New dialysis nurse in training

Specialties Urology

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Specializes in Nephrology.

Just started as a dialysis nurse. And as a nurse in general. Two weeks since I started. While first week was only computer now I learn to work on the floor as a pct for a first month and then the nursing part will start as well.

Last week my preceptor showed me how to set up a dialysis machine himself, and then moving on to another machine during turn over asked me to set that one myself, which I didn't do that well. So I asked him to walk me through the process while I am doing it, which helped me much better then just observing him. it was three days (that I worked that week) on the floor, the last day I felt like I did much better at setting up/priming the machines. I am also very anxious about everything and feel pretty overwhelmed, for there is still so much new info to learn. But today the nurse told me that I am being too slow, and the preceptor cannot move on to another tasks cause I am not good at priming the machine :( I really thought it was the matter of practice. I tried to work faster today but then I make pretty silly mistakes. So it is just really discouraging.

For those who once were new to dialysis, how much time did it take for you to learn the machine and work at a normal pace. And how did the learning go in general?

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I'm new also to the area. Be patient with yourself and you'll make less mistakes. I know what you're going through. It's going to get better.

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Specializes in Dialysis.

You have to be patient with yourself. Everybody learns at a different pace. It can be very anxiety causing when you are expected to set up a machine during turn over. Do they not have machines in the biomed office that you could practice on? Seasoned techs and nurses on the floor can forget what it's like to be a new person. They will try to rush you as much as possible, but you have to say if you are not comfortable yet. All you can do is keep practicing everyday. It will become second nature, I promise you.

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Oh my gosh how can you possibly be expected to be comfortable stringing a machine after 3 days??? Dialysis is a precise practice imo, so you need to be proficient in setting up one machine before you can even think about two.

When I first started (1 year, 3 mos) I was told by each and every nurse there that it would take about a year to feel comfortable/confident. I have been on my own (without my preceptor) for 13 months and I can tell you that they were absolutely correct. These machines (ours is Phoenix) can be super complicated it seems but once you learn why certain lines go where it makes life so much easier, at least for me. This takes time and it's not fair that your preceptor is getting frustrated with you so early. Advocate for yourself... dialysis is very taxing on a person and seasoned nurses/techs are so used to the effects that it's like a no-brainer to them. Like a previous commenter said... they can forget what it was like to be new. It's overwhelming! Stick with it, be kind to yourself, and you'll get there, I promise!

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In the same boat as you. New RN, new to dialysis, about a month and a half without a preceptor on the floor. During turnover I want to jump out the window. They say it takes time to feel comfortable. As other posters have said, we must be patient with ourselves. Sometimes when I'm waiting for a blood pressure to take I close my eyes, deep breathe, and try to remember what someone told me: This place isn't machinery, it's people's lives. So if you're going slow - you're protecting others - and yourself. It'll be okay.

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TouchingAllOceans, yes, you're absolutely correct... be kind and patient with yourself. I promise you it will get easier.

A wise charge nurse told me once "everyone will get on the machine, and everyone will get off of the machine." Meaning it's all ok, if it takes you a bit longer with someone, it's ok. The treatment will come and go, and they'll go home and so will you. Take your time and allow yourself the time to learn. Good job guys. Stick with it.

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Specializes in Peds Critical Care, Dialysis, General.

It takes repetition to learn to string the machine. One day, you'll see you've done it without thinking about it. No way you'll get in the very short time frame you mentioned.

I'd also suggest you read the machine's manual. We have Fresenius 2008K and I decided to ready the manual. Some of the biomed/tech stuff was difficult, but the actual set up and what does what was very informative. I also got to spend some time with an excellent BioMed tech.

As others have said, breathe. Don't forget to breathe. Everyone will get on and everyone will get off the machine. Some days will always be better than others. Be gentle with yourself during this learning time. You will get there!

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I am currently in the interview process with the FA for a job with chronic dialysis. I am to do a 2 hour "shadow" this coming week at a ripe hour of 0500!!

I feel like that will be the deciding factor for me; whether I wish to pursue. A) how is it, really?? and to me, more importantly , B) are the techs and the ONE other nurse that works there , friendly and welcoming? ( yes I know the hour will be early, but). Because I just left a place that was "Toxic" and extremely cliquish, and I will not repeat that experience again; I can pursue home health and stay away from other nurses, for the most part.

I might add I have been a nurse since 1994 so I've experienced many workplaces and environments! There is just something about the dialysis field/job that intrigues the Heck outta me...

I don't know how it's going to end up. I envy you, OP, that you are already on your way.

:-)

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I'm new to dialysis but not new to nursing (I left an ICU RN job to give this a try). I'm in my third week (out of six) of tech training, and feel a bit disillusioned. The machine set-up, I've pretty much gotten down after about 3-4 weeks (while I was in lecture class, with an hour or so being on the clinic) of being drilled non-stop and just repeating it over and over again. You'll get it, I'm sure of it. A major reason why I took an acute dialysis RN job was because of the workload, the prospect of having 1 or 2 patients at a time, and a repetitive workflow. I didn't get hired as a tech, and I'm not even going to be working in a clinic, so to me it's like, "Why am I spending time being trained on rapid turnovers and clinic procedures when that doesn't even apply to my role?" Also, I'm not even sure what exactly I'm supposed to learn at this point, other than cannulating patients. I've gotten rinse-backs and decannulating down pretty good, so what else am I going to learn for 3.5 more weeks here?

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Specializes in Dialysis.

I'm new to dialysis (3 months in) but a nurse of 20 years with multiple areas of experience. Dialysis is a totally different animal! I work with the Fresenius 2008K2 machines. I literally 2 weeks ago just started the nursing orientation part, which isn't bad. Some things are done differently, of course, but an assessment is an assessment and administering meds is just that. The tech part is hard, and I'm still as slow as sap! I've been told it takes about a year to become confident/competent, by many nurses. I do like the comment that every patient will get on and every patient will get off. I will share this wisdom and remember it as well in the future. I'm still up in the air as to if I like it or not. I don't hate it, enjoy my work while there, but loved my LTC work so much more, but my body couldn't take it anymore so I had to give that up. I'm going to give it a year or 2 to see. Right now, my big issue is being there at 5-5:30am as I'm training to open the 3rd and 4th shifts, which are just going to be opening in my clinic (to normal folks this is approximately 2nd shift in the regular world), so maybe once I get to my regular hours of work, things will be better-I'm not a morning person by any means. We'll all get through this and in a year we can have a good post of how we made it!

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Specializes in Dialysis.
I'm new to dialysis but not new to nursing (I left an ICU RN job to give this a try). I'm in my third week (out of six) of tech training, and feel a bit disillusioned. The machine set-up, I've pretty much gotten down after about 3-4 weeks (while I was in lecture class, with an hour or so being on the clinic) of being drilled non-stop and just repeating it over and over again. You'll get it, I'm sure of it. A major reason why I took an acute dialysis RN job was because of the workload, the prospect of having 1 or 2 patients at a time, and a repetitive workflow. I didn't get hired as a tech, and I'm not even going to be working in a clinic, so to me it's like, "Why am I spending time being trained on rapid turnovers and clinic procedures when that doesn't even apply to my role?" Also, I'm not even sure what exactly I'm supposed to learn at this point, other than cannulating patients. I've gotten rinse-backs and decannulating down pretty good, so what else am I going to learn for 3.5 more weeks here?

Troubleshooting. So much can go wrong in a fleeting moment. I've already seen it

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I'm new to dialysis but not new to nursing (I left an ICU RN job to give this a try). I'm in my third week (out of six) of tech training, and feel a bit disillusioned. The machine set-up, I've pretty much gotten down after about 3-4 weeks (while I was in lecture class, with an hour or so being on the clinic) of being drilled non-stop and just repeating it over and over again. You'll get it, I'm sure of it. A major reason why I took an acute dialysis RN job was because of the workload, the prospect of having 1 or 2 patients at a time, and a repetitive workflow. I didn't get hired as a tech, and I'm not even going to be working in a clinic, so to me it's like, "Why am I spending time being trained on rapid turnovers and clinic procedures when that doesn't even apply to my role?" Also, I'm not even sure what exactly I'm supposed to learn at this point, other than cannulating patients. I've gotten rinse-backs and decannulating down pretty good, so what else am I going to learn for 3.5 more weeks here?

As an experienced acute dialysis nurse (3 years) I will tell you that rapid turnovers are necessary on a day that you have 10 patients, only have 3-4 machines in your unit and are at the mercy of hospital transport. Trust me, the experience in the clinic will go a long way. I can decannulate 2 patients, hold sticks and turn over 2 machines and get 2 more patients on in 45 minutes. You have to walk before you can run. A good tech is worth their weight in gold as far as training is concerned.

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