fistula question

[grannyM]

I went from Hemo to PD.  The PD nurse is insistent to use my fistula for labs and giving me iron.  It is twice the work to use my other arm and she gets frustrated.  She told me come Monday she is using the fistula.  I repeatedly told her my understanding was to guard the fistula and nothing but hemo needles were to ever go into it.   She says she worked HD before PD so she knows what she is doing.     So is it really OK to let her?  Thanks for your input.

[Restorer]

See what your nephrologist (or vascular surgeon if you're in contact with one) says first. If you can't do that before she wants to stick you on Monday, ask to talk to the head nurse or any nephrologist that's in the clinic at the time, or whoever your PD nurse reports to. Don't let her do it without agreement from a higher authority (even then, I'd put up a fuss).

[smcd23]

My hubby's PD nurse used to use his fistula until it clotted. The PD nurse before her did also. I don't think he ever worried too much about it personally, but he hate getting stuck with needles, so if she could get it out of the fistula, he was ok with that because he didn't plan on gong back on hemo ever.

[noahvale]

^

[smcd23]

And know your veins! If you know a good spot aside from your fistula (and I guess to nurses they just look so darn tempting) try directing the nurse there.

My Hubby has a really nice looking vein on the top of his hand but it *always* rolls and when the nurse twists the needle to try to grab it, it infiltrates and his hand blows up huge. The veins on the underside of his forearm don't look as good, but they are a lot easier stick. Nurses always want to go for the hand and he always fights with them to use the one on the underside of his forearm

[amanda100wilson]

I too think that you need to stick firm and not let her do it.

[SteveK87]

Go to your facility administrator and politely let her know you decline having any fistula sticks other than for treatment cannulation until after speaking with your vascular surgeon and/or nephrologist.   Your fistula is your lifeline.  If something happens that you can't do PD (an infection comes to mind) and will need hemo treatment, your fistula will be the fall back.  Don't allow anyone in the dialysis center to be cavalier and say, "you can always get a permacath placed for a while."  If the PD nurse has a hard time finding another vein, let someone else in the clinic try.   Do not allow yourself to be bullied!

Well said.

If you don't like the way something is, put up a fight.  It's YOUR body, not theirs.  I'm sure if the rolls were reversed the nurse would be thinking differently on how she is approaching this.

[jbeany]

Just say no to drugs idiot nurses who want to take the easy way out for themselves.  It's not there to be played with - and if she mucks it up, she's not the one who has to have surgery.

[grannyM]

  Thanks to each of you for your input.   IHD is a great site 

[Grumpy-1]

I was told that ONLY a Dialysis nurse should use the fistula.  That includes the PD nurses - IF they have had experience working on the hemo side of the house before PD.   It is not so much the use of the fistula for labs or iron, but someone NOT knowing how to do it that can mess it up.   I've been on PD for a couple years now and the nurses never had a problem in sticking the fistula.  BUT my clotted up and now it is 6-7 sticks in the arms, hands, and finally the foot before they get blood.  My body just doesn't want to give it up...   Grumpy