Its not the Hemo

[KICKSTART]

thats getting me down , its the bitchin nurses ! Im sick of going in as a person , being treated like a number and coming out totally depressed . Im coping with hemo , im turning up, but im sick of all the crap im getting while there. They are only small things but because im so helpless while im there , its mounting up and up till i know one day im going to explode. In a normal situation none of this would bother me , because i could fix it , but stuck in that chair you cant do anything. I told you i had neck probs , well yesterday they stuck me in a chair by the window (you might think how nice a view , but the blinds are closed and my back was towards the window) and it was blowing a gale through it. I asked the nurse to check it was shut and it was , she just said, oh yeah they are draughty and went. Yeah 4 f***in hours of draught all down my back and what could i do ? nothing. So today as you would expect my backs got cold in it. They are also sticking me back in the main room every shift and i am having to fight to get the light off , its broad daylight so not like they need them on and i never ask till everyone is on the machines . Someone (staff) also commented on my eyes and told me to eat a phosphate free diet .. is there such a thing ? She doesnt know anything about me , my diet , my battle with binders. I said would bread and water be ok , because i cant think of anything that doesnt have phosphate. I want to put each and everyone of those dam nurses in a chair and ignore their basic needs for nearly 5 hours , in fact i think it should be part of their training. Before some of you start on about taking control ..I cant , i have a line in , i've been told home hemo isnt an option because i live alone , so im stuck , stuck with the same unit , the same staff , we cant pick and choose.
Also could i ask ..do you get a choice of where you sit? or are you allocated a chair/bed?
How long from walking through the doors to your chair do you have to wait to be put on ?  Same again, how long till you get taken off ?

Ps forgot to add , i also got a lecture because it was Aranesp day and my bp was too high for me to have it, so then the nurse started to tell me how much it cost and now it was going to have to be thrown away etc etc , like it was my fault !

[RichardMEL]

To try and answer your questions from my experience in my unit over the past 3 and a quarter years:

1. I'm on an afternoon shift, and thus we're affected by what goes on in the morning - so if ambulence transport is late, or inpatients are late, or whatever then that will affect when we get on. Things are usually pretty good though. We were originally supposed to show up from 1pm, but a few of us started coming in a bit earlier - I arrive around 1230 and it's a 50% chance the machine will be ready for me, but if it isn't I'm usually on by one.

2. We don't get a choice where we sit. The machines are allocated during the morning shift and the nurses set up the folders and the bicarbinate solutions and all that before we arrive. In certain situations we can change - but it's more about what works better for them than us (though i think if *I* asked they might try and help - because they seem to like me). I'm happy wherever I can get a power point for my laptop so I'm not usually fussed. We have one patient(a bigger man) who demands the bigger chair - fair enough - but then he complains when he has to wait a bit longer for that chair to become available - well you can't win can you??? He was given a talking to recently and he's promised to not complain again (we'll see! LOL). Another reason we can't pick and choose is that only some positions in our unit can take a bed, and that affects how they allocate the spots depending on what patients they may have coming in from a ward or something.

3. We usually get taken off when the clock gets to zero. On rare occasions our allocated nurse may have another patient to do and either I tell them it's fine I can wait 5 minutes, or one of the others will be free and do it. Because I do longer hours than most other patients there sometimes I'm the last left anyway so I get 3 or 4 to boot me out in quick time!!! 

I'm sorry you seem to have such a difficult bunch at your unit running things. I know the staff in my unit wouldn't behave the way you describe - even to the more "problem" patients we sometimes have.

re drafts... yes, sometimes the air conditioning is too much at our unit. I have my trusty blankie to keep me toasty.. or if I'm REALLY cold I turn up the temp on the machine to 36, but that's in an extreme case!!

[KICKSTART]

Thanks RM , it seems pretty much like everyone is allocated a place  , doh ! i forgot about setting up machines before hand ! You are quicker at getting on and off than me ! Because ive got a tunnel in i seem to get left till last (because it straight forward i guess ? ) So even if i turn up at 1 , it can be half past or later before i get on, the most stupid thing is ,that is the staffs dinnertime !
The draught wasnt from any air con , it was from crappy windows and we do have blankets but i could hardly wrap it round my neck for my lines !

[billybags]

kickstart, I agree with you about having lines in. Alan's unit allocates the chairs and he could be any where. He complains he is last to get on and it takes ages to get off because you need two nurses to take the  lines off. He gets very frustrated because the same people seem to turn up very early "mornings" and get  straight on. Whether they have been going for a long time I don't know. His unit is always very cold and the lines are open to fresh air because you can not have a jumper on with them, unlike arm fistulars, so he has to have a couple of blankets. The pick up service is utterly rediculas, he gets up at 5-30 in a morning, gets picked up at any where between 6-10 and 7-45 to be on the machine at 7-45. He gets home at about 1-00 its like doing an 8 hour shift. What can you do about it. Apparently the ambulance pickup service was fine when the NHS was running it but it went out to private tender and what a balls up.

[KICKSTART]

Yeah i agree about what clothes you can wear , no thick jumpers etc ..and dont forget guys its bloody cold over here !
One thing i dont understand is ..why does it take 2 nurses to take him off ? I only ever have one put me on and one take me off , but like Alan , i wait and wait !

[RichardMEL]

We usually have one nurse to put someone on (needle, set lines, set machine settings like UF target, time, pump speed), then a second nurse will double check everything(usually a bit later like 20-30 mins) to make sure the right sort of bicarb is being used, that the settings make sense and all that.

Getting off it's usually two nurses - one to do the washback and pull the needles, do the gause and tape and a second to pull the lines from the machine, set it to rinse, remove the unused bicarb & saline and all that kins of thing, and throw the bloody lines in the biowaste. I suppose one nurse could do it all, but it would take a lot longer that way, and usually when I finish it's the end of the shift so there's usually a few around to help out. Like my last session today I had 4 of them "helping" - of course two were discussing all the food they wanted to eat and my tummy started rumbling!! 

Luckily one of the nurses sometimes cooks me her best dish - chicken biryani! YUM!!!!!!

Yes, I understand not being able to wear much warm stuff(and trust me, we've just been in winter and it's still cold here, and as we all know all dialysis patients feel the cold more than most!).. I wear a short sleeve polo top which is warmish, but leaves the fistula free for access, plus I have a fleece blanket that I use.. It usually keeps me warm enough - usually.

[KICKSTART]

1 nurse =4 patients , all the time regardless of fistula/lines , no wonder it takes ages for us to get put on and off ! No second nurse checks , nothing !

[pdpatty]

I am in the first shift. Supposed to be in waiting room by 5:30. Depending on who is in that bay ,I can be hooked up by 5:35 - 5:50. I always have the same chair. There are 4 of us in that area and we all sleep. We have our individual tvs that pick up 70+ cable channels but mostly I sleep. Sometimes I am awake enough to see them put the zemplar and epo in the lines.

When the machine starts buzzing,the tech is right there to wash me back,put a glove on my hand and let me hold for about 10 mins ,bandage my arm and if the tech is Kenny,he will even fold my cover and put it in the bag.

Compared to the treatment you are getting,I think we are a bit spoiled.

Perhaps some of the grumpy ones should read how you are being treated and they would appreciate our center more.

[RichardMEL]

I *wish* I could sleep in the chair! I am envious of all those that can!

We only get about 10 channels on the TV's and they are mounted on the ceiling, so I give up and take my laptop to watch. No ads too!!!  70 would be pretty sweet it would probably keep me occupied.

About the ratio of nurses to patients - we have 12 spots in our unit and between 4 and 5 nurses on (not all 12 spots are used sometimes - it depends on inpatient loads) so I guess it's like 1:3 or sometimes 1:2 which is pretty good.

[cloud393]

Sorry to hear you are having such a bad time.  I usually to PD but am currently doing hemo (again) temporarily.  I always seem to get colder as the treatment goes on so we tried putting a blanket on the chair before I sit down.  It really does help.  You can even pull some of it down over your shoulders to help keep you warm.  I also cover with a blanket.  Maybe you could try it.  Good luck.

[Poppylicious]

Ah, now I understand the private message!  I get so annoyed on Blokey's behalf when he comes home with these sort of horror stories.  I write a pretty nifty letter of complaint sometimes and am desperate to write one for him, but I know it probably wouldn't do any good (although it would make me feel better!). 

[Lillupie]

Kickstart have you ever thought about PD?? It is sooo much more freedom and different. i love it and you dont need a partner!
Try wearing a sweater. I am not sure where your fistula is at on your arm though. Well I have had a little experience on hemo. I will tell you my chair time started at 4pm. I got there at 3, an hour early, I didnt get called to go back until 4:30pm, an half and hour late! and it wasnt even my fault. I was pissed! Come 7pm, i of course had time left on the machine, and i said i was leaving I was not going to stay later because of them. NO! I mean not my fault that they called me back their late when i came early(This was the only time this happened). They seem to have assigned seats. I guess it helps them to be organized. I suspose you can ask for a different time or days. THe social workers are there for you. You can and should be able to file a complaint to them, talk to the medical director or see about going to a different center. I am sure they will work with you. They dont want to lose your insurance money. I dont understand the whole anarsp problem you have. Cant your nurse wait until the next day or take a little more fluid off that day to give it to you. I just dont belive that they have to throw it away.
 I hate hemo, and it is every other day, by the next time you go in, i would expect your blood pressure to be high as the sky. On PD for me, my blood pressure is much more acceptable.
Good luck and keep us posted.

Lisa

thats getting me down , its the bitchin nurses ! Im sick of going in as a person , being treated like a number and coming out totally depressed . Im coping with hemo , im turning up, but im sick of all the crap im getting while there. They are only small things but because im so helpless while im there , its mounting up and up till i know one day im going to explode. In a normal situation none of this would bother me , because i could fix it , but stuck in that chair you cant do anything. I told you i had neck probs , well yesterday they stuck me in a chair by the window (you might think how nice a view , but the blinds are closed and my back was towards the window) and it was blowing a gale through it. I asked the nurse to check it was shut and it was , she just said, oh yeah they are draughty and went. Yeah 4 f***in hours of draught all down my back and what could i do ? nothing. So today as you would expect my backs got cold in it. They are also sticking me back in the main room every shift and i am having to fight to get the light off , its broad daylight so not like they need them on and i never ask till everyone is on the machines . Someone (staff) also commented on my eyes and told me to eat a phosphate free diet .. is there such a thing ? She doesnt know anything about me , my diet , my battle with binders. I said would bread and water be ok , because i cant think of anything that doesnt have phosphate. I want to put each and everyone of those dam nurses in a chair and ignore their basic needs for nearly 5 hours , in fact i think it should be part of their training. Before some of you start on about taking control ..I cant , i have a line in , i've been told home hemo isnt an option because i live alone , so im stuck , stuck with the same unit , the same staff , we cant pick and choose.
Also could i ask ..do you get a choice of where you sit? or are you allocated a chair/bed?
How long from walking through the doors to your chair do you have to wait to be put on ?  Same again, how long till you get taken off ?

Ps forgot to add , i also got a lecture because it was Aranesp day and my bp was too high for me to have it, so then the nurse started to tell me how much it cost and now it was going to have to be thrown away etc etc , like it was my fault !