yesterday. . .

[hurlock1]

I went to dialysis as usual. The least talented tech was there to hook me up.. She's a sweet, nice person. I would never do anything to hurt her feelings. She got the lower access right off, then she just couldn't hit the upper (Venus). She stabbed and searched and stabbed and still couldn't find it. After too long she called another tech, the least experienced tech one that has just been turned out, and she had no luck, then they called the old pro and he dug around for a little while. Finally, collectively, They decided that it was clotted. I don't understand how it was decided, because an inch away, on the same vein the other access was thrumming away. They sent me to the hospital for a fistulagram. They had called the nurse practitioner and she said go to the Hosp., that enterventional radiology didn't open until 8 am (this was at 6:30 am) But I've been to enterventional radiology, at that hosp. more than once at 6am. So, I went to admitting and she didn't have anything on me; she sent me to enterventional radiology, I sat there for a little while, they came out and sent me to admitting. My wife works at the hospital as an RN in the eye center. She saw me in the hall, heard what I had to say, Called the dialysis center, got the name of the nurse pratitioner, found the number, Got the enterventional radiology outa' bed and eventually had the orders sent to the hosp.
Since I was a walk-in, It wasn't until 2 pm before I was seen. I had the fistula gram done and no clots! nothing! Nada! BUT they made me stay until 6pm anyway. I went directly to the center, I looked through the window in the door and there were two techs the place was full, and alarms were going off everywhere, so I left. I'd had enough and for the day. I got home and called the person that answered was somebody I didn't know; they told me to call at about 8:30 this morning. I was thinking that I would just skip dialysis for today, and go on Monday, It's been since Wed. since I've been dialized. Would there be permanent aftereffects going that long?

[monrein]

What a nightmare time for you. I don't know about permanent side effects but that's quite a long time to have toxins and fluid building up in your body and potassium in particular can cause serious, even fatal, problems if that is something that runs high for you.  I can understand that you don't want to go in but they really should try to accommodate you at the unit since in fact they really dropped the ball in some ways.  Call again and see if they can take you and insist that they do so since it really is quite important in my opinion.

[David13]

It appears as though the staff were incompetent, and so rather than admit it, they blamed it on your fistula "clotting". 

You should try to get in for a treatment ASAP.  It is definitely an inconvenience, but it is probably safer to just do it.  You probably should have been dialyzed in the hospital after the procedure, providing they have facilities there.

Sorry to hear you had to go through all this. 

[Zach]

Please don't let their incompetence cause you to take risks with your health.
Go for dialysis today.  It's a must!

[hurlock1]

I'm learning not to be "offended" by incompetency. I realize that people are people. It's,  I guess that mostly, my normal day off was lost because I spent my dialysis day at the hosp. doing a pointless procedure, and it cost me money (copay) that could have been spent somewhere else. I'm pretending that I'm not angry. I don't know how I'mona act when I get to the center. I have the reputation for being a nice guy. . . I am a nice guy, but I'm only pretending not to be angry. I'm scared that they won't be able to hit the venus again. I don't know how to demand the most experienced people to hook me up, and not shake the confidence of the lousy tech even more.
 I guess I should go, and dive in, and what will be will be. I have to go sometime, no putting it off

[Zach]

One of the things I learned as a person on hemodialysis is you can't be everyone's friend.

[David13]

I admire your emotional fortitude, but after what you have been through I don't think anyone could or would have a problem with you requesting that someone different and more experienced place your needles. 

[twirl]

that happened to me once and I was sent to downtown Houston for the fistula ex-ray -
there was nothing wrong
my nep doc got mad he told the unit to get someone who could cannulate me-
his face got all red -- he can be a jerk but he is the best doc to get his patients what they need -
the techs and nurses do not like him -- I love him --
which I always tell him when I am in the hospital under the influence of drugs 

I am so sorry you had such a rotten day  -  please do not got Wed until Monday to get dialysis

it will get better 

[Wallyz]

Offend her. Tell her you don't trust her and you need a more competent tech.  It's her feelings vs your health.  Since her job is to keep you healthy, and nobody is paying you to keep her happy,


You can be friendly with the staff, but they are not your friends.

[dwcrawford]

I worry that if you offend the staff you won't get the attention you need.  First three days were great.  Nurse was fantastic, fun and knew what was up.  Tan has 12 people in her bay and each tech has two ... but often they are short a tech or so, but it works out.  Mine was Nelson.  He's new at the job and very, very  consciences.  Always there to help.

But last night was (hell).  Tan was working elsewhere.  The nurse replacing her was sweet but once she got you set up she disappear for most of the night.  I had to ask her to do the little things (lick  change the dressing on my wound) that Tan just does. 

Ok, now Nelson was sent to another bay.  There were three tech on the floor.  The supervising nurse was there a lot I suppose checking up on this less than competent crews.  She is Jamie (my buddy from way back in Jan  when I took the Davita classes.  The two huge techs did little or nothing.  They wouldn't help me with blankets, etc. like they usually do and me with no free arms.  There was one little skinny boy who was new and very, very busy.  Again I guess he was trying to prove him self by working so hard but basically he handled all 12 people.

Then Jamie, the supervisor told  the two fat techs they need to get to work.  Wow! Fireworks.  They gossiped and complained and pointed and even got Mary involved (the hear nurse).  Later Jamie came over to check me out and got me Maalox (I was getting sick) then she sat down and we BSed for a while.  The tech saw her and then avoided me from then on.  Thank god for the little new kid.  Anyway, I was a nervous wreck when  I got out.

So  I am concerned about  offending  them.  After all, my life is depending on them.  I didn't know it would be a bunch of clicks seeking power.  Jamie said she would do her best to give me the old team and I should just bear in there quietly.

This was my rant.... though I didn't label it rant.

[hurlock1]

Offend her. Tell her you don't trust her and you need a more competent tech.  It's her feelings vs your health.  Since her job is to keep you healthy, and nobody is paying you to keep her happy,


You can be friendly with the staff, but they are not your friends.

I'm from Houston. I moved from there in 2002. I miss everything about it. Well, not EVERYTHING. I moved here to Albuquerque, NM, where it is right now, 66 degrees and a nice soft wind blowing, and the sky is the most gorgeous blue, all the way down to the horizon. The relative humidity is 28, and That is high for normal. I love Houston though. I lived there for 52 years. Saw alot of growth. My brother and sister still live there. All of my friends still live there. The last time I went there in 2005, we got to Hwy 6 at I-10 went to a gas station, the AC had been on in the car, I got out of the car and I couldn't breath. I spent about 3 min. in traffic going south on Texas 6 and couldn't believe the traffic. We got used to it after a week of being there and going all over town, but after coming back, I decided that I'm NEVER going back. (never say never) I'll go back, probably, if there's a funeral or something.. But I am still a Houstonian, living in Albuquerque. I think of Albuquerquiens as them. and Texans as us.

[RichardMEL]

It's funny isn't it with the politics and the dilema that it is their job to give us treatments to keep us alive so it's a fine line. I have to say your unit sounds big and not terribly well run. Mine is small (12 stations) and is stocked with top notch division 1 nurses - most of whom I count as being very friendly with. It absolutely helps if you get on well with the staff but I also find it fosters god teamwork, and frankly I think there's even a bit of respect that goes the other way. What I mean is I demonstrate some understanding of the process, the issues and so on, and so they don't just treat me as a blob in the corner but we actually discuss stuff. Lately they don't mind if I set the machine the way I like it (stuff like temprature, UF profle, etc) - I know some nurses don't agree with what I've selected, but I've found a setup that works for me and they don't actually stop me doing it and I think I've proved through not crashing and cramping that it DOES work for me. I'm convinced one or two have actually learned a few things (specially about profiles, which aren't used much).. of course my primary nurse put me onto the UF profile in the first place 18 months ago and we just love it

Socially it is important too. We have formed more of a little community as much as anything else. I swear some of the staff see us more than their families sometimes, and I do believe in an environment of long term care like dialysis where you see the same people literally for years, that it is more than "us and them" (although I understand it absolutely can be like that in some places and I am glad I am in a great unit!!) I mean it is still professional obviously but we all share bits of our lives - like the guy who tells me about his 3 dogs and I download star wars stuff for, or the other nurse who tells me about her dogs and her kids lives and stuff.. and of course they are all on my back about getting a girlfriend!  Oh and we almost always share laughter when we can.. that is vital.. if you can't have a sense of humour that would make it all that much tougher because let's face it... there's just some times with dialysis that all you CAN do is laugh at it all.

[hurlock1]

that happened to me once and I was sent to downtown Houston for the fistula ex-ray -
there was nothing wrong
my nep doc got mad he told the unit to get someone who could cannulate me-
his face got all red -- he can be a jerk but he is the best doc to get his patients what they need -
the techs and nurses do not like him -- I love him --
which I always tell him when I am in the hospital under the influence of drugs 

I am so sorry you had such a rotten day  -  please do not got Wed until Monday to get dialysis

it will get better 

I'm from Houston. I moved from there in 2002. I miss everything about it. Well, not EVERYTHING. I moved here to Albuquerque, NM, where it is right now, 66 degrees and a nice soft wind blowing, and the sky is the most gorgeous blue, all the way down to the horizon. The relative humidity is 28, and That is high for normal. I love Houston though. I lived there for 52 years. Saw alot of growth. My brother and sister still live there. All of my friends still live there. The last time I went there in 2005, we got to Hwy 6 at I-10 went to a gas station, the AC had been on in the car, I got out of the car and I couldn't breath. I spent about 3 min. in traffic going south on Texas 6 and couldn't believe the traffic. We got used to it after a week of being there and going all over town, but after coming back, I decided that I'm NEVER going back. (never say never) I'll go back, probably, if there's a funeral or something.. But I am still a Houstonian, living in Albuquerque. I think of Albuquerquiens as them. and Texans as us.

[RichardMEL]

Don't mess with Texas!!!!!!!!!!!!!!!!!!!!!!!!!!   

[jbeany]

You can be friendly while insisting on having things done your way.  It is a fine line to walk, but I'd rather have them bitching about me when I'm gone for the day than screwing up my treatment while I'm there!

[kitkatz]

You have to have them do things your way. After all this is your body and health they are practicing medicine on.

[RichardMEL]

You have to have them do things your way. After all this is your body and health they are practicing medicine on.

This is true. I actually mentioned this the other day when one of the nurses was questioning my choice. I explained that I've found a setup that works for me and that since it was my body I actually cared the most about what happened to it and that it should be appropriate for me to select the manner in which treatment was delivered.

Now yes, if I was trying to dictate meedication levels or stuff like that - that's totally different - I'm not a neph or renal expert by any means and they'd be quite right to call me on something like that, but just day to day "comfort" stuff like temp and UF profile, pump speed and the like.. yeah I absolutely insist on having at least that level of control over the way my body is treated.

[monrein]

It really is tricky to find the balance that is friendly but yet firm about our needs.  I find it important to preface almost every request with  "this isn't personal but...I really need...".  I also think that it's good to allow for the fact that mistakes can be and will be made by staff, or that you can get angry abort things that screw up your treatments but that life will return to a status quo without dreadful grudges being held on either side.  My most tricky situation at my former unit was a nurse who was moody and hyper-sensitive and who took everything very personally.  I had to call her on some things and she then stopped speaking to me at all which meant I had to take her aside and ask how I had offended her.  She pretended all was fine but I just calmly told her that I had noticed a real change in her attitude and that I hoped we'd be able to resume a normal relationship since we HAD to work together.  I also try to always apologize to staff if I'm short or grumpy with them in an unreasonable way and that is usually appreciated.  The truth is that dialysis is a stressful thing for everyone involved but since we are the ones who pay the physical price for all that can and often does go wrong, we have every right to take charge of our treatment, to speak up about what works for us, to ask as many questions as we need answered and to complain if we don't like certain things.  We also have an obligation I feel to be respectful of staff and not take things out on them but they owe us the same and in this case ,hurlock, you need to make sure that what's best for your health gets done.

[dwcrawford]

About Houston:  60 years and I'm not used to the heat or the traffic... Don't like the hurricanes either.  But other than that, with Air Conditioning, good Auto Insurance and places to hunker during storms, it is a great place to be.   lol

I think they said my dialysis unit had 120 chairs.  Its the biggest in town and before last night I was very happy with  the staff.  They did get me on track it seems as today I feel  almost human.

[G-Ma]

I am always afraid of offending someone and having them do something to my machine....sooo what I am doing is...if a nurse or tech does something that is not right for me...I talk to the charge nurse or director with the offender with us.  That seems to cut out talking behind the back etc and we get along well.  I come in and enter my numbers in the machine, do my BPs and settle in and get my arm ready.  I'm not back to self canulating yet as my right hand shakes so much..I wish I could get beyond that...but I was impressed the other day the Director asked if I would be willing to help stick people if there ever is a problem with techs being out ill....you know I would jump at that.  I'm reallly left handed so I could do that in a min, my prob is my fistula is on my left arm.   

[monrein]

Excellent approach to problems with staff G-Ma.