Hemodialysis patients are critical and sensitive to handle. Even the tiniest negligence can be fatal for the patient. Considering the gravity of dialysis patients, it is essential to have an adequate number of trained staff in hospitals to ensure that patients get undivided attention during their dialysis sessions. The lack of staff can lead to chaos and blunders otherwise ignorable if the staff is not overburdened.
Among other conditions, venous needle dislodgement is common during dialysis. It can lead to stagnant blood, and patients can bleed to death in minutes. This can happen if the number of patients is higher than what the hemodialysis nursing care staff can handle. Understaffing means that healthcare professionals are handling more cases than they can or ideally should. Hence, the chaos divides the attention, and patients do not get due attention and care. According to the US Department of Health, 60% of hospitals are expected to get overburdened due to a rise in the number of patients.
This post addresses the problems faced by the dialysis staff across USA.
US Senate Law for Dialysis Staffing
To address the dialysis staffing problems across USA, the Senate has passed a bill, which regulates staffing in hemodialysis settings in hospitals. This is the first law formulated with specific nursing and administrative rules and regulations. Many USA states supported the bill, including Georgia, Maryland, Massachusetts, Oregon, South Carolina, Texas, and Utah. The support from multiple states made the bill stronger.
The bill stated that one nurse would be allotted to eight patients, with one dialysis technician per four patients and one social dialysis worker for every eighty patients. The dialysis unit shall remain free for sixty minutes between patients and shall be properly sanitized in the interval. Penalties will be imposed on hospitals that fail to follow the regulations. The law helps dialysis staff from being overburdened and enables proper care for patients.
While one group of workers agreed to this law, another group suggested that this bill will push the patients away if the state cannot balance adequate staff to patient ratio in hospital settings. They also claimed that the bill might have unfruitful outcomes because it is difficult to find and hire trained and certified patient care technicians and dialysis nursing staff. The country’s largest hemodialysis companies, DaVita and Fresenius Medical Care, also resisted the bill and created hurdles in its approval. DaVita and Fresenius Medical Care handle 90% of the dialysis market in the US, and their resistance was a major concern. On the contrary, the American Society of Nephrology and the National Kidney Foundation did not support nor oppose the bill.
Engulfing Staff and Frightening Patient Ratios
Staff aggression towards patients due to overload of work is one of the most important problems in hemodialysis centers across USA. Workload has drastically risen with time. According to reports, only ten patients were served per day in 1994, while the number has gone up to twenty-five patients a day. The increase in workload has led to an overwhelming and engulfing staff in dialysis centers across USA.
It has a direct effect on patient care leading to poor care of patients by the nursing staff. It was reported that some patients puke and choke on their vomit until dead while the nursing staff is catering to other patients. The per-day failure to save patient lives is remarkably increasing as the staff has to rush from one patient to another. This is why a sixty-minute break is essential when dealing with dialysis patients.
Wage Problems of Nursing Staff
The nursing staff working in dialysis care units across USA struggle with wage issues. The low wages are demotivating for the staff and keep them from working with complete devotion. It is suggested that with the bill addressing staff to patient ratio, a separate bill addressing patient to salary ratio shall also be proposed soon. Dialysis technicians are paid only ten dollars on average for working eighty hours without any halt. The big dialysis franchises such a DaVita and Fresenius pay their workers only thirty dollars, which too is insufficient.
It is important to pay the staff well as it is an effective motivational factor and encourages them to work to the best of their abilities. A well-paid team is more likely to provide quality care to patients without any negligence. Companies like DaVita and Fresenius can easily afford to hire nursing staff on decent wages as only their marketing profits total to two million dollars per annum. DaVita earned a profit of 1.6 million dollars in 2014, Fresenius earned a total profit of around 1.3 million dollars in the same year. According to DaVita and Fresenius, finding certified and experienced staff is difficult. Hence, DaVita and Fresenius also came in opposition to the strategic proposed bill regarding the low wages of dialysis nursing staff across USA
The length of the dialysis shift and span between multiple patients is also one of the major problems in hemodialysis centers across USA. The sixty-minute break and scheduled day and night shifts can ease the workload and dialysis obstacles.
These are some of the major problems faced by the dialysis staff in USA during the pandemic, and due to understaffing and a stark surge in cases, the situation is only worsening across the country.