Do techs do assessments on your unit?

[Hellllllo Nurse]

DIALYSIS nurses:

Do techs do assessments at your unit?

They do in mine, and I strongly disagree with the practice.

Every day, I find the "lungs clear" box checked on the pts who are on 02, have COPD and are very dyspnic.

I find the "heart rate regular" box checked on pts whom I've never heard to be regular.

"No signs of fluid overload" is checked on SOB pts w/ weeping 4+ pedal edema.

I often cross out the techs' assessments and write in my own, accurate assessment.

I know for a fact that some of our techs never take their stethoscopes off of their necks.

When I expressed my concerns to mgmt, and showed them some tx sheets, I was blown-off.

I don't think techs should be allowed to do assessments.

I was visiting a friend who works for another dialysis company in AZ last week. At her unit, the techs even access the caths and change cath dressings.

What do you think about this?

[Hellllllo Nurse, BSN, RN]

I wish my facility would not allow the techs to assess our pts. The

"assessments" they do are almost always totally inaccurate, and leave a lot of "clean up" work for me, as I am constantly going behind them, doing a REAL assessments, and changing the goals on pts.

This is a big hassle for me, and DANGEROUS for the pts.

[DialysisNurseDA]

Hi

I am new to the dialysis forum. I plan on going to work in a dialysis unit next week, this will be my first experience. I have no clue what a tech can or cannot do. I know what and LPN, and CNA can do in my state and the surrounding states near me, because I was both at one time in my life. I am RN, C BS now have been for years.

I suppose it depends on the training. Nursing assistants in hospitals here do not even need to be certified, they can insert catheters, because they are trained. CNA's who are certified cannot insert catheter's in long term care. It is regulation differences. When I was in the hospital as LPN working I found the NA's to be superior to then CNA's in the LTC and this was because of the difference in there training. I really feel most of them worked on an LPN level, as I see little to no difference in an LPN an RN except Laws. I was basically just there, because the NA's did everything but pass meds.

I was exposed to CMA just recently temporarily and I was empressed with some and some I did not care for. They are trained to give medicines. In a nursing home they give meds, but the nurse is the one responsible for overseeing everyone if it is LPN or RN. In other words it is kind of scary. When push comes to shove it will be the RN's head on the platter if there is a incident. If a med aide gives the wrong medicine to someone and does not report it and then the patient suffers distress from it and the RN does not get the report. It is still the nurse who will pay. I have worked with some superior people in many fields and what I try to do as the RN is tell these coworkers to report anything unusal even if it is a med error, anything so we can fix it before it becomes a potential problem.

However, as for lung sounds that would not be appropriate for any Tech or CNA, since this is a skilled that takes a long time to get familiar with as LPN and RN can tell you. You really need to know what you are hearing and sometimes it can be distortion. I find this one of my most tedious skills. As for taking a pulse, BP and other VS it depends on your training.

I will keep my eyes open for any inappropriate actions by Techs at my new position, and I will discuss it with the manager if I feel it is inappropriate. I will also educate my coworkers about laws and responsibilities. When I start I plan on asking for a job description of a Patient Care Tech.

Thanks for sharing this information.

Darci

[nursefiggy]

Our PCTs do assessments. Most of them are very experienced and know what they are looking for. If anything, I see mistakes in what they call 1+-4+ pitting edema. Our techs can't touch a catheter or a chart. They don't call the docs or draw up or push meds. They assess, cannulate, initiate, monitor, end tx and hold sites. I am very proud of our PCTs.

[Marie_LPN, RN, LPN, RN]

Only a nurse does the assessments where i work. For the exact reasons that the OP stated.

[babyboomerRN, RN]

we have wonderful techs in our unit but they are not allowed to do any assessments.

[jnette, ASN, EMT-I]

No assessments...Rns and LPNs do these. They MAY, however, do caths, dressing changes, heparin bolus, etc. They also do their share of nursing notes/progress notes which are then cosigned by a nurse.

As with anything, you get good ppl and not so good, You get really motivated techs who are interested, willing to learn, learn well, and perform well. I've seen some awesome techs.

Then you get some who are kinds "just there", who bear watching. Guess that's with anyone, anywhere... including nurses. Depends on the individual.

A sorry tech is no more harmful to a patient than a sorry nurse.