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Author Topic: Positioning of the machine  (Read 10444 times)
nkviking75
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« on: August 22, 2006, 05:31:19 PM »

I gather many of you can see the screen on your machine and can shut off alarms.  In my unit I can't do either, although once in awhile someone swivels the screen just enough for me to get a glance.  How do you feel about that?  Do you want to see the screen and deal with the alarms?
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susie q
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« Reply #1 on: August 22, 2006, 05:43:18 PM »

The nurses here are generally good at turning the machine so I can see.. I like to double check the numbers and keep an eye on that clock.. Lol.. I don't deal with the alarms but have very few anyway.  8)
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John S.
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« Reply #2 on: August 23, 2006, 01:48:23 AM »

In my clinic most of the people are elderly and wouldn't understand what the screen was about if it was staring them in the face. I always have the screen pointed at me so i can take my own pressure, ( which means i don't live with a BP cuff on) turn off alarms that are not important, check my litres of blood processed and keep a constant eye on the venous and arterial pressurews so i can make a needle adustment myself.

DO NOT DARE TAKE THE SCREEN AWAY!! I WANT TO KNOW EVERY SINGLE THING GOING ON!!!

john
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BigSky
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« Reply #3 on: August 23, 2006, 07:32:19 AM »

It is nice to see the screen.  However it should be postioned to what is convenient to the nurses or techs, not the patient.   It is for them to have quick easy access to the equipment to do their job.




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Black
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« Reply #4 on: August 23, 2006, 08:42:50 AM »

It is nice to see the screen.  However it should be positioned to what is convenient to the nurses or techs, not the patient.   It is for them to have quick easy access to the equipment to do their job.

IMO, the position of the machine ought to be determined by the patient based on their assessment of the situation.

If the nurses and techs are efficient, conscientious and frequently monitor the patients and the screen, it may be OK to face it for their convenience away from the patient, IF the patient agrees.

If the patient is interested, concerned, willing to learn, or already knowledgeable, and the employees are not attentive and conscientious, and do not frequently monitor the patient and the screen, then it should always face the patient.

Every patient has the responsibility, whenever possible, to be as proactive in their own care as John S, and the staff should encourage such behavior.  JMO
« Last Edit: August 23, 2006, 11:41:59 AM by Black » Logged

Lorelle

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« Reply #5 on: August 23, 2006, 11:14:23 AM »

IMO, the position of the machine ought to be determined by the patient based on their assessment of the situation.

If the nurses and techs are efficient, conscientious and frequently monitor the patients and the screen, it may be OK to face it for their convenience away from the patient, IF the patient agrees.

If the patient is intrested, concerned, willing to learn, or already knowledgeable, and the employees are not attentive and conscientious, and do not frequently monitor the patient and the screen, then it should always face the patient.

Every patient has the responsibility, whenever possible, to be as proactive in their own care as John S, and the staff should encourage such behavior.  JMO

I mostly agree with what you have said.  Not to offend anyone, but most patients don't have clue one about what their machine says.  For those that do and are in a regular unit or those that are in a self-care unit I think it is great that you can play a stronger role in the quality of your treatment.  The problem lies with those patients that don't know and only want the machine turned so they can hit the reset or mute button.  That can cause serious problems for the patient if they are continually correcting a problem by pressing a button before the tech can have an opportunity to figure out that problem.  The other aspect of this is that unless you are in a self-care unit, there is someone who is supposed to be responding to those alarms when they happen.  If you reset those alarms regardless of if you know what they are or not you are giving the staff the message that they don't have to respond to the alarms because you will just take care of it.  The PCT's tend to be lazy enough as it is, you don't want to give them the message that it is ok to ignore your treatment because they will.  If you are one of those people that know whats going on or not, in my opinion you will get better quality of care is you call the PCT's to do their job when the machine alarms.
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« Reply #6 on: August 23, 2006, 05:30:43 PM »

... The problem lies with those patients that don't know and only want the machine turned so they can hit the reset or mute button.   That can cause serious problems for the patient if they are continually correcting a problem by pressing a button before the tech can have an opportunity to figure out that problem.  The other aspect of this is that unless you are in a self-care unit, there is someone who is supposed to be responding to those alarms when they happen.  If you reset those alarms regardless of if you know what they are or not you are giving the staff the message that they don't have to respond to the alarms because you will just take care of it.  The PCT's tend to be lazy enough as it is, you don't want to give them the message that it is OK to ignore your treatment because they will.  If you are one of those people that know whats going on or not, in my opinion you will get better quality of care is you call the PCT's to do their job when the machine alarms.

I totally agree with you about the alarms.  If more patients who are capable were taught about the machines, I believe fewer would be as irresponsible as you indicate some currently are.
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Lorelle

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John S.
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« Reply #7 on: August 23, 2006, 09:53:27 PM »

Well here is the problem i have sometime. At my clinic from about 7:30pm until 9 or so, ther is very little for the techs and nurses to do as we are down to very few patients left. In that time period, there is a nice meeting table up front and techs are very rarely seen.

I  guess I am one of the people who have an extensice knowledge of the machine and it's screen. I can competently do anything on the machine except string it, and I'm quite sure I could learn that in about 20 minutes.

john
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angieskidney
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« Reply #8 on: August 24, 2006, 05:28:16 AM »

I want my screen facing me and within reach because I am in a Self Care unit where I deal with my own alarms. There are some patients that don't like one diabetic who can't see the screen. The nurses do tend to make everything convenient for them and not the patient but then the nurses are usually to busy to answer every need and alarm so I want to be able to reach the screen.
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« Reply #9 on: August 24, 2006, 11:03:21 PM »

If you are the type of patient that likes to monitor your situation, simply ask thr nurse or tech to move you screen so you are able to view it. Whats the big deal, They can move it back when they did to view it. I have NEVER had a problem with a tech moving my machine so I can monitor myself. If they don't move it ask to speak to the charge nurse and demand it. Bottomline.
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angieskidney
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« Reply #10 on: August 25, 2006, 08:13:05 PM »

Every time I tell the nurses to turn it toward me, move the garbage within arms reach, readjust my BP cuff, give me my blanket they moved away from me, etc, they reassure me that they will, then put my needles in, turn off the light so there is no reflection on the TV screen and walk away without doing the rest  :-[
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« Reply #11 on: August 26, 2006, 10:58:56 PM »

Every time I tell the nurses to turn it toward me, move the garbage within arms reach, readjust my BP cuff, give me my blanket they moved away from me, etc, they reassure me that they will, then put my needles in, turn off the light so there is no reflection on the TV screen and walk away without doing the rest  :-[

What would they do if you refused to allow the needles in until AFTER everything else was done?
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Lorelle

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« Reply #12 on: August 27, 2006, 01:23:46 AM »

Every time I tell the nurses to turn it toward me, move the garbage within arms reach, readjust my BP cuff, give me my blanket they moved away from me, etc, they reassure me that they will, then put my needles in, turn off the light so there is no reflection on the TV screen and walk away without doing the rest  :-[

What would they do if you refused to allow the needles in until AFTER everything else was done?

I like you style "Black"  ;) Seriously Angie, damn stand up for yourself a little more. Don't make ME go down there.  ;)
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Joe Paul
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« Reply #13 on: August 27, 2006, 03:43:25 AM »

Every time I tell the nurses to turn it toward me, move the garbage within arms reach, readjust my BP cuff, give me my blanket they moved away from me, etc, they reassure me that they will, then put my needles in, turn off the light so there is no reflection on the TV screen and walk away without doing the rest  :-[

What would they do if you refused to allow the needles in until AFTER everything else was done?
Thats easy, they would no doubt call your Neph, and say you are being non compliant  ::)
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angieskidney
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« Reply #14 on: August 27, 2006, 07:07:04 PM »

Every time I tell the nurses to turn it toward me, move the garbage within arms reach, readjust my BP cuff, give me my blanket they moved away from me, etc, they reassure me that they will, then put my needles in, turn off the light so there is no reflection on the TV screen and walk away without doing the rest  :-[

What would they do if you refused to allow the needles in until AFTER everything else was done?

I like you style "Black"  ;) Seriously Angie, damn stand up for yourself a little more. Don't make ME go down there.  ;)
:D lol If you came down there (or UP there considering I live North of you .. uh .. and east of you) I am sure they would never mess with me again :P

Every time I tell the nurses to turn it toward me, move the garbage within arms reach, readjust my BP cuff, give me my blanket they moved away from me, etc, they reassure me that they will, then put my needles in, turn off the light so there is no reflection on the TV screen and walk away without doing the rest  :-[

What would they do if you refused to allow the needles in until AFTER everything else was done?
Thats easy, they would no doubt call your Neph, and say you are being non compliant ::)
Ya isn't it something? They love to slap that lable on anything we do ;)
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« Reply #15 on: August 28, 2006, 12:08:52 AM »

I don't know how this missed me, since this is my greatest complaint.  I want to see the machine, but in my unit, they are not in a position that you can see them. I like to see my BP, know how much time I have left and know my pump speed.   I often used to ask to have them turned a bit, but they never seem to like to do that.  Well, I saw another patient do something nifty.  She had a little hand mirror that she would use.  I brought one and now I don't have to ask.  We have two types of machine though - the LED is harder to read, and the LCD does well if the machine is at the correct angle.
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« Reply #16 on: August 29, 2006, 06:30:48 AM »

I move the machine to where ever I want it.
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MattyBoy100
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« Reply #17 on: August 31, 2006, 03:49:14 AM »

We can see the machines in my unit and the nurses said they would teach me how to operate them.  There seems to be varying standards in the U.S. or the level care at my hospital is very good, I don`t know which it is?
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« Reply #18 on: March 17, 2007, 07:33:28 PM »

I always prefer to have the machine turned toward me, but the staff at my centre had never really encountered a patient who was interested in their own treatment until I came along. Therefore, when I would ask for the machine to be turned, I would get weird looks and comments (not rude, just weird). Well, I finally talked to my social worker about the issue, and she talked to the unit manager. The UM sent an email out to all the staff asking them to turn my machine toward my chair when I got there, and to let me help with my treatment. Now they seem to be discovering how much that makes their jobs easier. They no longer have to come running to reset my alarm or make a minor adjustment to the machine, because I am finally allowed to do it myself. Without having to worry about me so much, they can spend more time with the patients who can't or don't want to help themselves. I no longer feel completely helpless when I'm at my centre, and I can now deal with the four to six month waiting period for my NxStage training a little easier now. Take care.

Adam
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« Reply #19 on: March 17, 2007, 07:38:49 PM »

Most centers dont like patients doing anything or helping with their treatment.. its against their policys... which I think sucks. Patients should know as much as possible.
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« Reply #20 on: March 18, 2007, 10:11:36 AM »

after everything is set up, my machine is turned so i can read it. i always ask. alarms, are the techs domain. there is no way i'm going to reset one. they need to know why it has alarmed. i want to see what my blood pressure is and make sure they set up the machine correctly. they actually have a choice, turn the machine or move my chair! this is my life here, you do it my way or you don't do it at all. of course it goes without saying, if you can give me a detailed and logical reason as to why you think we should do it differently, i'm more than willing to listen. but you had better really know what you're talking about, because chances are i've done more research on it than you.
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« Reply #21 on: March 18, 2007, 05:34:16 PM »

Aren't informed, educated dialysis patients a royal pain in the butt? >:D
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« Reply #22 on: March 18, 2007, 06:11:55 PM »

Aren't informed, educated dialysis patients a royal pain in the butt? >:D

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« Reply #23 on: March 18, 2007, 07:40:21 PM »

I almost always have the machine turned towards me so i can check the numbers specially when starting. In fact a few of the nurses double check with me their calculations to make sure we all agree - which I think is a vote of conidence that I have some idea about what is going on. I also double check stuff like pump speed, and the UF rate and so on. Every so often they might leave the pump at 300 and I ask for it to be up to 350 (I understand I am one of only 2 in our unit who are at 350) - note for US folks, down here they prefer to run the pumps slower for less pressure on the body and thus we do usually 4-5 hours (which sucks!) so the usual speed they run pumps at is 300 or 325. I aparently have a good size fistula so they have run me at 350 pretty much all the time - but that is the max they will go to.

I don't touch my alarms, but mostly they are stuff I can't do much about, like the saline is low or something, so the nurses come and deal with it anyway.
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« Reply #24 on: March 18, 2007, 07:42:25 PM »

It's great to hear you all taking actions into the care of yourselves! :thumbup;
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