The charge nurse is irking my noodle

[jbeany]

So, Raina, have you had anymore run-ins with her?  How's the Southern Belle advice working?

I do the "bless her heart" thing all the time, and I'm not even southern.

[Sluff]

So, Raina, have you had anymore run-ins with her?  How's the Southern Belle advice working?

I do the "bless her heart" thing all the time, and I'm not even southern.

Thats because you are so eloquent in your interaction with others.

[DeLana]

Hi, Raina,

sorry to hear about this! The nurse is definitely way out of line to be asking you personal questions that are clearly not welcome (if she can't perceive that... well, then talk to the center director and/or social worker and ask them to enlighten her).

You are also correct about your patients' rights, which include taking you off the machine when you ask for it.  The nurse can, and probably will, present you with an AMA form; you don't have to sign it, but she will then chart that you refused to sign the form and that she explained the risks of stopping treatment early (it's just a formality anyway and done for liability reasons).  Be aware, however, that too many AMA forms - signed or unsigned (with the note: "refused to sign") - can be held against you if you want to get a transplant; it is considered noncompliance. 

As for giving you saline, in some states techs are not allowed to do so; however, they should certainly be able to put our feet up, reduce UF to minimum or stop UF altogether while they get a nurse to assess you - and give the saline!  However, don't expect them to allow you to touch the machine yourself; this is usally prohibited for safety reasons (an exception may be a center that teaches home dialysis, or PD patients using the cycler).  The machine alarms are intended to get the staff's attention (so don't mute them!).  Giving yourself saline is a definite no-no (probably couldn't even be done) as it is very dangerous and can lead, among other things, to an air embolism.

Sorry you're having such trouble, I hope it will get better soon.

Best wishes,

DeLana

[angela515]

Wow, your nurse would not like me... I would definately give her my  .. heh.

To comment on the AMA papers, your only supposed to have to sign those if your getting off the machine more than 15 mins early. They shouldn't need a reason, all you need to say is I want off now, thank you.  HOWEVER, like mentioned earlier... don't do it too often if your wanting a transplant.... they will take it as not complying.

Let us know how the nurse thing is going!

[DeLana]

Wow, your nurse would not like me... I would definately give her my  .. heh.

To comment on the AMA papers, your only supposed to have to sign those if your getting off the machine more than 15 mins early. They shouldn't need a reason, all you need to say is I want off now, thank you.  HOWEVER, like mentioned earlier... don't do it too often if your wanting a transplant.... they will take it as not complying.

Let us know how the nurse thing is going!

That depends.  In my clinic an AMA form had to be signed if the patient wanted to get off early, even a minute early.  If, however, it was at the nurse's discretion (for medical reasons, such as low blood pressure) then this would of course not be necessary.  If at all possible, however, we were not allowed to take a pt off early (some sorry colleagues would have abused that for their convenience - so they could go home early!  )

DeLana

[thegrammalady]

I have the same argument everytime I show up I try to tell them my dry weight should be changed because I gained some weight from quitting smoking but they wont change it so I wind up getting serious cramps I am ready to kill someone if they won't listen to me. SHIT WHAT DO YOU HAVE TO DO TO GET THESE NURSES TO PAY ATTENTION

I'm beginning to sound like a broken record, but, the dialysis nurses don't set dry weight, nor make any decisions about your treatment. The especially don't get to decide how much fluid to take off. Everything is up to you and your doctor. If your dry weight needs to be changed your doc has to do it.  Have a detailed discussion with your doc.

My policy is this is my life you're messing with and when it comes to that WE DO IT MY WAY, OR YOU DON'T DO IT AT ALL.

yes, i am a bitch. live with it

[angela515]

Well said gramms! At my unit, they never decided what my dry weight was, nor did they decide how much fluid they took off. I would walk in, weigh myself, write it down, and then hand it to the tech. She wrote it on my chart, I then told her how much fluid I wanted off, she put it in the machine, and were on our way.

[kitkatz]

Welcome to the bitch group on IHD.com. Here I saved you a chair right up front with me and my big stick!

[goofynina]

Welcome to the bitch group on IHD.com. Here I saved you a chair right up front with me and my big stick!

Skooch over ladies,  another bitch is in the hizzouse   (said with pride mind you)

[thegrammalady]

i never, never, never told anyone i was a nice lady. it's all a figment of your imagination.

[Triker]

This sounds like my home clinic. I've had a few exchanges with the techs, nurses, and even the director. When they step on your feet, step up and let them know, in no uncertain terms. I've found that we get along much better afterward. The charge nurse was the worst one. I've even gotten to tolerate her and she seems to tolerate me. LOL! It doesn't have to be that way. I frequently go to another clinic for extra treatments, and I've never had a problem. I'm like you, I don't need a mother. I'll be 55 years old next month, and they try to make me feel that way at times. I have fluid problems, and often need extra treatments. Everytime we get a new tech, I wind up having an exchange with them. They start with a sarcastic "you know what causes this don't you" or a "I told you so".  I tell them that "Of course, I know what causes my fluid overload, I've be doing this much longer than you've been a dialysis tech." They are obligated to inform, but not to chastise. If they can tell me something to try, that I haven't tried, I would appreciate the input. My first exchange was with the clinic director. She directs two clinics, and was at my home clinic on this day. I don't even remember what it was about, but I remember getting her attention. I was beginning to hate going, due to all the smart aleck crap. It is an open area, as I assume most are, and she was across the room. I fairly loudly told her "You know, I HAVE to do dialysis, but I don't have to put up with a lot of smartass crap" The room fell silent for a little while. Later, she apologized. We've been friends since. We laugh, kid, and cut up, and the atmosphere is much better. My advice is to be assertive, and if that doesn't work, you may have to be a little aggressive. 

[SierraJim]

Aye Raina.  Hang in there.  This nurse has a lousy attitude and ought to have her plug pulled.  Although she may be well intentioned, she isn't doing you any favors by being overly motherly.  You don't need a mother there, you need a competent and knowledgeable nurse!  I've had to cut my dialysis treatments short for another reason.  I suffer from extremely severe intractable pain that is mediated by narcotics.  Sometimes the narcotics work better than others, and when they don't work well, I can't sit.  So, I have to cut the session short.

At first everybody was aghast, but gradually they understood that I can't sit there in severe pain.  I am firm and assertive, but always maintain a gentlemanly attitude.  I don't argue - I assert!  I encourage you to do the same.  Regarding stopping treatment early, you have every right to do this.  Nobody can tell you that you can't stop early.  I encourage you to stand by your guns and demand satisfaction.  At the end of the day, it is you who are paying their salary -- not the other way around. 

Thank you again for your post, good luck, and best regards.

Jim

[SierraJim]

i never, never, never told anyone i was a nice lady. it's all a figment of your imagination.

Just a note of correction.  If you "never never" told anyone, then you must be telling everyone constantly.  This is because of the intractable rule that two negatives make a positive.  Thus, never never = always.  (Gads I must be toxic!!!)

SierraJim

[kitkatz]

Yep, two negatives make a positive in a sentence.  However never, never is not how a double negative works.  Oh forget the grammar lesson!