Dar's Guide To Dialysis Nurses

[LifeOnHold]

     After four years at my dialysis clinic, I discovered that there were eight different types of nurses. They are:


     #1 The Brute

     Puts his/her weight behind the needle. "Advances" the needle
directly into your spleen. Feels the need to teach your graft a
lesson, because he/she is always chooses the trouble spots. Ignores
patient discomfort that warns of infiltration, because "We HAVE to
get these needles in!" By the time you're hooked up, you want to go
home!

     Warning sign that your nurse may be a Brute: If he or she constantly
asks, "Are you STILL using lidocaine?"
 


     #2 The Finagler

     A timid nurse who fears causing the patient pain, which results in
him/her inserting the needles 1/300th of a millimeter at a time. He/she
wiggles, rolls and twists the needles sloooowly, thinking that this
is "less painful." Actually, what he/she REALLY fears is
infiltrating the patient, convinced that the "Bosses" will use it to
get them fired.



     #3 The Get-In-Get-Outer

     Confident, business-like, and far too rare! Knows which spots to
avoid, inserts the needles into your graft, gets the machine running
and gets out of your hair. Asks for assistance when necessary, but
can handle most emergencies alone.

CAUTION: If you get this nurse too often, it can aggravate the
effects of The Brute, Finagler, and Aztec Two-Stepper, Mangler, and
Rosie the Riveter.



     #4 The Aztec Two-stepper

     Hooks you up fine. The fun begins when the machine keeps alarming.
Then the Aztec Two-Stepper springs into action-- yanking, pushing
and pulling the needles in an ill-fated attempt at avoiding
repositioning them. To this nurse, re-doing needles is admitting
defeat, and he/she will wrap your arm in six pounds of paper tape
before pulling out an uncooperative needle. It's easy to spot the
victim of The Aztec Two-Stepper-- just look for the patient with the
contorted arm position and pained look as each time he/she relaxes
the tiniest bit, the machine starts alarming again.



     #5 The Oblivious

     This refers to attitude towards patients, not lack of experience.
This nurse can walk right past a patient who's passing out and
feebly calling for help. If The Oblivious would have been paying
attention to the appearance of the patient, he/she would have
noticed the signs of imminent fainting (restlessness, panting,
wiping face with hand) and the episode could have been avoided. The
Oblivious also has trouble deciding which side of the unit an alarm
is on, when to give antibiotics, and when to refill jugs. This is
the type of person who gets evicted from an apartment for
non-payment of rent.

CAUTION: May be passive-aggressive in disguise!



     #6 The Mangler

     Thinks every graft is like the perfect textbook model from nursing
school, and that every patient's graft is the same. This leads to
intense drilling as The Mangler tries to shove the needle into a
non-existant space. Wanders around in your arm like it's a National
Geographic special. Forgets to use clamps and stands there
bewildered as your blood flies all over the place. Curses equipment.
Unlike The Finagler, The Mangler gives not a damn about
infiltration. "Hey, we all do it sometime!" is The Mangler Motto.



     #7 The Wolf-Crier

     Cousin of The Finagler, The Wolf-Crier lacks confidence in an
emergency and jumps ship the minute anything happens. Is unaware of
basic dialysis facts that even the patients know.
Here are a few calls of The Wolf-Crier:

     "Miiiiiike!"
     "Maaaaaary!"
     "Lindaaaaa!"

     Good news: These nurses seldom stay employed for very long.



     #8 Rosie the Riveter

     A conglomeration of The Finagler, Aztec Two-Stepper, and Mangler.
Thinks it's important to know how many ways a needle WON'T go in,
too. And guess whose arm will be the guinea pig?

     Rosie has a production-line mentality, with a self-imposed deadline
of 6 p.m. Woe betide the tardy patient! Extra riveting is in your
immediate future!


                                                            ***
                     
I showed this article to the nurses at my dialysis unit, and they loved it. I'd been afraid that feelings would be hurt, but they considered my writing to be a wakeup call... we now have far fewer Brutes and Manglers! I'm sure I've benefitted all of my fellow patients by creating this article. Personally, I'm glad that suffering finally created some good!

[Epoman]

Very nice guide, thanks for sharing. What I wouldn't give to be able to stick some of the techs/nurses I've known.

[BlackJack]

You showed it the the nurses and they "loved it"?  I've worked dialysis for many years and I've never worked with a group who would have loved that.  If the nurses and techs made up a little story regarding the various shortcomings of the patients, I suppose the patients would "love it" too?  In any line of work, there are people who for various reasons, don't belong there.  Dialysis is no different.  Your little poem is outside the realm of "constructive criticism" and shows a bitterness and anger within you rather than exposing the legitimate shortcomings of the staff.  I continually strive to be better and I always ask the patients for their input on cannulation, fluid goals, and other treatment issues.  Only you know the spirit in which your story was created but........Count me as a nurse who doesn't "love it".

[LifeOnHold]

Sorry you didn't like it, but ALL of the problems I wrote about were things that I've experienced as a long-term dialysis patient.

I thank God that my nurses have a much better sense of humor than you seem to have.

[BlackJack]

I have a good sense of humor if something is funny.  I seriously doubt that this piece was written with humor in mind.  Only you know that.  You make a lot of assumptions about why these various types behave as you allege they do.  I too am thankful that not all patients are as bitter as yourself.   

[LifeOnHold]

Why do you feel the need to come to a site called 'I hate dialysis' and attack a patient?

That's not very nurse-like of you.

[Epoman]

You showed it the the nurses and they "loved it"?  I've worked dialysis for many years and I've never worked with a group who would have loved that.  If the nurses and techs made up a little story regarding the various shortcomings of the patients, I suppose the patients would "love it" too?  In any line of work, there are people who for various reasons, don't belong there.  Dialysis is no different.  Your little poem is outside the realm of "constructive criticism" and shows a bitterness and anger within you rather than exposing the legitimate shortcomings of the staff.  I continually strive to be better and I always ask the patients for their input on cannulation, fluid goals, and other treatment issues.  Only you know the spirit in which your story was created but........Count me as a nurse who doesn't "love it".

I don't think you understand the relationship some patients have with techs/nurses. I know if I had wrote a list like that the techs would find it amusing. You mention shortcomings of patients, well you know what we have a right to have shortcomings you and other techs/nurses are there to do a job and the persons doing that job should be well trained and have empathy for patients. I have seen MANY techs and nurses in my 12+ years and MANY fit those above descriptions to a tee. Just because you strive to be better (I commend you for doing so.) doesn't mean others do. I personally feel that all techs and nurses who go into the dialysis field should have 2 dialysis needles stuck in their arm to get an understanding of the pain dialysis patients go through. Many techs I have seen are so poorly trained it's appalling. I have also seen some nurses who should never be nurses in the first place. Is "Lifeonhold" bitter and angry? Maybe and she has earned that right with over a decade of putting up with poorly skilled techs who have no idea what it is like to be chronically sick.

Please not misconstrue my reply to this thread, I am in no way trying to flame you or trying to start an argument. I welcome you to the board and I hope you post more and continue to provide us with your perspective.

[BlackJack]

There is no argument intended.  If this is just all one-way though, forget it, I won't be back.  I think Life on Hold's perception that this has been an "attack" is a case of dishing but not taking.  Perhaps she has also forgotten that she posted it in the "workers" section of the board.  I don't even go into the "patients" section to "attack" anyone.  Anyway, I won't pursue it any further.  She has a right to post it and I have a right to not like it although I guess I don't have a right to express my dislike.   I think I already understand that any dissent will be taken as attack here.
 Sure, it's a job, but we're not paid enough to be punching bags.  Do all our dignity, feelings, and emotions get checked at the time clock?  I fully agree that many nurses and techs are below par.  However, have you noticed that not many people are battering down the doors to work in chronic dialysis facilities?  It's not high on the list of places to be employed in healthcare and this lack of supply means that the bad apples stay.  It's not right, but it is what it is.  Denigrating poems won't affect the supply and demand of the labor markets that exist.  Does anyone have a right to be angry and bitter?  I don't know.  What has happened over the past 10 years is water under the bridge and all that anger will shorten your life.  I don't know.
I've never bought into the theory that dialysis nurses and techs "take two in the arm" to learn empathy.  I don't think an ER nurse needs to take a bullet in the head and I've never understood why police officers need to be maced and tasered.  It's a silly infliction of pain and a method of forced empathy.  I've had a lot of painful dental work done and it would bring me no satisfaction to have my dentist feel the same things he is inflicting on me.  I simply don't get that mentality.  Also, I feel that cannulation is somewhat like hitting a fastball.  You can hone it, but the basic hand-eye skill is either there or it isn't and taking two needles in the arm, while it may teach you empathy, probably won't do much to improve cannulation skills.  And improvement is what you want, right?  Or do you simply want people to  feel what you feel?
 

[BlackJack]

My apologies.  I didn't read closely enough.  I thought that the "workers" section was for dialysis workers to come and discuss issues.  I closer look reveals that it is for patients to talk about the workers.  You all certainly have a right to do this, but it's certainly not the place for me to be.  I'm not a cheerleader with my eyes closed, but I am a proponent and I do stick up for dialysis workers.  Nearly every site I've been to (especially DEO) is simply a place to come and rip on the workers and the industry.  I don't need it.  If I feel like being a punching bag, I"ll just go to work.  Good luck to all.

[Epoman]

There is no argument intended.  If this is just all one-way though, forget it, I won't be back.  I think Life on Hold's perception that this has been an "attack" is a case of dishing but not taking.  Perhaps she has also forgotten that she posted it in the "workers" section of the board.  I don't even go into the "patients" section to "attack" anyone.  Anyway, I won't pursue it any further.  She has a right to post it and I have a right to not like it although I guess I don't have a right to express my dislike.   I think I already understand that any dissent will be taken as attack here.
 Sure, it's a job, but we're not paid enough to be punching bags.  Do all our dignity, feelings, and emotions get checked at the time clock?  I fully agree that many nurses and techs are below par.  However, have you noticed that not many people are battering down the doors to work in chronic dialysis facilities?  It's not high on the list of places to be employed in healthcare and this lack of supply means that the bad apples stay.  It's not right, but it is what it is.  Denigrating poems won't affect the supply and demand of the labor markets that exist.  Does anyone have a right to be angry and bitter?  I don't know.  What has happened over the past 10 years is water under the bridge and all that anger will shorten your life.  I don't know.
I've never bought into the theory that dialysis nurses and techs "take two in the arm" to learn empathy.  I don't think an ER nurse needs to take a bullet in the head and I've never understood why police officers need to be maced and tasered.  It's a silly infliction of pain and a method of forced empathy.  I've had a lot of painful dental work done and it would bring me no satisfaction to have my dentist feel the same things he is inflicting on me.  I simply don't get that mentality.  Also, I feel that cannulation is somewhat like hitting a fastball.  You can hone it, but the basic hand-eye skill is either there or it isn't and taking two needles in the arm, while it may teach you empathy, probably won't do much to improve cannulation skills.  And improvement is what you want, right?  Or do you simply want people to  feel what you feel?
 

I want improvement, I want techs and nurses who truly care and granted some do. But the dialysis field is a specialty and should not be entered just so you only have to work 3 days a week and get overtime. I think we both agree that there are techs who do not care and are only there for a paycheck. And please do not tell me the money is not there, I have seen some techs paychecks and with their level of education they do quite nicely. But anyway back on subject I too agree that the skill is either there or it isn't. But I still stand by my stance that techs should be stuck with needles, however you do make valid points about the ER nurse. And I will reevaluate my stance but for now maybe it's my bitterness that is making me have that stance. But again I welcome your view points and opinions to the board. It helps to get an employees perspective on a dialysis related situation.

You wrote "She has a right to post it and I have a right to not like it although I guess I don't have a right to express my dislike." of course you have a right to express your dislikes. That is why this board is here for people to express how they really feel. Yes this board was created for patients however anyone can come and post, family, friends, techs, nurses, other workers. But try to understand the "board" in general will be more on the side of the patient since the board was created by a patient.

[Epoman]

My apologies.  I didn't read closely enough.  I thought that the "workers" section was for dialysis workers to come and discuss issues.  I closer look reveals that it is for patients to talk about the workers.  You all certainly have a right to do this, but it's certainly not the place for me to be.  I'm not a cheerleader with my eyes closed, but I am a proponent and I do stick up for dialysis workers.  Nearly every site I've been to (especially DEO) is simply a place to come and rip on the workers and the industry.  I don't need it.  If I feel like being a punching bag, I"ll just go to work.  Good luck to all.

No apologies necessary. Please see my post above this one for a reply to this post. I am glad you stick up for the workers. And I welcome you back to express your feelings. Feel free to rant and rave too. But like I said in the above post This board will lean more to the side of the patient since we are the ones who live with "Dialysis" 24 hours a day 7 days a week, unlike techs or nurses who only "See" it 8-12 hours a day just 3 days a week.

I mean this in the most respectful way possible and in a joking manner to help lighten the situation. Since you are a defender of dialysis techs/nurses (as you stated "but I am a proponent and I do stick up for dialysis workers"  ) you should start a web site called "ihatedialysispatients.com"   

[BlackJack]

Fair enough Epoman.  You are very level-headed and it is appreciated.  Perhaps I need to try harder to see both sides of things.  Thanks and have a nice weekend. 

[Epoman]

Fair enough Epoman.  You are very level-headed and it is appreciated.  Perhaps I need to try harder to see both sides of things.  Thanks and have a nice weekend. 

Thank you and please come back and tell us some stories so we too can see the "other" side of dialysis. Enjoy your weekend too.

[LifeOnHold]

BlackJack, you're right about DEO (as much as I hate to admit it!    )

I used to be a frequent poster there, but I was always getting attacked for saying that I was in a good unit with a lot of good nurses and techs-- I was accused of being 'industry', a doctor getting kickbacks, and all other kinds of crap that showed me that nobody was really reading what I'd written... if they'd actually read my posts, they'd have known I was a patient.

The last straw was when someone posted a story about a New York patient who had been kicked out of a dialysis unit and then came back and shot a nurse-- they were trying to say that this guy became crazed because of 'Jiffy Lube dialysis!'  And then I got attacked for saying that if 'short dialysis' caused mental problems, we should all be shooting our nurses, how come that's not happening!  (Yes, it was a free-for-all over there... they really don't like any 'facts' that imply that anything is a patient's fault.)

So even though BlackJack might think I hate nurses, I do stand up for them, and I do understand that patients do rotten things, too.

[BlackJack]

I went over there and read your replies.  Very rational.  I felt bad about our sparring and perhaps I did not read your story with an open mind and a sense of humor.  If the nurses accepted it and it did cause them to improve their performance, then that is all that matters.  I think we all agree that the system is deficient and needs lots of improvements.  I too, have seen some hideous things in the chronic units.  Techs that literally cannot do basic subtraction and therefore remove too much fluid right up to unit administrators who won't leave the office.  Anyway, I'm glad your story helped.

On a side note: is that you in the picture?  If you don't mind, what caused your kidney failure?  You don't have to answer, but I am curious.  Thanks. 

[BlackJack]

Oops......I read your story in the introduction.  Still learning my way around the site.  Thank you.

[LifeOnHold]

BlackJack, that's Dido in the photo... I picked her as an avatar because I do one of her songs, "Thank You," at karaoke.

[Epoman]

BlackJack, that's Dido in the photo... I picked her as an avatar because I do one of her songs, "Thank You," at karaoke.

Well I'm glad you guys resolved your situation.

Yeah that's an avatar that you can choose in your profile settings. Or you can UPLOAD your own avatar. See mine for an example of one I chose. I may choose a different one but for now I wanted to show how you can have any avatar you want not just the choices on this board. Feel free to add your own avatar this goes out to all members.

[Rerun]

Avatar:  n.  1. Hinduism a god's coming down in bodily form to the earth; incarnation of a god  2. any incarnation or embodiment, as of a quality or concept in a person.   (Webster's New World Dictionary)

For those too stupid to know what that was.  Not that I had to look it up!  Just trying to help those weaker than I.......  

[Epoman]

Avatar:  n.  1. Hinduism a god's coming down in bodily form to the earth; incarnation of a god  2. any incarnation or embodiment, as of a quality or concept in a person.   (Webster's New World Dictionary)

For those too stupid to know what that was.  Not that I had to look it up!  Just trying to help those weaker than I.......  

Actually here's a link for a more cyber definition. http://www.urbandictionary.com/define.php?term=avatar 

[Jamie]

Lifeonhold,
  I must say I just read your list on different nurse's and personally I think it was one of the funnest things I had ever read.
  I guess when I read I'm saying at the same time (while laughing)this is so true if its O.K. with you I would like to print it my self and bring it to my unit too. I think they would get a kick out of it.....Jamie-G

www.jamiegmagic.com

[LifeOnHold]

Sure, go ahead... just write "Written by Dar from  Massachusetts" on it.         

[Epoman]

Sure, go ahead... just write "Written by Dar from  Massachusetts" on it.         

And be sure to add "Originally posted on Ihatedialysis.com" 

[LifeOnHold]

Jesus, Epoman, you'll have 'ihatedialysis.com' written on your friggin' tombstone! 

[goofynina]

This post is dedicated to a member of this website that i never had the pleasure of meeting.  I have heard alot about her through other posts and she seemed like an AWESOME lady, i wish i would've had the chance to meet her.   A member told me about something she wrote (thank you Bajanne) and i laughed so hard i cried because it is true.  With every # i read, i was thinking to myself the names of the techs that fit that description.  She hit the nail on the head.  I am definetly going to print this out and send 15 copies to the clinic, address one to each of the workers there,  whether they like it or not, i dont care.  Maybe this will open their eyes and ask themselves "Is that one me" and maybe, just MAYBE they will find ways to improve themselves and make life better not only for the patients but for themselves too.   Thank you LifeOnHold, you truly ARE an amazing woman... May you Rest In Peace....

Goofynina


.....and she wrote...


After four years at my dialysis clinic, I discovered that there were eight different types of nurses. They are:


     #1 The Brute

     Puts his/her weight behind the needle. "Advances" the needle
directly into your spleen. Feels the need to teach your graft a
lesson, because he/she is always chooses the trouble spots. Ignores
patient discomfort that warns of infiltration, because "We HAVE to
get these needles in!" By the time you're hooked up, you want to go
home!

     Warning sign that your nurse may be a Brute: If he or she constantly
asks, "Are you STILL using lidocaine?"



     #2 The Finagler

     A timid nurse who fears causing the patient pain, which results in
him/her inserting the needles 1/300th of a millimeter at a time. He/she
wiggles, rolls and twists the needles sloooowly, thinking that this
is "less painful." Actually, what he/she REALLY fears is
infiltrating the patient, convinced that the "Bosses" will use it to
get them fired.



     #3 The Get-In-Get-Outer

     Confident, business-like, and far too rare! Knows which spots to
avoid, inserts the needles into your graft, gets the machine running
and gets out of your hair. Asks for assistance when necessary, but
can handle most emergencies alone.

CAUTION: If you get this nurse too often, it can aggravate the
effects of The Brute, Finagler, and Aztec Two-Stepper, Mangler, and
Rosie the Riveter.



     #4 The Aztec Two-stepper

     Hooks you up fine. The fun begins when the machine keeps alarming.
Then the Aztec Two-Stepper springs into action-- yanking, pushing
and pulling the needles in an ill-fated attempt at avoiding
repositioning them. To this nurse, re-doing needles is admitting
defeat, and he/she will wrap your arm in six pounds of paper tape
before pulling out an uncooperative needle. It's easy to spot the
victim of The Aztec Two-Stepper-- just look for the patient with the
contorted arm position and pained look as each time he/she relaxes
the tiniest bit, the machine starts alarming again.



     #5 The Oblivious

     This refers to attitude towards patients, not lack of experience.
This nurse can walk right past a patient who's passing out and
feebly calling for help. If The Oblivious would have been paying
attention to the appearance of the patient, he/she would have
noticed the signs of imminent fainting (restlessness, panting,
wiping face with hand) and the episode could have been avoided. The
Oblivious also has trouble deciding which side of the unit an alarm
is on, when to give antibiotics, and when to refill jugs. This is
the type of person who gets evicted from an apartment for
non-payment of rent.

CAUTION: May be passive-aggressive in disguise!



     #6 The Mangler

     Thinks every graft is like the perfect textbook model from nursing
school, and that every patient's graft is the same. This leads to
intense drilling as The Mangler tries to shove the needle into a
non-existant space. Wanders around in your arm like it's a National
Geographic special. Forgets to use clamps and stands there
bewildered as your blood flies all over the place. Curses equipment.
Unlike The Finagler, The Mangler gives not a damn about
infiltration. "Hey, we all do it sometime!" is The Mangler Motto.



     #7 The Wolf-Crier

     Cousin of The Finagler, The Wolf-Crier lacks confidence in an
emergency and jumps ship the minute anything happens. Is unaware of
basic dialysis facts that even the patients know.
Here are a few calls of The Wolf-Crier:

     "Miiiiiike!"
     "Maaaaaary!"
     "Lindaaaaa!"

     Good news: These nurses seldom stay employed for very long.



     #8 Rosie the Riveter

     A conglomeration of The Finagler, Aztec Two-Stepper, and Mangler.
Thinks it's important to know how many ways a needle WON'T go in,
too. And guess whose arm will be the guinea pig?

     Rosie has a production-line mentality, with a self-imposed deadline
of 6 p.m. Woe betide the tardy patient! Extra riveting is in your
immediate future!


                                                            ***
                     
I showed this article to the nurses at my dialysis unit, and they loved it. I'd been afraid that feelings would be hurt, but they considered my writing to be a wakeup call... we now have far fewer Brutes and Manglers! I'm sure I've benefitted all of my fellow patients by creating this article. Personally, I'm glad that suffering finally created some good!