There are many things that fall under the role of a Dialysis Technologist. How your unit or the physicians there define your role is what dictates the responsibility you have. There are still many techs out there (hopefully they will add some comments to this) that play an active role in patient care. Dialyzer specifications and which ones are better for particular patients, which types of treatments might work better then others,etc. are all things that the Dialysis Tech can and should be able to ADVISE on. The ultimate responsibility falls on the Nephrologist, but with input from all disciplines (you are part of the Health Care Team). You have to follow the philosophy of the Unit you work for, if it includes technical input great, if it doesn't you repair machines. Here in Sudbury, we do interoperative dialysis during cardiac bypass surgery. There is no Nurse present, and we follow Doctors orders regarding the treatment. At one time we were responsible for harvesting kidneys, eyes,spleen etc for transplantation. The scope of things have changed due in part to direction from our Nephrologists. If they still wanted us to be a part of it, I'm sure we would.
I hope this answers some of your question.