tx (seen in practice) - thus they are consuming more fluid than they normally would. But if i have to use sodium modelling, i would use UF Profiling together with the Sodium to make sure that complications is minimized. But i would rather use UF profiling alone (instead)..