Dialysis Clinic Employees Closely Monitor Patients

A dialysis clinic is a busy place, with two to three shifts of patients coming in daily and spending three to five hours there each time. Clinics in the Twin Cities may have 12 to 28 stations where patients with kidney failure are treated by patient care technicians (PCTs), under the supervision of registered nurses.

PCTs currently receive training from their employers and are not required to be certified, but Medicare will require certification by each state or a national commercially available certification program within 18 months after October 14. The Nephrology Nursing Certification Commission (www.nncc-exam.org), Board of Nephrology Examiners Nursing and Technology (www.bonent.org) and the National Nephrology Certification Organization (www.ptcny.com/clients/NNCO) offer certification programs.

Patients depend on technicians

"PCTs are the frontline, the backbone," says Patrick Howard, eastern Minnesota area manager for Fresenius Medical Care (www.fresenius.com), which has 20 dialysis clinics in the Twin Cities area. "They're the ones that actually initiate, monitor and discontinue the dialysis treatment."

Clinic operators also train equipment technicians, for whom a plumbing background is helpful because dialysis is all about water. "Because of the uniqueness of the dialysis industry, we have to provide our own training," Howard says.

The rest of the staff

Other healthcare roles within a dialysis clinic include:

Facility administrator, who manages the clinic.

Charge nurse, an RN who oversees patient care on a daily basis.

Dietician, who helps patients with dietary requirements and restrictions.

Social worker, who assists with insurance and economic needs.

Nephrologists see their patients in the dialysis center, often weekly, but a minimum of monthly, according to Dede Erickson, RN CNN, regional director for DaVita (www.davita.com), which operates more than 30 dialysis centers in the Twin Cities and surrounding suburbs.

At Fresenius, a nurse practitioner, physician assistant or kidney specialist will examine each patient weekly. Each PCT is responsible for four stations, and each RN for 12. Social workers and dieticians may work at several clinics and maintain a rigorous schedule of monthly meetings with patients and families.

Each dialysis patient is assigned a PCT and a charge nurse, who monitors the patient's weight, heart and lungs at each visit and closely monitor the patient during dialysis, according to Erickson.

"We have a variety of scheduling options for teammates in dialysis, depending on the location," she says. "It is a fulfilling and challenging career."

Nancy Crotti is a freelance writer who lives in St. Paul.