How to handle suspicions of subtle, passive-aggressive staff behavior

[rfranzi]

Hello. I just had a fistula gram a week ago. I infiltrated today. I am going to make a long story short here because I am sick of just dealing with this kind of crap and not living my life. I am from the NE, so I am a bit outspoken. I moved to Seattle about 10 years ago. I noticed around here, if I say the "f" word, people get offended. I thought swearing was one of the priviledges of being a grown up, at least thats what my parents told me growing up. Anyways, I think fistulagram is just a fancy term for fixing a f*cked up fistula anyways. So, after weeks of clots and infiltrations, it was finally fixed. Two smooth sessions, well kind of. I did mention to the tech the last couple of times that it shouldn't hurt more coming out than going in. What is the proper way for them to hold the needle when it is being removed? Near the needle part? In the middle? Away from the needle? I hate to accuse people of things wrongly, but frankly, in four months of dialysis, so far I have been hurt more than helped, and a good portion of that is technician technique (another fancy word for saying they can either do the job or they suck at it.) When she stuck me, it felt like it was right on the edge, as if I moved the tiniest bit it would sting and poke. I made it three hours. I moved (not much) and it infiltrated. It had started to earlier in the beginning, but I managed to situate myself so that the machine said it was ok.  I did the best I could to just get through a treatment (after having missed too many and having gotten stuck too many times in the process)....As I was leaving, my nurse and the lady who stuck me were there. I told them I want the same person to stick me while I am getting settled and that this was wrong today. I was told it wasn't always possible to schedule the same person. I hate pat answers. I said, I know that, but it is possible to do sometimes and obviously I am asking within the realm of what is possible. I told them I was tired of being hurt. The girl who did it told me she was the best there. I stopped arguing there, because it was idiotic. Obviously, if she were the best, I wouldn't have ice on my arm right now and have lost an hour of treatment. She may have seniority, but she is burnt out, rushed and sloppy. She will not stick me again. Any advice? I don't want them to completely ruin my fistula before I actually have a chance to use it. Thank you. Hope your day is going better than mine.

[jbeany]

You have the right to refuse to let that particular tech stick you.  Don't let them argue with that.  And it's not like she is the only one on a shift.

Have you considered buttonholes or self-cannulation?  Then you never have to worry about some newbie making hash of your access.  It's much better for the life span of it, and obviously, you can feel exactly where you are placing the needles from both inside and out.

[rfranzi]

You have the right to refuse to let that particular tech stick you.  Don't let them argue with that.  And it's not like she is the only one on a shift.

Have you considered buttonholes or self-cannulation?  Then you never have to worry about some newbie making hash of your access.  It's much better for the life span of it, and obviously, you can feel exactly where you are placing the needles from both inside and out.

Thanks, I appreciate the support. Yes, 4 mos. into dialysis, supposed to be on the schedule to be trained for both buttonholes and in home, by my freakin self, hemo. That's the only thing keeping me sane.

[rfranzi]

You have the right to refuse to let that particular tech stick you.  Don't let them argue with that.  And it's not like she is the only one on a shift.

Have you considered buttonholes or self-cannulation?  Then you never have to worry about some newbie making hash of your access.  It's much better for the life span of it, and obviously, you can feel exactly where you are placing the needles from both inside and out.

P.S. Love the reference to Homer.

[jbeany]

LOL!  I'm from a family of professional chefs, so it's a cooking metaphor where I come from, not a pop culture reference.   

Although, I've sometimes wondered what my hospital staff was munching on lunch breaks, now that smoking is forbidden on the hospital campus....

[rfranzi]

I forgot to mention how the session STARTED....I was led to believe this girl, Shannon, who had gotten it before, would do it. When I realized she wasn't, I told the tech who was there (a new face since I recently switched to days in hopes of getting better care) - that I didn't appreciate surprises and in the future I would like to know and participate in decisions about who is working on me. As they continued, I was reminded of a recent experience when the night mgr/nurse increased the amount of fluid to take off from .6 to 1 and I threw up in the chair. Today, I was having a lot of cramping, more than I've ever had, and they started mucking with the settings. I also called them over at one point for sharp chest pains, another one I've never had. One of the interim techs came over at that point and started muttering something about saline. Granted, I am new at this (had to go in via chest catheter, it (meaning dialysis) came before I had a chance to get a fistula in or really prepare at all, so I am playing catch up now with learning it all and switching from pre-dialysis mode, (diet wise, other wise....) to dialysis. I didn't mind switching to needles at first. I couldn't wait to get those tubes out of my chest. But, these people are making me, someone who used to consider needles a side hobby, hate them. They sure suck the fun out of everything, even this....but seriously, I just felt like they were hurting me on purpose. If I am sleeping, as I was at one point today, they woke me to hand me a piece of paper and walk away. Just inane (and not so inane) stuff. Does anyone else experience any of this? And I am still serious about the right way to remove a needle...thanks much, all!

[MommyChick]

I believe you have every right to tell them how it should be done so they wont hurt you! Over time they will just know how the needs must be, etc. I used to be a hard stick when I first got a fistula. I've had it over 6 yrs now & never had any major issues with it, although it did take a while to mature & lots of bruising in the first year. I also learned that the way my fistula was made that my needles need to be propped up w/gauze so they don't hurt me during my treatment. But its your body, your say! Good Luck with your fistula!
 

[Leanne]

i totally think we should be able to refuse any person to stick us.  I had my chest cath for about 8 months since my dialysis was started suddenly when I dropped suddenly from about 21% to 14%.  Then it took two tries to get a fistula to mature.  I finally got rid of the cath and what a freakin relief!  There is one girl at my center that is so careless and rough.  I realize infiltrations do happen but she acts like a bulldozer in a china shop with that needle and she has only stuck me twice. Both times infiltration and huge knots and black bruising from my elbow to my shoulder.  Once i could barely move my arm and had to see the surgeon, get dye and a baloon to stretch and unclog it after.  My surgeon complained about her to my neph.  He was pissed to put it mildly.  Said we go thru too much just being on dialysis and useless pain for us and extra procedures because of careless techs pisses him off.  I refuse to let her stick me anymore even if I have to wait.  The others are careful and try to be easy and not dig around.  I told that girl she wasnt mining coal to ease the hell up. 

Some of them could care less if we have to go get another tree shoved in our chest.  Pisses me off.  No way do I want that back.  It always hurt when she took out the needles too.  It doesnt have to.  To some ppl its only a payday we dont matter to them.  Sad but true.  Iv had to learn to say no and speak up for myself.  It hurts us if we dont get a good treatment.  They get to go home feel fine and have a great day.  So if they say you dont have a choice I dont agree. 

[frankswife]

Oh gosh, guys, you are really scaring me. Hubby tried to have his first dialysis this past Tuesday and they couldnt get one needle to work. We arent allowed in there while patients are being put on or taken off the machine so I have no idea what they are doing, and hubby may not say anything not knowing if what they were doing was normal. Usually I protect him like a pitbull as much as I can but I feel so helpless here. I am afraid they wont be able to use his fistula and then what. Oh Lord why cant something go right for him JUST ONCE

[frankswife]

Sorry everyone I didnt mean to hijack this thread.

[Whamo]

I always thank the nurses that work on me, and I try to compliment them too.  The women love it if you notice their hair or their clothes. 

[jbeany]

You can learn to pull your own needles, too.  Tell them to prep the gauze pad help you remove the tape, and then let you pull them yourself.  It's actually easier to put pressure on that way, since you know exactly when the needle is coming out. 

And no, I rarely had any pain pulling needles - they are supposed to come out the same angle they went in, not just get yanked any which way.

[cassandra]

I agree with Jbeany, if you can't/won't stick your own needles in, it's quite easy to pull them your self, and 99% less chance of it hurting. Just Google "pulling your own hemo-dialysis needles" and more than a few will come up with little clips included. I'm seriously disappointed with myself for not starting the self cannulating/pulling bit many years earlier.

good luck Cas