Where do you live? I know nothing about having to be a CNA first. Well, I take that back, in the chronic unit, CNA is not a prereq for being a tech. In Texas, you do not have to be certified. My company is now requiring it, but in the next year I'll be an LVN so it doesn't apply to me. Being certified usually just means a small pay raise, but again, it may vary from state to state.
In my typical day, here is what I do (again, this is a chronic dialysis unit, I am not referring to hospital dialysis.)
get there around 430, make bicarb for the day, do water checks.
Set up my four machines for the first run of patients.
draw up heparin.
set the machine according the physician order for time, fluid removal goal, heparin pump, any sodium or UF profiling.
put on the four patients, sticks only. In TX, the nurses put on the catheters, I just get their blood pressures, temp, get their catheter soaking.
v/s every 30 minutes.
notify the CN of any change in condition, administer NS for cramps, hypotension, etc.
after each patient comes off, get their post BPs, temps, weights, assessments. pull the needles, stop the bleeding and make sure they are stable before leaving.
turn over their chairs/machines for the next patients that are (sometimes) patiently waiting outside in the lobby.
get on that second shift of my patiens, all the while going to help other teammates with their patients, machines, BPs, someone who might be bleeding, vomiting, etc.
once everyone is on for 2nd shift, go back and finish charting on the first shift.
BPs every 30 minutes.
notify CN of any changes...
take off 2nd shift, clean chairs, machines, finish charting. rinse the bicarb loop at the end of the day, check the water system again.
this is a typical 12 hour day. the downtime is slow, but the change over time is very fast paced, requiring time management. where is this patient going to go? who comes off first? who is going to take more time to stop bleeding? who will be up and out?
re: certification, I think you have to have some experience before you can take the exam, not sure though.