Dialysis Staffing

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Does anyone have any ideas or suggestions on where to find the guidelines for staffing ratios or how to have them changed? I have called the Renal Network for my area & was told to check with the board of nursing. I had no luck there either, I have looked for info from CMS and can't find the regulations. We currently work a 4:1 PCT / pt ratio, with one RN. It is horrific. A neighboring state less than 5 miles away has a mandatory 3:1 ratio. Both of the clinics are owned & run by FMC and we do share staff. The problem is that no one wants to work in the 4:1 ratio clinic when they can work a 3:1 ratio for the same amount of pay. We have tried to talk to our regional manager (who has no medical background) about this issue & it got us absolutely nowhere. Now, to make matters worse, techs are working off the clock in the morning to get their assignments ready because the regional mgr told them they aren't allowed to clock in earlier than 6am. The first patients come into the unit at 6:45am, it is not enough time unless we start to cut corners & not follow policy. I know that this is not legal for FMC to do this, but this is a big company with lots of $$$$$$. Please any suggestions would be helpful, everyday feels like we are hanging on by a thread & the patients are the ones who are paying the price. HELP!!!!!

When you get to be my age you call everyone "kiddo" LOL LOL. It appears that you look down on kidney patients in general based on your most recent post's. Some of them actually try to help us with FMC. [/quote]

Nursing is not a vocation. It's a career. When you get to be my age. 58 Kiddo is an insult and I'm pretty sure you know that. What your problem seems to be is that you don't like someone disageeing with you. BTW I was an LPN for 17 years. I worked in HD for 2 1/2 years as an LPN. My patients took up a petition for me not to leave. I left because I couldn't give EPO. If you'll read the CMS regs, posted here earlier, you will see that someone has overruled you. LPN's can be in charge whether you like it or not. You can complain about it til the cows come home. Go ahead and try to get CMS to change their mind. CMS won't even set staffing standards.

I don't look down on my patient's. I see them as they are. Read the other kidney patient's blog. You'll see a different prespective. Dialysis, From the Sharp End of the Needle.

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I am 65, and outdate you by several years kiddo. This is what you think about dialysis patient's, and let me quote you "They are really like most other patient's very self centered."

Sorry you feel that way about patients, but they are very sick, and in pain most of the time.

The word kiddo isn't condescending it is just coming from an old person who has learned how to control his temper along the way.

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I am 65, and outdate you by several years kiddo. This is what you think about dialysis patient's, and let me quote you "They are really like most other patient's very self centered."

Sorry you feel that way about patients, but they are very sick, and in pain most of the time.

The word kiddo isn't condescending it is just coming from an old person who has learned how to control his temper along the way.

I'm not gonna lower myself to your level.

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Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

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Specializes in Cardiology (ITU), Acute Renal/Dialysis.
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

I'm also in a uk nhs acute unit where the ratio is 2RNs to 7 patients. We are small & mostly its fine but am sure changes are afoot! NHS is quickly becoming big business orientated and money/saving money is becoming daily talk. I personally dont believe Nurses should be worrying about costs - just their patients (NHS atleast).:nurse:

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I wonder if you still are in dialysis. I have been doing dialysis for the past one year and after reading alot of messages on this site, realize I am in the same boat.....short staffing, long hours, sore feet and NO concern from management. We have 16 chairs, 3-4 PCT's and myself as the RN. Horribly unsafe for the patients and unfair to the staff!

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Hummm sounds familiar

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Iamsignal3 - r u in dialysis and is this the same situation for u?

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In my unit in Pennsylvania, we have 13 patients, me (RN) and one PCT. It's horrible and unsafe. There's some instances where half hour checks are done every 2 hours. No one cares. It's all about $$.

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Specializes in Dialysis.
In my unit in Pennsylvania, we have 13 patients, me (RN) and one PCT. It's horrible and unsafe. There's some instances where half hour checks are done every 2 hours. No one cares. It's all about $$.

Hello chelegrn, are you at davita I heard that was the norm. 5:1 ratio

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Specializes in Nephrology-Dialysis.
Hello chelegrn, are you at davita I heard that was the norm. 5:1 ratio

5:1?! I've experienced this kind of staffing before and I ended getting burned out from where I use to work. I just lasted a year and moved to a new workplace. Currently, we are following 3:1.

It's a small unit of 12-beds, with 2 beds alloted for acute care.

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Specializes in Dialysis.

5:1?! I've experienced this kind of staffing before and I ended getting burned out from where I use to work. I just lasted a year and moved to a new workplace. Currently, we are following 3:1.

It's a small unit of 12-beds, with 2 beds alloted for acute care.

I haven't worked for davita my self but I am at a unit that is being taking over by davita and when asked what the ratio was, the pct told me its MWF with 1 RN and 1 pct each with 5 patients. I agree it's a crazy work load and I wouldn't do it.

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