I've been a nurse for 3 years, and been inpatient Acute dialysis since June. I first started cannulating without any difficulties, now I'm having serious problems. I'm either on top of the fistula or of on the side it. I feel terrified to reposition the needle to get inside of it. Every time I'm unsuccessful I get so discouraged and hard on myself. I just don't know what to do. I know practice makes perfect but I'm getting so discouraged. Anybody have any cannulating tips.
Unfortunately, you've answered your own question. Practice makes perfect. Also, remember that we all have spells that we can hit an access from the other side of the room, and sometimes no matter what we do, we couldn't hit the broad side of a barn! Don't be hard on yourself, we all have rough times, no matter what area of nursing. Take a deep breath, and know that this too shall pass. I know that I'm using many cliches, but they are all truthful. Also, I hope your still in an orientation (Fresenius offers 6 months, not sure about DaVita), ask your preceptor, educator, or a trusted colleague for some tips. Don't give up, you can do this!
When I think I can't get an access, I close my eyes and just feel the access under my fingers, take a deep breath and only when I feel like I have the feel of it do I put a needle in. You will have days where you can't hit the broadside of a barn, but these will diminish. Overall, don't be hard on yourself. Acutes can be stressful enough without you putting more stress on yourself. You can do this, and yes, ask a preceptor or someone you trust to look at your Cannulation technique. Sometimes you change things without even knowing. Keep on trying and it will get better. Or so they say!! I've been in this field for 33 years and some days are just hard. Hats off to you for working in Acute Dialysis - sometimes the hardest place to be.
I've been doing dialysis for 4 years, part pediatric and part adult. Some days you got it and some days you don't. My 2 missed accesses were with the same doctor who does not like me. I actually call for changes in patient condition (patient bleeding profusely after 45 minutes of pressure, to the NP who told me to hold manual pressure, like my fingers weren't already cramping, took another 45 minutes to control enough to bandage. 30 minutes for the upper access. Though he might want to know about the patient who coded (DNR) while on treatment. There were other factors in play and another doctor is in hot water for a bleeder that he refused to come in and check.
Be patient, you got what it takes. It's just like with IVs, you go through dry spells.
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