Acute Dialysis - CRRT : Role of Critical Care Nurses or Renal Nurses?

CVICURN2003 · May 10, 2008

In my ICU we are trained to tun the CRRT/CVVH machines. The dialysis nurses set up the machine and do the first connect to the pt. I am responsible for the UF rate and everything else. I am entirely responsible for my very sick patient. Yes, I will and have called the dialysis nurse to trouble shoot the machine, but not my patient. They don't touch my patient. Even during regular dialysis (in the ICU at bedside) I am responsible for what goes on with my patient. I have no problem calling the doc on the case and letting them know what is going on if I have a problem with what the dialysis nurse is doing. I have never had to do that, but I would in an ICU setting. I hope that answered you question.

RNFELICITY · May 10, 2008

I guess the trend nowadays is that CVVH or any other CRRT is being taken care of by ICU nurses. Depending on facility, some Renal nurses are wholly responsible for most renal/dialysis cases.
What do you all critical care nurses think of this?

In the 3 ICU's I have worked in, we are trained for CRRT and we do all the start ups and stoppages. The dialysis nurse is not involved at all.

gradcare, LPN · May 10, 2008

All units i've been involved in ICU will do CRRT until the patient is stable and able to tollerate IHD (if it is going to be needed post discharge). If the patient is going to need IHD post ICU discharge then the renal people come and do it. So short answer for us continuous renal replacement from us Intermitent dialysis from the renal team. The Machines we use are different.

mpccrn, BSN, RN · Jul 3, 2008

i was a critical care nurse, then did a stent in dialysis, left and back to critical care. let's just say there was a BIG difference between those of us with critcal care experience and those that were stickly renal......being able to understand the entire picture allowed those of us with critical care experience led to a far better treatment which ultimately made the ICU nurse's job just a bit easier! :wink2:

moonshadeau, ADN, BSN, MSN, RN, APN, NP, CNS · Jul 3, 2008

In my ICU we are trained to tun the CRRT/CVVH machines. The dialysis nurses set up the machine and do the first connect to the pt. I am responsible for the UF rate and everything else. I am entirely responsible for my very sick patient. Yes, I will and have called the dialysis nurse to trouble shoot the machine, but not my patient. They don't touch my patient. Even during regular dialysis (in the ICU at bedside) I am responsible for what goes on with my patient. I have no problem calling the doc on the case and letting them know what is going on if I have a problem with what the dialysis nurse is doing. I have never had to do that, but I would in an ICU setting. I hope that answered you question.

Agreed in my practice, except that ICU nurses do not run hemodialysis.

Creamsoda, ASN, RN · Jul 3, 2008

In our ICU, the RN does everything related to CRRT. We do the setup, bag changes, mix bags, conect the pt, troubleshooting. We dont have a dialysis team that comes to the unit to setup. In fact when I read on allnurses, that alot of hospitals have someone else responsible for the machine, I was baffled. It really doesnt make sense, to have to call someone in to troubleshoot the machine, or do a new setup. Its a skill that takes time to learn, but once you learn it, its not hard to do, as long as you are able to handle the sick pt that comes along with it and understand the concepts. On our unit, some nurses are trained for intermitent hemo, and TPE as well. That being said, im in Canada, and we only nurse 1:1 so maybe we have more time to be able to run the machine. The only time we have 2 pt's are the chronic patients who are stable, and usually just a chronic vent wean.

Miss Poppy · Jul 4, 2008

In our ICU, the RN does everything related to CRRT. We do the setup, bag changes, mix bags, conect the pt, troubleshooting. We dont have a dialysis team that comes to the unit to setup. In fact when I read on allnurses, that alot of hospitals have someone else responsible for the machine, I was baffled. It really doesnt make sense, to have to call someone in to troubleshoot the machine, or do a new setup. Its a skill that takes time to learn, but once you learn it, its not hard to do, as long as you are able to handle the sick pt that comes along with it and understand the concepts. On our unit, some nurses are trained for intermitent hemo, and TPE as well. That being said, im in Canada, and we only nurse 1:1 so maybe we have more time to be able to run the machine. The only time we have 2 pt's are the chronic patients who are stable, and usually just a chronic vent wean.

Both ICU's I've worked in have been the same. The renal unit isn't even consulted until the Pt is ready for IHD.

dorie43rn · Jul 5, 2008

In our hospital system wide, dialysis nurses do the dialysis. They sit there for hours. I still take care of the patient in every other way, but we know nothing about the dialysis machine other then what I learned in school.

TLCinCICU · Jul 8, 2008

CRRT/CVVH is 1:1 on my nursing unit and is the responsibility of the ICU RNs, from set-up to dc. We require attendance in our unit-taught class and an orientation period (only about 4 hours) in order to be "competent". The dialysis RNs only perform IHD. When they are on the CICU, they are only responsible for their machine/treatment. (One even gets on the call light to let us know if an IV pump beeps.)

diveRN · Jul 8, 2008

CRRT/CVVH is 1:1 on my nursing unit and is the responsibility of the ICU RNs, from set-up to dc. We require attendance in our unit-taught class and an orientation period (only about 4 hours) in order to be "competent". The dialysis RNs only perform IHD. When they are on the CICU, they are only responsible for their machine/treatment. (One even gets on the call light to let us know if an IV pump beeps.)

Yeah. That. ^^^ almost exactly. Our class is 4 hours and we orient to the assessment and machines for a shift.

The only difference where I'm at is that most of the HD RNs are pretty good at looking after the pt if they're compliant, relatively stable, and not too needy.

CVICURN2003 · Jul 9, 2008

We don't run regular dialysis..just CRRT/CVVH either. But I am still responsible if anything anything happens.