Trouble in Paradise

[rfranzi]

Okay, I have written here periodically since my diagnosis of fibrillary glomuronephritis a couple of years ago. I started dialysis a little over three months ago via chest catheter while I waited for my fistula to heal. I was recently very happy to have my chest catheter removed and to move forward so that I can start training to do home hemo. I also started feeling better at around three months. I felt like I came out of a coma, it felt sort of short of a miracle. I call it when I "woke up", because for the first month and a half or so I pretty much slept and barely remember much, its a blur. Anyways, I was happy to be making progress and even recently moved to accomodate a separate room for home dialysis. Then, they started having trouble with my needles, seemingly right after my chest catheter came out. Last week, for instance, I missed Monday and Wednesday's treatment, so I had to come in on Thursday and they got it that time. So I came in the next day, Friday, and they couldn't get it again (clots, infliltration, you name it....one reason or another). I gave it a rest over the weekend (my arm was a mess) and came in this week. It took an hour Monday and four needles to get it, but the tech pushed up my fluid reduction from .6 to 1 which made me throw up breakfast at 3 1/2 hours in. I came in on Wednesday and they got it, but one of them blew up. We tried once more and it clotted, and we couldn't get it. I went to the surgeon the following morning and had an ultrasound. They said it was flowing fine, drew a "map" of the fistula, which did have a turn in it, for the staff and sent me back. So last night, with the "map", they got it. I am feeling quite tired and I know it will take a little while of consistent treatments to feel better again. The thing is, at one point as my son sat by my side during this debacle, I leaned to my son and muttered "keystone cops" and he muttered back "good analogy". I favor the night schedule, 5:30-9:30 pm, but my neph actually said to me not so long ago, that if I want more qualified staff I may have to move to the day shift. Have I gotten myself stuck with a night staff straight out of a bad sitcom? I am just worried that their incompetence will cause unnecessary additional surgery to my fistula, the way they are going. If they had missed it last night, we would have been close. Any advice or similar experience is appreciated. I admit I have been a little too tired to properly advocate for myself. I am educating myself and my son as we go along.....thanks!

[jbeany]

Does your center train for button holes?  Teach patients to self-cannulate?  These are both better for your access - only one person sticking them all the time, and no newbies flailing around at you with a needle.  Both of these will make your transition to home hemo easier if you have them already accomplished.  Some centers will train you to do this at the same time you start home hemo training, too.  Unfortunately, for both options, the odds are good you will have to do morning shifts for a while.  The better trained - and therefore training -  nurses tend to have more seniority, and probably won't be working the late shift.

[AnnieB]

Does your center train for button holes?  Teach patients to self-cannulate?  These are both better for your access - only one person sticking them all the time, and no newbies flailing around at you with a needle.  Both of these will make your transition to home hemo easier if you have them already accomplished.  Some centers will train you to do this at the same time you start home hemo training, too.  Unfortunately, for both options, the odds are good you will have to do morning shifts for a while.  The better trained - and therefore training -  nurses tend to have more seniority, and probably won't be working the late shift.

That's true. Most new nurses start on nights.

[MommyChick]

When my fistula was maturing & I was getting used to the sticks, the new nurses weren't coming close to me!  My body my say as to who sticks me. I'm going 7 yrs with the same fistula & no major issues. I'm very protective of my fistula. Also they never should have pulled your cath. Out before having your sticks down pat. Hope things work out for you!
Good luck

[kitkatz]

My say, who will stick me.  No NEWBIES!

[Rerun]

I would just go on days and get rid of the night idiots.

[noahvale]

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[noahvale]

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[AnnieB]

That's true. Most new nurses start on nights.

What proof do you have - other than anecdotal reports - that most new nurses (I'm assuming you are including floor techs in your definition of "nurses") start on nights?

I'm a nurse.

[rfranzi]

That's true. Most new nurses start on nights.

What proof do you have - other than anecdotal reports - that most new nurses (I'm assuming you are including floor techs in your definition of "nurses") start on nights?

I didn't say I had proof, I just said that's what I was told. Are you a nurse?

[Leanne]

Oh wow, I got my chest cath out a few weeks ago.  My fistula was doing so well until this one tech stuck me.  Five needles and an infiltration and she wasn't easy.  She would dig and dig.  She has stuck me two different days and both times I had to see my surgeon.  He got so angry because my fistula wasn't blocked either time and he said it was unnecessary procedures and pain for me.  He was upset about the amount of bruising and swelling I had as well.  So I told the RN at my center that even though I liked that girl fine as a person , I am no longer willing to let her hook me up.  Nothing personal but I have no desire to have another chest cath because she destroys my fistula.  I told them I will even wait to be hooked up if I need to.  Whatever it takes to keep my fistula in good working order.  Personally I think wego through way too much as it is, so we don't need someone causing us to need even more things done.  I had my chest cath for 8 months.  No way do I ever want that tree back in my chest.

[AnnieB]

That's true. Most new nurses start on nights.

What proof do you have - other than anecdotal reports - that most new nurses (I'm assuming you are including floor techs in your definition of "nurses") start on nights?

I didn't say I had proof, I just said that's what I was told. Are you a nurse?

Nurses that have seniority, as jbeany pointed out, usually get the better shifts. Not many people thrive on or ask for night shift voluntarily, unless they are part ghoul. Usually days are more in demand, even if they do tend to be busier.

[Rain]

at my clients but i guess it's in Canada so we are different.  the Nurses work either 12 or 8 hour shifts and they rotate between morning, afternoon and evening.
For 12 hour shifts you either work 6:30-6:30 or 11am-11pm.