Practice concerns in Dialysis Clinic

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Please answer the following questions to help me make a case for changes in our unit:

1. What is your Registered Nurse to patient ratio?

2. What is your staff mix? e.g. all R.N.'s, LPN's or RPN's. Renal Tech's, Biomed Tech's

3. What are your hours of operation and what length of shifts do most of your nurses work?

4. Do you use chairs or beds?

5. Do the nephrologists visit clinics not directly attached to or part of hospitals? If so, how often?

We currently have a 6 chair unit with 2 R.N.'s working 12 hour shifts. We run 4 patients in the a.m. and 6 in the p.m. We have been told that they plan to add an LPN for 6 or 8 hours and increase our patient load to a minimum of 6 patients in the a.m. and 6 in the p.m.

Your feedback will be much appreciated.

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1. At worst, our RN/pt ratio is 1:8. Our center is broken up into 3 "sections" of 8 chairs and we have 1 RN in each section. We also have a charge nurse too...and she floats during turnover, so at times we have 2 RNs in our sections. Sometimes we may have 2 RNs in a section, depending on how things are scheduled.

2. We have RNs, LPNs, Dialysis Techs, Dialysis Assistants, Recirc Techs, a lab tech and biomed engineers. Usually we have 4-5 RNs on duty at one time, 1 LPN, 9 Dialysis Techs, 1 Assistant (she makes up bleach rags, stocks supplies, helps tear down and set up machines, and holds some pt's sites when needed), 1 or 2 Recirc Techs, 1 lab tech (who deals with all the labs that are taken) and 1 biomed engineer.

We also have dieticians, social workers, shift managers and receptionists.

3. RN shifts are 12 hours long, as are the Dialysis Technicians. Hours of operation of the center...the first person gets there at 4:30 to start setting up for the day. First patient walks into the clinical area at approximately 5:30. Last patient, depending on the day, can leave anywhere from 8:00-8:30 to 11:00-11:30. (Mondays, Wednesdays & Fridays have a fourth shift of patients that come in).

4. We have recliner chairs.

5. Our nephrologists visit every week. Our center is not attached to a hospital, but the dr's office is right next door. Usually we'll see them every day, doing their rounds at differring times. We also have a Physicians Assistant that comes in a few times a week.

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Recently I have been reading messages at dialysis boards. I am horrified at what I am hearing from patients. All negative. What gives? I don't understand how patients can be so neglected. I want to learn about dialysis and understand why things are so bad. :nurse:

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Recently I have been reading messages at dialysis boards. I am horrified at what I am hearing from patients. All negative. What gives? I don't understand how patients can be so neglected. I want to learn about dialysis and understand why things are so bad. :nurse:

It probably depends on the dialysis center. I don't have any experience outside of the center that I'm working at now, so I can't really say. If there was neglect, I would think that the state would shut them down. Our center has been rated well by our patients, the only real complaint being that occasionally it gets noisey. :rolleyes:

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