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angieskidney
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« on: February 14, 2007, 12:47:37 PM »

I wanted to talk about this hear as I am curious ... am I a bad person or is the nurse too senstive .. was there a better way to handle this? I am not the most socially-adept person so I thought the best thing to do is learn from this experience and either get reassurance that it wasn't anything I did wrong or a kick in the ass and an explaination of why I was in the wrong.

Here it goes:

I went to dialysis on Monday and set up my machine (tubing & saline, numbers, heparin, and got tape and gauzes and flushing shringe with more saline ready)and grabbed 2 blunt needles for cannulating my fistula. I then asked who my nurse will be that will cannulate me. I wanted the same nurse I was lucky enough to have the last 2 times. She has done a great job the last 2 times before this so I thought that as long as I get her I would have them established in no time.

When I found out I would have a different nurse I was upset since this would be the first time after a weekend that we would try blunts. The 2 other times after a weekend it never worked. The nurses told me I had no choice that all nurses have been doing this for years. This confused me as I was told only some know buttonhole and I have had some nurses look at buttonhole as if it is just the ladder technique in the same hole and no real skill is required. I was almost to tears because of my frustration with feeling like I have no say, no rights, nothing even though it is MY arm! Then after the nurse cannulates me with little trouble and I am releaved, the other nurse comes up and tells me that the nurse was hurt because it seems like I don't trust anyone and that I don't think they know what they are doing or have any job skill.

Now have your say. Thanks. My cab is here so sorry if there are spelling mistakes!  :thx;


EDITED: Thread moved to proper section: "Dialysis:Workere" - Bajanne / Moderator
« Last Edit: February 15, 2007, 01:45:37 AM by bajanne2000 » Logged

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shay_pcb
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« Reply #1 on: February 14, 2007, 01:22:58 PM »

I have no idea what most of those terms you used means, bc I have never been on hemo! lol (ex: buttonholes, cannulate, & blunts) Could you give a link so that I, and others, will know what you are talking about?

As for the nurse, I think she took it too personally. If she were the one getting stuck more than once a week every week, then she would think differently.
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glitter
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« Reply #2 on: February 14, 2007, 02:02:56 PM »

I have no idea what most of those terms you used means, bc I have never been on hemo! lol (ex: buttonholes, cannulate, & blunts) Could you give a link so that I, and others, will know what you are talking about?

As for the nurse, I think she took it too personally. If she were the one getting stuck more than once a week every week, then she would think differently.


http://ihatedialysis.com/forum/index.php?topic=965.0
http://ihatedialysis.com/forum/index.php?topic=2499.0
http://ihatedialysis.com/forum/index.php?topic=2628.0
http://ihatedialysis.com/forum/index.php?topic=964.0

Shay
just do a search on those terms in IHD ,

Angie,my husband has been told the same thing,that by asking too many questions,he is demonstrating that he has no confidence,hurts their feelings,etc.....but I tell him(,after learning here-)it is too bad if you hurt their feelings,you MUST look out for yourself first and foremost,and it has nothing to do with anything other then taking as good care of yourself as only you can,and you are SO RIGHT wanting your care to be consistent.I have really followed your ordeal because where he has dialysis,they know very little about buttonhole,and he wants to do it...right now we are waiting for the surgeon who built the fistula to sign-off on it before they will even consider him sticking himself OR buttonhole.

I mean-it isn't personal,its business.(and you are your business)
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jbeany
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« Reply #3 on: February 14, 2007, 02:44:08 PM »

Her feelings are hurt.  Tough.  It's your arm and your long term health that you are trying to prevent from being hurt.  You have every right to be upset, to demand the proper care, to insist on getting a nurse who knows how to buttonhole properly.

I had a nurse tell me "You don't sound like you trust the doctors and nurses very much."  My reply - "Of course I don't!"  She looked pretty shocked when I said that.  She will have to get over it.  I trust my own judgment.  This is my body and my health. 

You do what you have to do, angie.  Borrow kitkat's big stick, or get a temporary membership card in the IHD bitch club if you need to, but do not let their hurt feelings stand in the way of getting the care you need to be as healthy as possible.
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« Reply #4 on: February 14, 2007, 02:50:00 PM »

As a patient you have the right to know if the person treating you is experienced.
The nurse should have reassured you that she knew what she was doing.

As for all the nurses doing that for years, I doubt it. At my husband's center only a few even knew what buttonholes were when he asked about it.

Good for you for speaking up, the nurse was way to sensitive, better her feelings hurt than you paying the consequences.

Question everything, everyone.
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Sluff
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« Reply #5 on: February 14, 2007, 02:58:32 PM »

Part of being in the medical profession is to help patients. If she took it personal thats her problem. Part of their job is also to realize when a patient is nervous or upset and should do their best to comfort the patient.

All I would do is say to her next time that you have had problems in the past and you were nervous about  cannulation and that she should not have taken it personal.

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Joe Paul
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« Reply #6 on: February 14, 2007, 03:02:46 PM »

A fistula is personal. If she took things out of context, not your problem  :twocents;
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« Reply #7 on: February 14, 2007, 03:10:00 PM »

Angie, first off congratulations on a smooth canualtion with a buttonhole!   :clap;


Next, trust is earned.  You are the customer.  If she would have screwed up.......would she feel bad?  Probably Not. 

I'm sorry, but you should have a choice on who sticks you.  Go to the director or your doctor if you have to.
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jbeany
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« Reply #8 on: February 14, 2007, 03:47:57 PM »

Try this. . .I bet kitkat will sign off on it for you. . .    ;D
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angieskidney
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« Reply #9 on: February 14, 2007, 07:11:25 PM »

Try this. . .I bet kitkat will sign off on it for you. . . ;D
OOOh now I want that on a shirt to wear to dialysis!!! lol of course they would probably not take it right .. but I know some patients would be like "right on girl!!" lol

Thanks for all your advice! It means a lot and I feel better! I just got home from dialysis and I really needed that! :)  :grouphug; :thx;
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Jill D.
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« Reply #10 on: February 14, 2007, 07:29:48 PM »

I agree with what everyone else has said in this thread...you have every right to question the techs and nurses when it comes to your health. I always say "who cares more about my health than me?" I had some techs at my center that were not comfortable with my fistula. I would say, "Nothing personal, but if you are not comfortable sticking my needles, I would rather have someone else do it." They were usually relieved instead of offended, and I would usually end up with the "best" person for the job!
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« Reply #11 on: February 14, 2007, 09:08:20 PM »

Angie, you have every right to request what you felt was the best person for the job.  Just as anyone else here would say, you are entrusting these nurses with your life line and that kind of trust has to be earned, not given.  Any damage you may have done to that nurses feelings will heal over time but you may experiance some sarcasum for a while.

Bottom line is this.  If you hurt your nurses feelings, their feelings will heal in time.  If your nurses hurt your fistula, you may not be so lucky.  Stick to your guns girl.
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angieskidney
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« Reply #12 on: February 15, 2007, 08:43:06 AM »

I agree with what everyone else has said in this thread...you have every right to question the techs and nurses when it comes to your health. I always say "who cares more about my health than me?" I had some techs at my center that were not comfortable with my fistula. I would say, "Nothing personal, but if you are not comfortable sticking my needles, I would rather have someone else do it." They were usually relieved instead of offended, and I would usually end up with the "best" person for the job!
Ya what I worry about is that I always have a different nurse and if it is supposed to be the same nurse all the time cannulating me until my buttonholes are easy to cannulate by any nurse, then how can they be hurt about me wanting it done right? I don't get that!
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« Reply #13 on: February 15, 2007, 10:02:07 PM »

Having been on the other end of this situation - the one whom patients did not want to stick their access - I nevertheless have to agree with you, Angie. You were right - it's your access, your lifeline, and you should feel comfortable with the person who has the potential of messing it up! Any stick can go bad, after all.

Yes, my feelings have been hurt before, but I never would have asked a coworker to tell the patient so. Some patients even apologized to me, but I didn't think this was necessary, because whenever I sensed that they didn't feel comfortable with me (as was often the case when I was new), I would have been so nervous that I probably would have screwed it up!  The only drawback for patients was that they had to wait for a colleague to be available since I didn't make the assignments; I would just ask them to cannulate the patient and then take it from there, so it wasn't too long a wait.

DeLana
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renal30yrs
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« Reply #14 on: February 16, 2007, 04:11:33 AM »

There feelings may or may not hurt and they can live with it.  Your fistula is hurt and can set you back in real misery for yours.  When I started dialiazing I made it very clear that I will compromise on any other issues and won't mind or complain on any other issues except sacred fistula.
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Ken Shelmerdine
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« Reply #15 on: February 16, 2007, 04:53:40 AM »

Angie,
Don't know much about the haemo side of it, but I think you are absolutely right to question hospital staff. If the nurse concerned is so sensetive to her own feelings that she can't make allowances for all the shit her dialysis patients have to go through, then she shouldn't be in the job. It's about us not them.
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Ken
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« Reply #16 on: May 27, 2007, 03:39:10 PM »

I've been confronted with similar situations many times in several different hospitals and clinics. We have every right to
ask questions, complain if things aren't up to standards, and respectfully as possible voice our concerns.

In all lines of work there are dedicated people excellent at their jobs, people who have good days and bad days,
inconsistent people, burnt out people, people who just want to do the minimum amount they have to for the pay check. Doctors and Nurses are no different. The good, the bad and the in between.

Of course nurses have feelings but I can't see where you did anything wrong.

When you wrote that "...the other nurse comes up and tells me that the nurse was hurt because it seems like I don't trust anyone and that I don't think they know what they are doing or have any job skill...." this shows how petty some can be and was totally out of order for that nurse, How quickly they forget what they were taught in nursing school!

So here you are trying to get through treatment and it's aftermath, deal with all the associated problems that come with
ESRD, and another nurse comes to you informing you/complaining that you hurt the other nurse's feelings? That's not patient oriented care.

Unfortunately, some nurses and health care practitioners take it way to personally if you question a procedure,
ask for a second opinion, or a different nurse. It's called EGO.

A doctor once told me " you have to be in charge of your own health care"  and " if you aren't confident with whose
sticking you, ask for someone else."

Good Luck.
...bdpoe
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thegrammalady
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« Reply #17 on: May 28, 2007, 10:20:37 AM »

if someone asking questions or appearing not to have confidence in a tech or nurse hurts their feelings, they are too sensitive and possibly in the wrong profession. letting someone keep you from asking questions because you might hurt their feelings makes you just plain stupid.  this is your life we're talking about here. THEY DO IT MY WAY OR THEY DON'T DO IT AT ALL!!!!!!!!!!!!!!! plain and simple cross me and i promise you'll find a raging bitch with a very big stick with all the power of Americans with disabilities act behind her. you have every right to ask for and expect the very best treatment. do your job correctly and i'm a pussy cat, but remember cats have claws.
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« Reply #18 on: July 20, 2007, 06:33:51 AM »

In my many, many years of being a quiet, compliant patient I have only now started to speak up for myself.  I am not on hemo, but I have researched it and due to my irrational fear of needles (I can get my blood drawn and certain shots, but much more than that leaves me in a puddle of hysterics) I can certainly understand why you would want the same nurse. 

Similarly, I hate, hate, HATE my Aranesp shots and have found that some people can do them and some people just can't.  I've had two *good* nurses and many more *bad* nurses in this situation.  I've asked a lot of questions and finally know how to tell a nurse how to do it *right* if one of the others isn't available.  I am sure that that sounds control freakish, but it's my body and I know how to make it hurt as little as possible.  If they want to feel hurt that a little ole' patient is telling them what to do than so be it.   

It is not your responsibility to babysit their feelings.  It is your responsibility to always do what is right for you.
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« Reply #19 on: November 26, 2007, 11:28:58 PM »

Well, I'm chiming in kinda late on this but here's my  :twocents; anyway.

I have been a kidney patient for many years.  My mom was always the kind of person to just say, oh okay and let people tell her what to do and how to do it!  I was that way as a kid but as an adult I have learned that there are times when you have to speak up and stand up for your rights!  You do have the right to refuse to let someone put your needles in, although that may result in delaying or having to rescheduling your treatment.  I have refused care from some people before but now I direct them where to put my needles and also how my xylocaine I need to be numb!  I think the best way to handle these situations is to talk to the charge nurse and also your social worker and voice your concerns!  At the hospital there is one dialysis nurse I don't allow to treat me anymore because she always treats me like I'm 5.  There have been abt 4 lab techs that I got fed up with and asked them to go get my nurse for me even though I had my call button right there.  That got them out of my room so I could talk to my nurse in private!

The staff at my center are pretty good abt calling someone else to help them if they are in over their head.  Especially with buttonhole!  I have never had a problem with any of them.  They always listen to me!

And finally, your fistula is your lifeline, if someone who doesn't know what they're doing or doesn't have enough experience screws it up, then you are the only one who will be hurt! 

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Nov. 1979 - Diagnosed with glomerulonephritis of unknown origin by Dr. Robert
                  Hickman
Dec. 1979 - Diagnosed with Viral Pneumonia
Late Dec. 1979 - Emergency surgery to place a Scribner Shunt in left arm for dialysis
Jan. 1980 - Start hemodialysis until recovered from viral pneumonia
Feb. 27, 1980 - Receive 5 antigen living related transplant from father
Mar. 3, 1987 - PTH removed and part of one placed in left arm.  Fistula also placed in right arm.
Sept. 1988 - Start hemodialysis
Feb. 4, 1989 - Receive 6 antigen perfect match cadaveric transplant
Jan. 1994 - Return to hemodialysis
Oct. 18, 1996 - Receive 6 antigen perfect match cadaveric transplant
Nov. 22, 1996 - Emergency surgery to repair aneurysm to artery in kidney
Dec. 20, 1996 - Emergency surgery to repair aneurysm.  Kidney removed due to infection which has spread down right leg to abt mid thigh.
Apr. 1997 - Arterial bypass surgery to restore arterial blood flow to right leg
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Dec. 7, 2002 Sm. intestine ruptures while home alone. Still conscious upon arrival at hospital.
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« Reply #20 on: December 09, 2007, 10:41:53 AM »

i yelled at one of the nurses one time, i called her a stupid sob.  she infiltrated me three times and stilll kept trying until i said stop you stupid sob.  she got upset but i didn't care.  she apparently didn't care about the pain she was putting me through.  i got written up as non compliant.  not long after they said i was depressed and medicated me for it.  im not depressed, im mad that they hire idiots who treat you as a pin cushion.  i yelled at another nurse once when she said "you dont know what its like to work here with all these sick people" needless to say i almost had to be restrained.  i seem to be the only one who stood up for myself and other people.  each time i had a 'moment' it gave other people the balls to stand up on their own. 
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dialysisguy
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« Reply #21 on: December 22, 2007, 12:44:27 PM »

Your first time with blunts should have been the same nurse that created the buttonhole. You were not wrong and should have insisted that the same nurse canulate you that time. If not a sharp could be used by a different nurse in a location other than the buttonhole site.
  Sorry, there should be standards for this procedure.
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Black
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« Reply #22 on: December 22, 2007, 03:10:33 PM »

Your first time with blunts should have been the same nurse that created the buttonhole. You were not wrong and should have insisted that the same nurse canulate you that time. If not a sharp could be used by a different nurse in a location other than the buttonhole site.
Sorry, there should be standards for this procedure.

There are procedures which are supposed to be followed, such as the same person doing the cannulating until the BH is well formed, but apparently many of the nurses and technicians disregard them. If I were in the chair getting BHs established, I'd have a copy of the guidelines handy to give to anyone that even thought about deviating from them. I would probably be the most feared and/or hated but most respected patient in the center.

The last time I saw my previous doctor he was so mad his jaw muscles were twitching from him gritting his teeth. I knew I was right and that he was wrong, and he knew that I knew it! Hurt his feelings and made him mad - TUFF! He almost let me die and I let him know that I would not settle for his lackadaisical care any longer and demanded changes. I was polite and softspoken, but unwavering. He refused to change, so I never went back. When I get my labs back next month I'm going to send him a copy with a nice note about how well I feel with the medications from my new doc, which he refused to prescribe, and how the new tests he was reluctant to order show I am doing much better than when I left his practice. Ah, not quite revenge but sweet just the same. Besides, if he pays attention and does a little research, it may save the life of another of his patients.  Just as speaking up to an incompetent tech or nurse may not save just you but others as well.
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Lorelle

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« Reply #23 on: March 26, 2008, 06:10:42 PM »

you set up your own machine?
It is your arm and you pick the stabber.
makes me too nervous to try someone new to me, I do not care how long they've done it
you are brave
I have never seen the needles
too afraid
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« Reply #24 on: March 26, 2008, 11:26:44 PM »

Mariannis: you may want to give yourself your Aranesp shots. After my cancer, I needed them for anemia and had the same experience you did. I asked my Dr and got permission to inject myself. I found that this was better for me.

Hope that helps.  :grouphug; Mike
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07/09 AV Fistula and Permacath added, PD catheter removed. PD discontinued and Hemodialysis resumed
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