I am an RN in a very small facility. We are opened MWF for three shifts (this makes our work-day about 14hrs). I enjoy my job, and want to give my patients the best of care. It seems to me that nurses are asked to be responsible for more (feet checks, access flows, ambulation checks)without getting any extra staff.I don't mind working hard, but to quote the PCT at my center "I feel like a slave!" We have 30 patients and 1 CM, 1 ET, 1 RN, and 1 PCT. There is no allotment for unit clerk or secretary, and dietician and social worker are there only a few hours on Fridays. One day, the PCT had to call in, and there were only 2 staff for patient care. Luckily, the dietician and social worker were there that day for telephones and assisting with cleaning machines and chairs. How do some other centers get better staffing levels? HELP?!

If you have 30 patients per shift you should have 3 RNs and 7 Dialysis Techs. Thats 1 Rn per every 10 patients and 1 Dialysis Tech per 4 patients.Where are you working with no help?Why are you doing all of the work? Dialysis Technicians do foot checks ,access testing,etc etc

Good luck with that oldschool. 1 RN to 10 patients is wishful thinking. For thirty pts there should ideally be 10 PCT 3:1 ratio and 2 RN's minimal working the floor. Often the providers get away with having the RN take care of one stable patient and do meds for the entire shift. In our clinic we have 15 pt - 2 RN's ideally but often that is not the case. I think 1 RN to 12 pts is the absolute max for pt safety but nowadays mgmt pushes it to 18 pt : 1 RN if they could. That REALLY sucks. Problem being is that noone will actually speak up to SET RN/PCT/Pt ratios ie CMS, state agencies.3:1 PCTs is the best especially in a reuse unit, although 4:1 is the norm around here. It's hard to do 4:1 in a reuse clinic for correct priming, etc. 1RN per 15 pts is really pushing it, especially if you have to takae a pt or 2. Dialysis staffing really sucks if you ask me. In the old days when I started - 1986 - we were an all RN staff - 6 RN's for 12 pts no reuse. Those were the days!

After many years staffing has become a very large problem. For profit units and all their money has keep CMS at bay and keep ratios out of regulations. The large corp. say that there is no evidence of a safety patient issues at the staffing we have today. The other problem is the shortage of qualified dialysis Technicians and RN's. Rn's are at a premium
so they want you to work with less, to keep the stock making mony. Good Luck