Dialysis Staffing

redknight · Mar 22, 2008

I`m a new grad and have been offered a second interview with FMC.Now that I`ve read a few forms here I`m really concerned about going through with this interview. Am I putting my new grad butt in harms way?

wordsmith · Mar 25, 2008

I work in Oregon and I'm an RN.

Our facility, which has up to 24 chairs, generally has two RNs. We used to have 2 techs per 7 chairs but are now experimenting with the 1:4 tech:pt ratio. Turnover can be nasty, especially if there are a lot of catheters and there are beginner techs, and the downside is that we're losing the teamwork effect that we've always had up 'til now. The RNs have always split the chairs in half and that hasn't changed.

I don't know if we'll keep the 1:4 thing but it's kind of a relief to know that it seems to be pretty much a standard. The administrator says we have too many RNs (!)--we find that hard to believe 'cuz whenever one of us comes in on a non-floor day that person winds up helping take off orders, answer the phone...you know, help with the nursing paper stuff because the floor staff are running their fannies off with crises. The way the acuity is rising I can't believe some of these people are still hanging in there. I know that sounds cynical but it's a testament to modern medicine and sheer stubbornness.

I'll stay with dialysis 'cuz I have a bad shoulder and can't lift the way I used to (an obese post-op patient and a student who didn't quite know how to roll someone over). Sure, I'd rather do telenursing or case management from home, but this ain't half bad, either, and I like to talk to the patients.

In Oregon the OARs (Oregon Administrative Rules) dictate staffing. They aren't exactly laws but have the force and effect of same. Just recently the staffing ratios in nursing homes, which hadn't been adjusted for something like 20 years, were changed to allow for increased acuities. About darn time, too.

missouriman · Mar 31, 2008

we are 6 patients to one nurse here in south dakota. it is to much.

turn over is really bad.

I will contact my state board and see if there is a set ratio.

holiday2525 · Apr 5, 2008

I can hardly beleive that a company will allow you to work off the clock the fines can be large.What BS. Taco bell treid that and paid big! If the little guys could prevail over a huge fast food company, y9ou can too. I would look for a lawyer, see which other company offices are doing that and file a class action suite. You will win, but it will take time. By agreeing to work oof the clock you re allowing they company to take advantage of you and it is part and parcle of the atomsphere that has been created. Good luck.

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wnf3 · Apr 6, 2008

I know I cant help with this,just wanted to share. I work in england in NHS dialysis unit our ratio is 2:5 (1RN+ renal assistant: 5patients) it is quite managable but since the FMC take over our ratio 1:4 for RN's and 1:8 for renal assistant, means 2 RN's are sharing for 1 renal assistant, and this is ridiculous. It is not our choice to go on private , its so happen that our NHS cutting down the budget, and we think everything FMC provided were cheap...We started as early as 6am for day shift coz our unit is running for 24 hours for 6 days

Hi,

I also work in England dialysis unit and our ratio is 2:8 ( 1RN + 1 tech: 8 patients). we start work at 6.30am and the last shift finish at 12.30am. the ratio works 99.9% of the time.

elizatru · Apr 9, 2008

When I worked for Davita the ratio was 4:1 (non-differentation to roles), it didnt matter what your role was as long as you were a body to open and close the building. Most times it was 1 RN (charge/giving meds/paperwork/and taking pts) then 2 pcts (always short). Best thing I ever did was LEAVE! I'm now with another company (not FMC or Davita). Our state mandate is 4:1. I now work 3:1 and the charge does NOT take pts therefore isnt counted in that ratio. There is a heaven lol. Just goes to show management can make the difference in keeping thier nurses happy if they actually try which is something I didnt see in the biggy companies. I work a KRU facility and will be moving on to acutes soon (thank goodness). But if I had to stay in chronics I love this company.

elizatru · Apr 9, 2008

hi I quit my job with davita yesterday, It was the same for me passing meds, pt assessments, put pts on take off, doing pct work, taking Drs orders and be treated like nothing I cried yesterday a lot but I know that was the best for me.

newmiccat · Oct 16, 2009

In our clinic they are running a 8-1 tech to patient ratio with one RN FMC at their best! Is this legal?

Tish88 · Oct 18, 2009

CMS will not set any staff to patient ratio. (As stated in the new condition of coverage.) We brought this up to the CMS, during a conference, prior to the new regulations and they indicated that they would NOT get into that and set a certain ratio - probably because there is not enough staff out there to cover a set ratio.

Each state is different, you will need to check with the state board of nursing. Many of the states do NOT have ratios for dialysis clinics.

My clinic is 20 chairs= 4patients per PCT and 1 RN for 20 patients. We do not have a state regulation.

Tish88 · Oct 18, 2009

In our clinic they are running a 8-1 tech to patient ratio with one RN FMC at their best! Is this legal?

There is nothing illegal about that ratio as long as your state you work in does NOT have a set ratio, which would be RN to patient ratio and not PCT to pt ratio, since they are not covered under the state board of nursing regulations.

Like I just wrote, my clinic is 1 RN to 20 patients.

newmiccat · Oct 18, 2009

CMS will not set any staff to patient ratio. (As stated in the new condition of coverage.) We brought this up to the CMS, during a conference, prior to the new regulations and they indicated that they would NOT get into that and set a certain ratio - probably because there is not enough staff out there to cover a set ratio.
Each state is different, you will need to check with the state board of nursing. Many of the states do NOT have ratios for dialysis clinics.
My clinic is 20 chairs= 4patients per PCT and 1 RN for 20 patients. We do not have a state regulation.

The best way to beat the system is to file complaints with the state, esrd network, and the FMC hotline. By doing this several times a week the area manager will be required to answer complaints that are annonymous, but still require an answer. Her or his time will be consumed with answering complaints, and not much more. When the problem is resolved the complaints cease. Everyone is happy, and can get back to work. I'll let you know if it works. So far it has. Managers hate paperwork.

TraceyLPN · Nov 12, 2009

DO NOT WORK FOR FREE!!!! that is exactly what you guys are doing and you shouldn't do it, you are all worth way more than that! I've been in dialysis for 10 years, first as a PCT, now and LPN about to begin the RN fast track program in Jan. I'm sure everyone who is working off the clock is working for a company who can DEFINITLEY afford to pay you. You need to all speak to the manager and if he/she does not do something about this situation, you need to move on up the ladder. This is something I would never condone, a previous poster was correct, if something happens it will not get paid for. If this doesn't get resolved I believe I would be changing jobs and work for an employer who appreciates the hard work. When I first began dialysis the ratio was 3:1, now it is 4:1. We have a dr. who is trying to get the company to factor in acuity levels when making staff assignments which would be GREAT as we have 3 patients who need a lift to transfer, several more in wheelchairs, and have one starting tomorrow who has a trach. Good luck, and please stop giving your precious time away.