New to Dialysis

I've been working in dialysis for around 2 years now...It does take time for some pts to get comfortable with "newbies". You'll probably end up putting on the same people for awhile...then slowly but surely others will warm up to you. Especially when they see that you can cannulate with the best of them. It just takes time.

Infiltration happens to everyone, unfortunately, no matter how long you've been working in dialysis. Don't sweat it too much. You'll learn how different pts grafts & fistulas are & how deep/shallow/curved/etc they are. It will come with time. The gal that trained me at the clinic I work in (as a tech...I'm in nursing school) said that it takes around a year to become comfortable in dialysis...sometimes quicker, sometimes longer. It just depends on the person. Hang in there! It will get better!

Agree with Liz on this, Rosy.

It DOES take time. Patients are wary about newbies, as we all would be at first. But I have found that while they might be a bit wary, most of them are kind and accepting. They do understand that you need to learn.

And yes, infiltrations will still happen on occasion, no matter HOW long you've done this!

So chin up, and give yourself the time you need. As with anything else, it takes practice, and a good sense of humour to get through the trying times. You'll get there... promise!

Be easy on yourself. :)

I agree with the others who posted, I have been in dailysis a long, long time and sometimes I can't hit the broad side of a barn. Sticking is a skill that you will learn and become more comfortable with as you do it. Remember the first few IV sticks you did, they were tough too, but as you build your confidence the patents will build theirs with you also. As AmyLiz says it takes up to a year or more to be comfortable in dialysis and all you do. You will do great just don't give up.

Hang in there Rosie nurse, I have been a dialysis RN for 9 yrs and a RN for 18. Don't beat yourself up too badly about the infiltration, that happens, I use humor and after apologizing to the patient profusely, offer to sign the bruise from the infiltrate. A suggestion to help the patients feel more comfortable with you is to just "be there" talk to them during the treatment, if you can (and this helps out with the workload issue) tear down the machine and set up for the next patient, making sure you visit with the patient while you do this. I think it helps the patient feel more comfortable if he/she sees that you are proficient at the many dialysis tasks. Approach another caregiver and ask him/her to pave the way for you, have him/her go up to the patient and say "Let Rosie put you on today okay, now Rosie Joe's graft is arterial thumb and you need to go in at this angle and watch out for this area..." If you don't like that person hovering while you put in the needles tell them they can go about their business and you will call them if you need them. Hope this helps... hang in there, we need all the dialysis nurses we can get!!

Don't sweat it, if you have confidence in yourself, pts can see that and will trust you to stick them, I gained pt's trust through interacting with them and took great care of everyone.

Hi Roseynurse

It is very common for patients to be wary about new nurses or techs cannulating them. Please don't take it personally.

As the others have said, once they've seen you around a while they'll get used to you. They'll feel more comfortable with you and then they'll let you cannulate them.

As for infiltrates - yep, happens to the best of us. To keep it from being so bad my CM taught me a trick. When you start treatment, increase their blood flow rate about halfway to where it should be from where you started (say bump it to 300 if their BFR is 400; 275 for 350) and watch the venous pressure. It if keeps climbing steady stop the pump immediately and treat the infiltration (pull the needle; apply ice). This keeps it from being so bad. It won't get as swollen, hard and discolored and the patient wont' feel so bad. This has saved me so many times from really messing up a patient's arm with an infiltrate. Also while you are icing the patien'ts infiltration site, you can work on other patients, shake off your bad feelings, and come back to that patient with your confidence restored.

Chin up! You'll be fine. :innerconf

Don't worry. Try to think about it from the patients view.....their graft/fistula is their lifeline. they have been taught to protect it, washing before cannulation, no bp's, no iv sticks, they rmember how long it took for a fistula to mature or may have had clotted grafts in the past.....it's just self-preservation on their part. I worked in dialysis for 2 yrs before nursing school and patients were always like that with new staff....just be patient, you know you can do it, convincing them is the hard part be proficient in other areas such as setting up and tearing down and they will warm up