CNNT FRONT LINE TALK: The Many, The Proud, The Able – The Technicians

CNNT’s First Ever PCT Survey

Jennifer Lunt, CCHT

Nephrology is a unicorn of a medical field. Yes, there are doctors and nurses, but a large amount of the bedside care is handled by the many and the able – the technicians. These talented specialists - many of whom learn their skills on the job and not in a classroom - are certified by exam and continuing education classes, but are not always licensed by the state.

In fall 2021, the CNNT released a survey to technicians through social media with questions about their compensation. The survey was anonymous with the participant asked only in which state they work. Because skills of a dialysis technician are not easily translated into other fields, many are loyal to their profession. The average time in the field among the 73 respondents was 18 years with the average age 52.

We are an educated lot as well. While nearly a quarter of those who responded have a high school diploma or an equivalent, 76.4% have some higher education, including 4% with more than a bachelor’s degree. There is nearly a 50/50 split of respondents’ employers who offer benefits like reimbursement in pursuit higher education.

The Centers for Medicaid and Medicare Services (CMS) require certification within 18 months of hire, and the Nephrology Nursing Certification Commission has issued a Certified Clinical Hemodialysis Technician (CCHT) or a Certified Clinical Hemodialysis Technician – Advanced(CCHT-A) to more than half of respondents.

Fifty-six percent of those completing the survey work in the chronic setting, which means they can see the same patients as much as three times a week. In addition to the patient care side of the job, survey respondents also have other responsibilities, including precepting new hires, access manager, inventory for the facility, unit clerk, and bio-medical tasks.

Over 60% of the respondents work in a state where licensing is required, and three-quarters are subject to state regulations on the care they may provide. Two-thirds may access central venous catheters and half may administer heparin and lidocaine.

There were responses from 25 states; one did not indicate their state. The hourly rate ranged from $15 – a high of $66. The average salary of the respondents - $22.00/hour. View results on page 16.  

Why does this matter? In March 2020, after the initial surge of COVID-19, a survey by Montoya et al. found 62% of nephrology nurses feeling burned out and 47% worried their attitude about patient care was hardening (Montoya, 2021).

Nephrology nurses and technicians are unique in that by nature of the work often develop close bonds with their patients. In addition to the underlying anxiety of long hours as well as concerns for self-health and their families, many worry the stress and strains of the working environment will result in a mistake in treatment or missing a change in a patient’s condition.

Eighteen months later, the continuing virus-induced stress raises concern as to how nephrology nurses can provide not just adequate care, but outstanding care to their patients.

Nurses in all practices are finding the anxiety and stress no longer bearable, leaving direct patient care (or health care entirely!). In dialysis, that means trained technicians are covering the gap in care working long hours without the deserved respect and for a wage not compensatory with their responsibilities.

While the initial intention of this CNNT survey was to learn about PCT compensation, the respondents showed us much more about their educational background and duties. Further insight into the capabilities of these healthcare providers may lead to expanded roles and improved salary.