Question about training for at Home Dialysis

[Lindia]

Does the caregiver have to know how to stick her partner --- BEFORE --- going to training ?   My husband has started sticking himself this week --- he's having some problems --- but,  now the head nurse is saying that I have to know how to stick him before going to training ? ! ? !       WHAT  -   I've never heard that before.  He is in pretty good shape, and has the capability to do that himself, and wants to do it himself.  I will take off work to be there for training - but I'm so fed up with his center, I don't really want to try to learn it there.

I think they are trying to throw up roadblocks to him getting into training ---  has anyone ever heard of this ?  Does it say anywhere in DaVita's policies that the caregiver must stick before training ?

[del]

If your husband can stick himself I see no reason for you to have to know how to do it.

[Lindia]

I wouldn't mind knowing how to do it - in case of an emergency or something -- but as a REQUIREMENT before training ? ! ?     WHAT   !          (sigh)

[Desert Dancer]

Does the caregiver have to know how to stick her partner --- BEFORE --- going to training ?   My husband has started sticking himself this week --- he's having some problems --- but,  now the head nurse is saying that I have to know how to stick him before going to training ? ! ? !       WHAT  -   I've never heard that before.  He is in pretty good shape, and has the capability to do that himself, and wants to do it himself.  I will take off work to be there for training - but I'm so fed up with his center, I don't really want to try to learn it there.

I think they are trying to throw up roadblocks to him getting into training ---  has anyone ever heard of this ?  Does it say anywhere in DaVita's policies that the caregiver must stick before training ?

They're full of it. I go to a DaVita clinic and - aside from the nurse who created my first set of buttonholes - NO ONE has ever stuck me except myself. As a matter of fact, Andy only ever had to come to TWO training sessions total; he had to know how to get me ON the machine, OFF the machine, and how to deal with emergencies. That's it. There was absolutely no requirement he know how to cannulate. It never even came up.

Why are you getting so much resistance from these people?

[Lindia]

Desert Dancer -  I WISH I knew ? ?     We do have private insurance, but would they really do all this just to keep us there longer, for more money ?      I'm thinking they are just covering their butts - as it was our stated goal to get to home --   and they didn't know there was a waiting list -- could they be that confused ? ?   No one in our clinic is sticking themselves, and they brought in a new girl  (who we really like)  to start his buttonholes -   this is the same clinic that infiltrated my hubby 4 times, and I told them - ONE MORE and we are out of here --- he hasn't been infiltrated since .

[boswife]

They 'let' us come in to the clinic for a week and a half (ahead of our scheduled time to train for nxStage) while they trained me. It was great as i am the one that had to learn...(hubby cant see good enough and other issues) I thought only one of you had to be able to do it. 

[Lindia]

Boswife,  was there a waiting list when you were training ?    If so -  how long was it, and how did you get on it ? ?

[MooseMom]

I haven't started D yet, so I haven't started any training, but both my husband and I have on different occasions talked to the social worker about training, and no one has said anything about my husband having to learn how to cannulate.  There is no way I want him to cannulate me!  Someone at your clinic is confused.

[Lindia]

Thanks MooseMom -  I think they are just full of BS.      I wish I could find something official on a DaVita website, so I could print it out and throw it in her face,  why do they make this SO HARD  !!

[kporter85db]

why do they make this SO HARD  !!

Not every clinic does. Sorry yours is.


I think I'd find a new clinic.

[Desert Dancer]

Desert Dancer -  I WISH I knew ? ?     We do have private insurance, but would they really do all this just to keep us there longer, for more money ?

Um, not to be too cynical but... it's certainly within the realm of possibility.

I'm thinking they are just covering their butts - as it was our stated goal to get to home --   and they didn't know there was a waiting list -- could they be that confused ? ?

If they ARE that confused, do you really want to work with them? I agree with kporter85db - I'd find a new clinic.

[paul.karen]

It would be good for all partners to Know how to stick the sick person in the house.

But being told tyou have to KNOW how to do it before training goes against the whole TRAINING aspect.  Of course you dont know how to stick a person until you are taught.  Thus you go to training.

I quess Davita nurses dont get trained on how to stick they just know how to do it?

Im so glad i go to a non profit outfit for dialysis.

[boswife]

It's kind of funny but the day we decided to go ahead and be trained for NS there didnt seem to be a 'list' at all. Then, when we went in for our pre training, we were told that someone was 'in' training, nearly done, and then one other infront of us.  I was so bummed... didn't like waiting for something i wanted very badly but was scarred about all the same.  I called a lot to remind them that we wanted that spot and sure enough, the couple ahead of us backed out due to it being during Christmas season and  having so much else to do.  So, yes, we still had to wait as the people in front of us had some issues that kept them longer, but we did get  going fairly soon after applied.  Then, during the 'issue' time for the other couple, they had us transfer to their center (we were in RAI closer to home at the time) and had us do his treatments their and trained ME to do the cannulation.  It was fun actually, quite exelerating actually, (and i was {still am for anything but canulating} a true needle phobic)  but then i freeked out and stressed over the treatment faze..  Dang!  lol

[lmunchkin]

Linda, when we trained for NxStage, I knew that I would have to "stick" my husband due to alot of health issues!   But I am not needlephobic, so I was more than willing to learn!  I dont understand the reason for sticking him before you train.  I learned while training.  But I did practice on strawberries and tomatoes so that I would be more prepared!  Crazy huh?

lmunchkin     

P.S.  I do think that in case of an emergency it would be nice to have that back up!

[Adam_W]

Sticking me was the only thing my dad didn't learn how to do in NxStage training. My current graft has only been stuck by someone other than me one time, and that was when I was in the ICU having violent coughing fits. Even the two other dialysis treatments I had in ICU, I still stuck myself. It shouldn't be a requirement for the partner to learn to cannulate if the patient can do it.

[monrein]

No one ever stuck me, except me, at home either.  I figured that if I did myself it all the time but then on some odd occasion couldn't do it, then my partner would be a very inexperienced sticker and would not be coming anywhere near my fistula.   At a clinic there hopefully isn't a nurse who cannulates someone just once in a blue moon.

Also if buttonholes are in play, consistency is key and you don't want an occasional sticker messing about with those.

One more thing...the pressure and stress on a partner would be huge if the time ever came that that had to happen...er, ahmm, darling, I know you haven't done this in several months but I think I can't get this needle in here today could you give it a shot?  I personally don't think that's fair.  A partner is under enough stress already.

My husband tried sticking me ONCE, at the hospital and it was not good...we decided then and there that if ever I was comatose or broke my needling hand or whatever we'd go in-center till I was "myself" again. 

[Lindia]

It's kind of funny but the day we decided to go ahead and be trained for NS there didnt seem to be a 'list' at all. Then, when we went in for our pre training, we were told that someone was 'in' training, nearly done, and then one other infront of us.  I was so bummed... didn't like waiting for something i wanted very badly but was scarred about all the same.  I called a lot to remind them that we wanted that spot and sure enough, the couple ahead of us backed out due to it being during Christmas season and  having so much else to do.  So, yes, we still had to wait as the people in front of us had some issues that kept them longer, but we did get  going fairly soon after applied.  Then, during the 'issue' time for the other couple, they had us transfer to their center (we were in RAI closer to home at the time) and had us do his treatments their and trained ME to do the cannulation.  It was fun actually, quite exelerating actually, (and i was {still am for anything but canulating} a true needle phobic)  but then i freeked out and stressed over the treatment faze..  Dang!  lol

Boswife -   thanks --  I think you ran into what we are --  only now -  there are more people in line, and no one seems to "get it" at my center.   We would still not know we weren't on the "magic list" if the social worker hadn't told us.   I so wish we had started calling the training place from day one ourselves. 

[Lindia]

No one ever stuck me, except me, at home either.  I figured that if I did myself it all the time but then on some odd occasion couldn't do it, then my partner would be a very inexperienced sticker and would not be coming anywhere near my fistula.   At a clinic there hopefully isn't a nurse who cannulates someone just once in a blue moon.

Also if buttonholes are in play, consistency is key and you don't want an occasional sticker messing about with those.

One more thing...the pressure and stress on a partner would be huge if the time ever came that that had to happen...er, ahmm, darling, I know you haven't done this in several months but I think I can't get this needle in here today could you give it a shot?  I personally don't think that's fair.  A partner is under enough stress already.

My husband tried sticking me ONCE, at the hospital and it was not good...we decided then and there that if ever I was comatose or broke my needling hand or whatever we'd go in-center till I was "myself" again.

Thanks Monrein -  thats exactly what I would be-  a  VERY inexperienced sticker  --  He's having problems getting the technique down himself ---  but he will.   Talking to all of you has certainly helped my stress level...  I will try to remain calm, and tell them to back off on me sticking -  especially his new buttonholes.

[boswife]

oh and YES!!!  do not have them have you both "establish" his buttonholes!!!!!!!!!!!!!!!!!!!  That is a one person job.  To learn afterwords would probably be a good thing, but NOT while establishing!!!!!!!!!  Very important that one person does this until it's done.  (about 8 or 9 times??  geesh, i forget) Anyone remember how many sticks before considered established???  ANyway, i'd give it a good few months before messing with it. 

[Lindia]

oh and YES!!!  do not have them have you both "establish" his buttonholes!!!!!!!!!!!!!!!!!!!  That is a one person job.  To learn afterwords would probably be a good thing, but NOT while establishing!!!!!!!!!  Very important that one person does this until it's done.  (about 8 or 9 times??  geesh, i forget) Anyone remember how many sticks before considered established???  ANyway, i'd give it a good few months before messing with it. 

One of his buttonholes did great on Sat --  they were short handed and stuck him themselves, which we were OK with, we've just been so stressed, by all the runaround on home training -  but his bottom buttonhole - the tech had problems with it, had to try several times.  The tech establishing his buttonholes is great - but one time she was gone- another tech messed with them - and the bottom one has been a hard stick ever since.  Its all so TIRING !!    watching constantly -  having to know more than they do -- I SO wish I was a nurse...

[mcclane]

oh and YES!!!  do not have them have you both "establish" his buttonholes!!!!!!!!!!!!!!!!!!!  That is a one person job.  To learn afterwords would probably be a good thing, but NOT while establishing!!!!!!!!!  Very important that one person does this until it's done.  (about 8 or 9 times??  geesh, i forget) Anyone remember how many sticks before considered established???  ANyway, i'd give it a good few months before messing with it. 

One of his buttonholes did great on Sat --  they were short handed and stuck him themselves, which we were OK with, we've just been so stressed, by all the runaround on home training -  but his bottom buttonhole - the tech had problems with it, had to try several times.  The tech establishing his buttonholes is great - but one time she was gone- another tech messed with them - and the bottom one has been a hard stick ever since.  Its all so TIRING !!    watching constantly -  having to know more than they do -- I SO wish I was a nurse...

Lindia :

I'm going thru the exact same thing your husband is going thru right now with the button holes.  Sounds like the track is there, but finding the hole in the vein is another issue.  This morning I spent close to an hour with the bottom buttonhole trying to find the hole in the vein.  I was literally digging for gold with the blunt needle.  I was sooo frustrated, i felt like grabbing an xacto knife and cutting something open to see where the hole was. 

The top buttonhole took me mere seconds to get the flash, but the bottom one was a PITA.  I got so fed up that once i got the flash in the bottom one, i used a pen to mark my arm, so i have an idea where the hole is.  It helped with the top one (using a pen on the arm as a marker).

oh, one thing i do find helpful, don't drain yourself dry !!!  I have a bad habit of cranking up the uf on my machine, so what winds up happening is that I'm so dry that the veins collapse, making it impossible to puncture the vein.  For the last 3 days, i've been drinking more fluid but taking less off, just to keep the veins plump.

[lmunchkin]

Oh Lindia, I agree with Boswife, if you are establishing buttonholes, do not attempt to stick him!  That should be done by him and him alone!  My husband does not have buttonholes, I do the "ladder" method on him! That way, if he needs to be stuck by anyone else, he can. If he is going with buttonholes, than absolutely do not stick him especially during the establishing phase.

lmunchkin