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10GaugeNeedles BSN

Acute Dialysis

Been in nursing for 11years. Medical ICU was my niche. Acute dialysis is my niche. Travel nursing is my jam.


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  1. 10GaugeNeedles

    Looking up patients on Facebook

    Hipaa protects the release of protected medical information. It’s not a violation to look up someone on Facebook unless you are releasing protected medical information. Rules govern what you can and can’t do so if you want to know if it’s actually breaking a rule, look up your handbook to see if there’s a policy about it. While not an actual hipaa thing, I’d leave it alone. Better safe then embarrassed. Your hospital might very well have a policy forbidding this activity.
  2. 10GaugeNeedles

    Acute dialysis travel

    Anybody have experience in acute dialysis travel agencies? I realize there aren’t many specific agencies for HD and big HD companies have in house travellers. Main question is, did they have orientation? Did it matter if you never worked with their machine before? What was the pay like? Tell me your experience? Cheers.
  3. 10GaugeNeedles

    Why is OR so common for travel?

    Do you have to have plumbing experience for your kitchen sink procedures?
  4. 10GaugeNeedles

    Over-tightened blood line connection and sterile caps

    Ive always used hemostats. Never damaged anything. I guess there’s a slight risk of damaging the hub but, that risk is out weighed by a delay of getting the treatment IMO.
  5. 10GaugeNeedles

    Peritoneal dialysis, no orientation, night shift

    I bet your pt could tell you what to do. I’m not kidding. They do this stuff every day and I bet they’d be more than happy to help you. There’s great tutorials online. When I was bedside, that’s how I did it, online tutorials. Just remember to always be SUPER sterile with that abdominal catheter.
  6. 10GaugeNeedles

    Inpatient dialysis

    I don’t do chronics. But for acutes (and it will vary by region and company how things are run)... autonomy: you run your own show. It’s all you. No techs. You setup, break down, the whole deal. There’s a bigger assumption that you will have full control and do it right so, know your policies. But you do feel a greater weight of responsibility. Solitary: you will be surrounded by people that don’t know dialysis. You rarely see your coworkers. We stay in contact via text and phone but, there’s no “work family feel” you get as a bedside nurse. You might find it lonely, you might find it liberating. But it feels very solitary. And you will hear every misunderstanding about dialysis by nurses that you can imagine. you really get to understand how specialized your specialty is. variety: you’re all over the place and each shift feels different since you could be in 3 hospitals over a shift. It rarely feels routine. I work nights so, often have hassles with missed orders, getting heparin, consult is not the same as the on call which can be annoying, lots of little things specific to nights. It’s always the same but it never feels the same or routine. It’s always your fault: and this is likely just nights. Day shift bumps some one to run overnight. You show up at 0100 and they want to know why you are so “late” cause, you know, we are just sitting around playing cards n stuff. LOL. But it does get to you with the whole blame game. And your manager generally does the same thing by saying you are supposed to call ahead for ETA or you were supposed to wouldcouldashoulda. well, you generally don’t know your eta till later but, that’s the line they give you cause you are blamed for everything and the boss is getting hassled by the hospitals and nephrologist. But all cr@p rolls downhill and you are at the bottom capiche? Satisfaction: you do an incredibly life saving job. Often at night, you showing up and running the treatment literally saves lives directly. It can be SUPER satisfying. You get to see t waves shrink, oxygen coming off, follow up abgs go from life threatening to stable, potassium goes from life threatening to WNL. And YOU fixed it. For me, that’s the coolest part. I get to directly fix life threatening medical problems and often, I’m the only one in the whole hospital that can do it. HOW COOL IS THAT? Also, you get to introduce new ESRD pts to their new life style. You get to explain what they can expect in this new world of dialysis. This person is about to have aHUGE life change and you get to help them but understanding what is going and what to expect. You have a VERY real impact in people’s lives. Overtime: at least in my market, you can literally work as much as you want. I could work 7 days a week 16 hrs a day if I really needed the money and it didn’t kill me. My point is, they generally have no problem with however much overtime you want to tolerate. Learning curve: acutes really is different and you won’t know till you go. Theres more but, that’s my 2cents. I wouldn’t do anything else in nursing.
  7. 10GaugeNeedles

    The wage gap myth

    Did you ask for a raise? No? If you see a discriminatory practice and do nothing about it, it’s probably going to continue. Maybe they see males as minority (which we are in jrsing) and they want more males. Or maybe the males came from a higher salary job and they were able to ask for a higher rate because of that. Who knows all the factors. If you aren’t getting what you are worth, ask for more. They will give it to you if they don’t want to lose you. But they won’t give it to you if you don’t ask for it. 2female nurses I work with who have less experience than me let me know they started with 50cents and 1dollar base rate higher than I did. And I have icu experience from a level 1trauma center. They didn’t. That is a pay gap and that’s my anecdote. I’m actually satisfied with my wages so it’s not worth it to chase down. But don’t think it’s just men who get more than women. It isn’t. don’t extrapolate your anecdote to a whole population. That’s a statistical sin. Your experience does not suggest institutionalized discrimination.
  8. 10GaugeNeedles

    The wage gap myth

    Gender wage gap is not a myth. It is a lie.
  9. 10GaugeNeedles

    The wage gap myth

    There is no gender wage gap. I currently know 4 females with 5 years less experience than me who make .5-1 dollar more base rate than me. I know I make more than them cause I work a ton more hours. That’s not a wage gap. Gender wage gap suggests conspiracy and institutionalized discrimination. This is false. The studies that claim the gap are research malpractice. The cohort would have to be EXACTLY the same. The only way to really claim a gap would be to compare hourly base rates controlling for age, experience, all factors at INITIAL hire and that includes interview performance which obviously is very hard to quantify, basically the ONLY variables can be base rate and gender. If they could establish that all factors were indeed equal and the ONLY thing that was different between sex categories was the different BASE rate, THEN they could claim a gender pay gap. As it is, they are committing research malpractice.
  10. 10GaugeNeedles

    EKG interpretation

    Sounds to me like you need a foundation. It’s incredibly easy to get lost in the weeds with those comprehensive study guides. I’d say know the ACLS categories. Organized vs disorganized, tachy vs Brady vs nsr, STABLE vs UNSTABLE, etc. know how to look at an ecg and immediately recognize “organized vs disorganized, Brady or tachy, are all the waves present in each complex (pqrst)”. It’s not necessary to identify all the details. It is necessary to recognize a problem. you’ve taken the acls class. Look at the algorithm and look at the treatable categories. Don’t worry about what you have to do to treat the rhythm. JUST differentiate each rhythm category. And most important, understand the difference between stable and unstable. One you treat and one you don’t and that’s extremely important to understand. The above should give you a good foundation to expand your toolbox from there. Good luck.
  11. 10GaugeNeedles

    How would Medicare for all affect nursing?

    I’m normally against government. But I could see it working. If all insurance premiums were averaged out and that was the Medicare tax, it could work. The best thing would be to do away with the charge master pricing system. There’s no transparency with pricing. Medicare would make pricing more in line with reality. Face it, private health insurance sucks. Mainly cause of gov regs. However, the whole country pays for only part of the population with taxes for Medicare right now. And it’s about go bankrupt. http://time.com/5575482/medicare-insolvent-by-2026/ so, can we really say it’s a good idea for a program that is about go insolvent to get even bigger? I definitely see wages for nurses dropping. I’m torn. I can see it working but, I can’t tell if it’s actually a good idea. Great topic OP.
  12. 10GaugeNeedles

    Is this enough training for experienced nurse?

  13. 10GaugeNeedles

    Anxious, depressed, and might need to go to HR.

    One more thing. Don’t try to “be better.” You will kill yourself trying to find the flaws in your practice that just aren’t there. Did anybody get hurt because of you? No? Would you be satisfied if you were the nurse taking care of you? Yes? Then you can’t fix what ain’t broke. Don’t let this person make you second guess yourself constantly. That was my mistake. It took me years to get over the second guessing and self doubt. You do NOT deserve this. But you also won’t be able to fix it. Again, I suggest signing up with a local agency and simply saying on the application that you don’t want your old job contacted. Get former managers and safe peers to reference you. Good luck.
  14. 10GaugeNeedles

    Anxious, depressed, and might need to go to HR.

    I had a VERY similar experience. You have to leave. That was the only solution for me. And you know what? It was the best choice I ever made. Different hospital, different unit, different state, different something, but you have to leave. Your mental health is more important than this one job. I feel for you. I HATE that this happens to us. But it’s way too common. HR won’t help. You have to leave. i went agency, layed low for a while till her reference didn’t matter anymore, then applied at a new hospital. U can try that if you need an immediate solution.
  15. 10GaugeNeedles

    Adjusting to NIGHT SHIFTS advice??

    I’ve been working nights for the last 10 years. Everything is more relaxed at night. The people, the pts (other than neuro....those pts NEVER relax...LOL), no doctors or managers to hassle you, no meetings or rounds to deal with, no PT/OT to annoy you, etc. all the procedures happen on days so, you might actually prefer all the activity on days depending on your personality. However, nights is when the codes usually happen. Also, all the cool kids work nights . I hate working day shift. There is good and bad. Try it out. If you don’t like it, u can always go back to days.