peritoneal dialysis....what do you think?

NephroBSN, BSN, RN · May 9, 2006

...............

limabean · May 10, 2006

Thanks for replying NephroBSN....no, we do not perform hemodialysis. We are the only floor that takes the ESRD patients (we send them to dialysis and manage their other multiple problems on the floor). We will now be getting peritoneal dialysis patients which the hospital has not been able to do thus far. Like you said most pt's know how to do their own peritoneal dialysis, but we will have to know how to manage these patients. And many of the patients that will be admitted to the hospital will be too sick to take care of it themselves. The nurses on our floor will be the only ones in the hospital able to take care of these patients and perform the PD. I am just curious to learn how in depth this is. We are going to be given a 4 hr inservice on how to do peritoneal dialysis soon. Thanks again.

NephroBSN, BSN, RN · May 10, 2006

Thanks for replying NephroBSN....no, we do not perform hemodialysis. We are the only floor that takes the ESRD patients (we send them to dialysis and manage their other multiple problems on the floor). We will now be getting peritoneal dialysis patients which the hospital has not been able to do thus far. Like you said most pt's know how to do their own peritoneal dialysis, but we will have to know how to manage these patients. And many of the patients that will be admitted to the hospital will be too sick to take care of it themselves. The nurses on our floor will be the only ones in the hospital able to take care of these patients and perform the PD. I am just curious to learn how in depth this is. We are going to be given a 4 hr inservice on how to do peritoneal dialysis soon. Thanks again.

There are several types of PD.

CAPD CCPD. Some use a cycler over night.

Who's teaching this 4 hour inservice. Do you have dialysis nurses on staff. Most hemo nurses don't do both. Some do. Is there an out patient unit that teaches PD. Are those nurses gonna be inservicing you.

I had a PD patient once on an M/S floor and her cycler messed up most every night. The PD nurse wasn't happy when I called her at 3 am on a Sun morning.

Good luck. I hope you have a good nephrologist. I hate to say it but most of them don't know much about the process of PD or hemo. I've had them ask what a UF profile is and what's it used for.

Oh as an after thought. How often do you anticipate having these patients. PD might be something use it or lose it from your skills set. Sorta like telemetry.

Chaya, ASN, RN · May 10, 2006

Peritoneal dialysis is like what they say about bumblebees flying- when you hear about it you say no WAY should that work, but it seems to, amazingly well for the simplicity of the procedure. For patients who are teachable and able to manage the aseptic connection it is a godsend in allowing them a relatively normal quality of life and more time at home. Will you be using one of the automatic cyclers? WE occasionally get a pt who has their own but usually we just use the sealed 2-bag system and run it to gravity. It takes about 1/2 hour total to drain the old fluid and then instill the new. Actual nursing time is a minute or two to get vitals, measure fluid instilled vs that drained (we weigh the bags) mask yourself and the pt and connect/ disconnect the "set".

limabean · May 11, 2006

I'm not really sure yet about the details. I dont know if we will be using the automatic cyclers. I will know more after I go to the inservice in a couple weeks. I believe the inservice is being taught by our unit educator, but we'll see. And from what I understand we will probably not have that many PD patients in at any one time. But many of the nephrologists in the area have decided to only use our hospital (our floor) for their PD patients once we start taking them.