Nurse trouble

[smile24x7]

Hi everyone,

I am in a sticky situation.  About a month ago I had a bad dialysis run. I really crashed bad.  At the end when I weighed I was a pound below my dry weight and this was after the pull was turned off and fluid was given back to me half way through treatment.  So naturally I was thinking that the goal was set too high and the nurse was pulling me too dry.  I believed that she mistakenly set the goal too high.  I was noticing for a while that this particular nurse was off her game.  She had trouble multi-tasking and seemed to be making a lot a mistakes, and not just with me but with other patients too. In fact that morning I got no assessment and she did not take my blood pressure before she put me on. 

At the next treatment I saw my administrator, and I told her what happened and that I thought the nurse was making mistakes.  She told me she would have a talk with her and that the nurse was having some medical problems of her own that was weighing down on her mind and maybe thats why she seemed off.  The admin told that maybe she would lighten the nurse's work load.  So I thought fine, I never had anything against the nurse so it was not like I wanted her fired or something.  In fact, we were always friendly and would chit chat.

So some time went by and I did not see the nurse at all.  Then when I finally saw her again I tried to say hey and she did not speak to me.  Automatically, I knew what was up.  I knew that she knew I had reported her.  For the next couple sessions she did not speak to me, but she also wasn't my nurse so it did not matter much.  Today for the first time she was my nurse and strangely she acted as if everthing was fine.  She even chit chatted with me like we used too.  Strange.  But then close to the end of my treatment I started to feel my blood pressure drop.  She turned of the pull and gave me back some fluid.  At the end of the treatment I was at my dry weight.  So this time I am thinking she set the goal high on purpose just to spite me.

So now, what do I do?  I think this nurse has some animosity for me and I hate to think that she would be vengeful and malicious, but hey you never know about some people.  I am feeling kinda vulnerable and I don't know if I should report her again or leave it alone.  Anyone else been through something similar?

You want to trust the medical people around you and hope that they will always do their best, but sometimes...........

[Wallyz]

It's unprofessional of her, and so if you feel your care is in any way threatened, document and follow Up. That sucks. There are a couple techs that I would not let touch me, and I was clear and consistent, and didn't worry about whether they liked me or not.  Its your health, be responsible for it.

[BigSky]

Machines can take off too much or not enough fluid even if the nurse sets the correct goal.  The calibration could be off on the machine among other things.

You should be checking the machine each time to make sure you goal is set right.  Also note what number machine(if numbered) you are on and how it pulls compared to others.  Note which ones leave you light, heavy, or right on.

[monrein]

BigSky is right about this issue.  You should know how much the machine is set to take off and it is a very good idea to do some note-taking about the specific machine used and how accurate it is in removing the set goal.

Be ever vigilant.  It's your body, not theirs.

[Ang]

if  your  gut  instincts  are  correct,,just  advise  the  powers  that  run  the  place  "i  don't  want  her  to  touch  me  ever  again"  and  explain  why.

[Joe Paul]

I would do as the others said, and take notes. Also, as time goes by, it is possible you have gained actual body weight, could be time to adjust your dry weight. Another factor would be your BP meds, such as when you take them, or dosages. Like you said, it is a sticky situation as Nurses and Techs tend to stick together, you surely don't want to be known as a "problem patient", thats an uncomfortable position to be in. IMO, dialysis is NOT an exact science, different factors could be at play when crashing out.

[smile24x7]

I would do as the others said, and take notes. Also, as time goes by, it is possible you have gained actual body weight, could be time to adjust your dry weight. Another factor would be your BP meds, such as when you take them, or dosages. Like you said, it is a sticky situation as Nurses and Techs tend to stick together, you surely don't want to be known as a "problem patient", thats an uncomfortable position to be in. IMO, dialysis is NOT an exact science, different factors could be at play when crashing out.

I think is a good idea to start taking notes.  And you are right about the nurses and techs sticking together.  I also know how much these nurses are responsible for so I am always patient and understanding.  I thought it was only right to say something about that nurse because her mistakes could cause somebody thier life.   

I took into consideration the fact I have not been having any crashing problems with any other nurses.  I have been leaving at my dry weight for months and I have been feeling great.  I know my weight could change, but I kinda can tell by way I feel in between treatments if I left too dry.   

[flip]

In my opinion you have two options:

Like many of us do....specify how much fluid you want to remove and the UF profile on the machine.

If they won't do that, just sign yourself out when you feel ready to crash. Make sure you list the reason on the AMA form before you sign it. That becomes a permanent part of your record.