dialysis nurse question

Specialties Urology

Published

I currently work in a dialysis nurse clinic. I am struggling with finding myself in this position. I did not receive the best training from the CHT (attitude issue) so I am still anxious with sticking fistulas and grafts. The charge nurse keeps on assigning float/med nurse position to me saying this is my strength and having the other RN (who had better CHT training) work in a bay sticking patients. I don't mind doing this. I round with the nephrologist and put in orders for the CN/nephrologist at request and call pharmacy/med rec/foot checks etc. 

However, if I want to eventually be a charge nurse in the dialysis clinic, how much sticking practice do I need? I am proficient at catheters but struggle with my sticks. 

Thank you. 

 

 

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Specializes in General, LTC, Nephrology.

It is unfortunate that you are not being allowed to stick more patients.  The only way to get better at this is to do it.  Maybe you could take one patient from each of the pods or areas to stick with the PCT standing by to help you at each turn around.  The more confident you are, the better your sticks will be.  Always use a tourniquet on fistulas and I use my ring finger above where I am sticking to add additional pressure to make the fistula really pop up.  In fact, I rarely use tourniquets as that is how I was trained back in the old days.  Even when you are assessing fistulas, try this and see how much better control you have over the area you want to stick.  May take some getting used to, but you will be more successful.  Best of luck to you - be assertive and ask for more sticking time.  You will gain confidence with experience!

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Specializes in Dialysis.

Confidence with cannulation comes with practice and time. Perhaps request people whose arms are easy? Also know that there are just people with difficult arms. So getting comfortable with an easier arm can help boost your confidence. 

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To be an effective and trusted leader on the floor, you must be proficient in not only "sticking" patients, but you must also understand all the physiology behind what can go wrong with the myriad graft and fistula configurations in modern surgical techniques. 

Being assigned the "float" and "med" nurse position will turn you into a glorified CNA with awesome computer skills.

 

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I agree with others. Ask for cannulating practice. Find 1-2 patients that don't mind you practicing on them and ask that you be their cannulator when they come in. Hopefully that's possible in addition to doing the job they currently need you in and it's a win-win for everyone.  

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Thank you for the awesome replies. I have been working on obtaining cannulating practice when I am placed in the float RN position. 

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 As for working in dialysis, I really like it but the drama between techs and RNs is a bit of a challenge.

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Specializes in Dialysis.
Guttercat said:

To be an effective and trusted leader on the floor, you must be proficient in not only "sticking" patients, but you must also understand all the physiology behind what can go wrong with the myriad graft and fistula configurations in modern surgical techniques. 

Being assigned the "float" and "med" nurse position will turn you into a glorified CNA with awesome computer skills.

 

And sadly, some are happy to be just that. Thank goodness OP doesn't seem to fit in that category 

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