Acute First time alone!

Chisca, RN · Dec 17, 2014

I like to keep a couple of faucet washers in my backpack. They're cheap but if you don't have one very hard to keep a connection from leaking. Plumbers tape is nice too but you can get by without it. One of those multi tools like a leatherman or at a minimum a set of pliers. Most units have codes for all the doors. Always nice if you know these but start your own notebook so that next time you don't have to ask over and over. If doors are coded by badge I make sure to come in early and visit security so that my badge will work on whatever elevators or doors I need to access.

As far as patient care trust your own assessment as to the stability of a patient for dialysis. No one else in the building knows half of what you know about osmosis and diffusion but they will feel free to blame you for anything that goes wrong with the patient once they are connected to the machine. No matter they are on 30 mcgs of levephed, fio2 of 100, 20 of peep, and 6 chest tubes -it had be your machine that caused them to code. Try to remind the ICU nurse you are their friend. Blood transfusions? No problem. Lab work? You can draw that. Turning? Let me help. Anything that you can do to help the ICU nurse will make you known as something more than just a dialysis nurse. Good luck.

ChicagoRN84 · Dec 17, 2014

Thank you! How did you feel your first few cases alone?

Chisca, RN · Dec 17, 2014

Like I was back home. Despite my ICU experience or because of it my orientation was primarily in the 15 bed acute unit. I discovered that my charge nurse delegated bedsides to those nurses who couldn't get along well with others. It wasn't for 3 months until I did my first bedside. Cannulating a difficult fistula may be a little intimidating by yourself but exude confidence and use your training and you will be fine. I think other dialysis nurses with a different perspective than mine could comment on how it was for them at first.

westieluv · Dec 17, 2014

Don't try to hurry. Take your time, think through each step as you do it, picture yourself in training with your preceptor if you need to.

Believe in yourself! This is critical. Do not think, "Oh, no, I'm a new acutes nurse and this is my first time alone!". Think, "I am a well trained professional doing the job that I was trained to do. I did it just fine when I was in orientation and I can do it just fine now." Even if you feel nervous, make every effort to appear competent and confident with the nurses on the unit. Most of them know nothing about dialysis and will consider you to be a competent dialysis nurse, but you have to show them that you think so too.

You can do this! Everyone who has ever worked in acutes has done it and we all survived. I am no longer in dialysis, but I know that if I could do this, you can too!