Fair Pay Rate, and help on advancement

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3/1 pt. ratio

Postby dreamwatcher33 » Mon Jan 24, 2005 5:42 pm

Fetus- I'm sorry so many people have been giving your a difficult time for simply asking a few questions and being honest. It's not your fault - it is your employer's fault. You should confront them on the subject of getting more education and training. Voice your ideas and desires to make this a career. If they decline, I would begin looking elsewhere. I'm from a small town. We have a 4 bed lab and I was hired on doing on the job training. But we have gotten training. We continue to recieve training continually. I believe anyone who believes they have reached the place of not seeking more information are the ones who cause the profession to decline. No matter if they have been on the job 6 months or 20 years! You can never stop learning. Our director (clinical and medical) are terrific. I have now met my 18 months of on the job training and my employers are paying for three of us to take the exams in June.

I would suggest making sure that you are 100% sure this is what you want to do for a career. Not just because of the opportunity but for the love of what you do. I believe the more you learn the more you will love it. If you cannot do so with your current employers, seek out a sleep center that will work with you and give you the training you need. I am truly blessed to be where I am and to have the staff that we have! I purchase various books in order to obtain more knowledge. If it doesn't intrest you enough to study study study ......then find something that does. By the way we never have more than 2 pts per tech and I don't know how you do it alone with three! No way I would do it. You never know what situation you could end up in. We do quite a bit of pt. education though. We give out a questionnaire sheet at the end of each study and one question that bothers me is the pts usually never knew what to expect prior to coming so it is our jobs to explain everything to them. But most all pt's check that the tech explained everything to them and they had no questions after we get through with them. If you have three pts you are taking away from that very crucial time of educating them. Oh- and tell them to hire someone to clean up in the morning...........HAHA!!!!!!!!!!

Good Luck!
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Fetus I am offering up my trademarked speach to patients

Postby sebastian467 » Mon May 02, 2005 4:25 am

Fetus,
This is what I usually tell all my patients;
"Do you know what you are here for and what the doctor will be looking for with this test?"
With that they usually say something like, " My wife says I snore,or I stop breathing at night.
Then I tell them,
" I am going to be hooking you up to a bunch of electrodes, some of them are going to monitor your heart rate, others are going to tell us what sleep stage you are in or whether you are sleeping or not.""we are also going to be recording things like your oxygen level and how many times you move your legs while you are sleeping.""After we are done someone will go through and count everything and the doctor will get a report on everything that went on throughout the night, ie. how long it took you to fall asleep , how long you slept before you first woke up etc."
"All of the wires I hook up to you are going to be hooked into a box and that box plugs into the wall so if you need to go to the bathroom throughout the night you can just let me know that you want to get up and I will come in here, unhook you and you can take care of your business from there."
Print that out, read it to patients if you have to and keep stressing important things like "do not attempt to unhook yourself"and " do not try to breath through your mouth while under CPAP therapy" because people only listen to 10% of what you tell them. so tell them everything 10 times and they should get it.
I use this speach on every single patient I have so it works very well and doesnt leave them much to ask.If they forget, tell them again.Nobody wants to be senteced to a life of sleeping with a mask so dont tell them they will be going to get a cpap, or when they get this unit home, as they could start panicking on you..Tell them the doctor can go over their options with them as most doctors that deal with sleep are very versed by all the medical suppliers they deal with..
If you have any questions I can go over with them personally with you..
PM me if you need any more help ....
:P
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Postby SleepGod » Tue Jun 14, 2005 3:29 pm

I just want to reply about the comments made about the 3/1 ratio so that Fetus understands that 3/1 is not always a bad thing. As far as the 3/1 ratio, this is a perfectly good way to perform sleep studies given the fact that you have qualified technicians responsible for these patients. We have 19 total beds and perform 3/1 nightly. Not every tech has 3 pts. and those that do are compensated additionally. Its all about how comfortable you are performing 3/1. We have a hook-up tech who sets up all of the 3rd patients for those techs who have 3/1 and we usually have at least 4 techs working together on the same night. So patient safety is not an issue. We have an AED that everyone is familiar with, we are all CPR certified and the techs like the additional pay for the third patient. I agree that not everyone should do 3/1 and some are just too lazy to do 3 pts. but there are centers that can perform 3/1 without problems or issues. We have for almost 10 years now.

However, I don't believe that someone like Fetus should be performing 3/1 with his limited experience and no one there with him. That is definitely a bad situation to be performing 3/1.
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Postby Rick » Tue Jun 14, 2005 3:53 pm

SleepGod,
What do you do at accreditation time?
Since the AASM has set the Standard Patient to Technologist ratio at 2:1?
Do you hide the fact that you have techs doing 3:1? Or do you boldly say that your rules are better than the Accreditation Standards?
Or do you think Accreditation by the AASM is uneccessary?
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Postby sleepadmin » Wed Jun 15, 2005 5:38 am

Did the AASM make a change recently? When we went through accreditation last year they didn't blink an eye at our written policy on a 3:1 ratio. AFIK, the 2:1 ratio is recommended, unless they just changed that?
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Postby Rick » Wed Jun 15, 2005 5:27 pm

From Accreditation Standards:
PE.2. The center must have a sufficient number of adequately trained
and supervised technicians.
Standards
(1) Technicians must have valid certification in cardiopulmonary resuscitation.
(2) The technical staff is able to perform the duties indicated in the appropriate Polysomnographic Technician Job Description.
(3) Technician staffing must be adequate to address the workload of the center and assure the safety of patients. It is recommended that there be a ratio of one technician to two patients under most circumstances.
(4) It is recommended that the center have at least one registered polysomnographic technician on staff.
Intent
The center must have personnel trained in cardiopulmonary resuscitation available at all times during patient testing. The technicians responsible for patient care must have cardiopulmonary resuscitation training. The number and timing of patients must allow the technician sufficient time to begin and end recordings at times that approximate the patient’s bedtime and rising time. Under most conditions, a ratio of one technician to two patients is considered adequate to assure the safety of patients.

(ALL ITALICS MINE)
Once again, you are right there is only a recommendation for a 2:1 ratio patients to techs. There is also only a recommendation to have any registered techs on staff.

Since these are just "recommendations" one could then staff 4:1 with nurses aides running the studies? Are we supposed to pick and choose which one we will follow? It is more cost effective to have a higher patient to tech ratio, it is also more cost effective to pay the technologists less, making it more reasonable to use untrained or minimally trained people in the testing roles.
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Rick

Postby somnonaut » Wed Jun 15, 2005 9:03 pm

Easy now.
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Better now...

Postby Rick » Wed Jun 15, 2005 9:09 pm

Now that I have had my sushi lunch and am sipping on my RockStar I feel better. However, these "recommendations" are just too darn amorphous, we should have more rigid RULES. If "guidelines" are bendable there will always be those who bend them to the point of breakage and see nothing wrong with the way they are doing things.

I do see a light at the end of the tunnel. I hear references to the AASM "taking over" some of the functions of the APT. Let's put some teeth into our self-regulation.
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Maybe then...

Postby somnonaut » Thu Jun 16, 2005 3:04 am

the AASM will DEMAND a credentialed sleep tech for accreditation.

I knew I started to see your vein popping out there on your forehead.
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Postby SleepGod » Thu Jun 16, 2005 7:42 pm

As was stated, it is only a recommendation to have a 2:1 ratio but it is acceptable to run a 3:1 ratio if you so choose. As a freestanding center you have to be as cost effective as possible and this is a very reasonable way of doing just that. I agree that you would not want a rookie trying to run three sleep studies however for the more experienced techs this is not a problem. Also I would not recommend it for sleep centers that only have 2-3 beds with one tech working alone for obvious reasons, however I can find no reason not to do 3:1 when you have multiple techs on the same night as we do. Obviously if were an issue with patient care we wouldn't do it!

Considering you don't know anything about us, I don't think you should be questioning our standards.
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Postby Rick » Thu Jun 16, 2005 10:51 pm

" I agree that not everyone should do 3/1 and some are just too lazy to do 3 pts."
"you don't know anything about us, I don't think you should be questioning our standards"

These statements make me question things.
You generalize that every tech should do 3:1 ratio, if they don't they are lazy. Then you are above being questioned for that statement.

"As a freestanding center you have to be as cost effective as possible"Does anyone remember the heat a fellow got for saying he could not see paying anyone more than $10/hr to "babysit the wires"? That would be really cost effective. I always worry that cost-effectiveness when improperly applied results in lowered patient care. The patient to tech ratio should be a codified Standard.

SleepGod, you are right, I don't know anything about you, as far as I know, you hire people who can't handle a job at burgerking- When you espouse a higher patient to tech ratio than is recommended, I tend toward believing the worst case possible. What can I say, I am a pessimist, not only is the glass half empty, it will probasbly be knocked over soon.
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12$ AND HOUR?

Postby SLEEPYGIRL8784 » Fri Jun 17, 2005 10:49 am

I didn't realize that wages vary from state to state by that much, but when I started out, I made 15$ an hour and ran only 2 patients. We NEVER run more than 2 patients (we are only a 4 bed free standing facility) And I didn't work alone for two months. When you are working and if you have questions, you can always go to the chat room and people will be more than willing to help you out there.
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Postby SleepGod » Fri Jun 17, 2005 3:10 pm

SleepGod, you are right, I don't know anything about you, as far as I know, you hire people who can't handle a job at burgerking- When you espouse a higher patient to tech ratio than is recommended, I tend toward believing the worst case possible. What can I say, I am a pessimist, not only is the glass half empty, it will probasbly be knocked over soon.[/color][/quote]

Well, I think you being a pessimist only holds you back from understanding that there's more out there than what you know or think. And what works well for some does not always work for others. If the AASM made the change to ALL sleep centers must operate at a 2:1 ratio then we would make the change. For some or most sleep centers 3:1 ratio probably would not work for them due to different situations or a lack of experience. But there are many sleep labs around the country that operate very efficiently in this manner and many of them are AASM accredited. Yes, I agree there are probably many labs out there that do not operate in an ethical manner and until they shut down all the labs that are not at least working towards accreditation, there will always be those out there.

If you want to come and see our facilty so that you can "fill your glass back up", come on down! I would be more than happy to show you how well we do things. I'll be in Denver if you want to meet and discuss it further, just drop me an email and let me know. Otherwise you can stop attacking me now before I track you down and put you in a sleeper hold! :D
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