Originally posted by jmtmom
what is the job of the RN versus the LPN versus the tech in dialysis clinics? When I toured my clinic, the majority of people on the floor were techs, though licensed personnel were there as well. Another thing: what makes life hard for the RN in dialysis? What makes you have a bad day?
I know that your post was addressed to Jnette, but I hope you don't mind if i resond, too.
LPN and RN do basically the same stuff at my unit, only RNs must take turns being charge, and LPNs do not call the docs to get orders, etc. an RN must do it.
The techs are not licensed and the nurses are ultimately responsible for the techs.
The techs are responsible for the technical aspects of putting the pts on the machines, cannulations, getting bicarb for the machines, stocking supplies, etc. Techs where I work are trained in basic assessment, but I often find that they write "lungs clear" on everyone, no matter what. I frequently hear adventitious lung sounds in pts that techs do not hear.
The nurses give all the meds, check that what the techs have done is correct and complete, etc. Also, lots of pts get their dialysis via "LifeSties" and caths, which can only be accessed by a nurse.
We also write the care plans
, make changes in pts treatment, etc. We do all the same stuff the techs do, plus the nursing stuff.
The techs usually get to take their breaks, and leave on time. Often, the nurses don't.
What makes it hard is that, at my unit anyway, it is overwhelmingly busy. Often we run without stopping from the moment we arrive, and don't get to take our breaks.
Plus, it's difficult to oversee so many techs and pts simultaniously.
Often, the techs have a "get 'em on, get em off and out the door" mentality about the pts.
Many of them don't understand why when I intervene to slow blood flow rates, give NS etc. when a pt's B/P is dropping too far, too fast. They get annoyed at me, because my interventions interfear w/ their plans to move the pts along as fast as possible.
The other day, I had just come on the floor when I found a pt w/ a HR of 38. She was diaphoretic, pale, just looked like crap.
I assessed her, changed her dialysis settings and took the tx sheet to call the doc. He told me to send her to a cardiologist.
I was on the phone to call the cardio's office, when a tech grabbed the tx sheet out of my hand and told me "hurry up. You're making us fall behind on charting our q half hr vitals."
It's cluelessness like that that makes me have a bad day.