10/29/2026

Nephrology News & Issues: Combat ‘rustout’ among dialysis technicians with new challenges

The inclusion of nonlicensed individuals as dialysis technicians into the renal community dates back to the early 1970s.

The Medicare End-Stage Renal Disease (ESRD) Program, passed by Congress in October 1972, resulted in an influx of patients that came with treatment demands that overwhelmed the existing available pool of registered nurses. To meet the demands and avoid treatment rationing, dialysis clinics turned to hiring nonlicensed workers who were provided on-the-job training in cannulation, setting up the machines, treatment monitoring and performing vital signs.

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‘Rustout’ as important as burnout.

The impact of COVID highlighted the issues with burnout. Severe emotional, physical and mental exhaustion were some of the effects of the excessive demands, lack of control, high pressure, changing and ambiguous expectations, fear and mistrust of that period. Dialysis technicians were not immune. Their well-being and ability to maintain attendance was a critical concern.

Read the full article here.