BrantleyRN

Thanks for the responses! Yeah I have heard sometimes the different caps make a slight difference. I feel we need a dialysis tool that would give us grip and leverage on the caps and connections to avoid wasted time dealing with it!

Thanks for the response! Yeah I have heard sometimes the different caps make a slight difference.

Very good topic! When cannulating I always grab the access between 2 fingers on it's sides and sort of pinch it up. This gives me a feel and a visual of my target. Then when I poke I do a hard jab to pass the skin and pop into the graft or fistula, once you see that flash, STOP. Then advance very slightly so you are sure the tip is fully in. That is when I lay the needle down and advance it all the way. Take a deep breathe, we all go through this, and even after you're fully confident you will have issues that will pop up, but the experience will teach you how to deal with those. Good Luck! -Brantley

THE PROBLEM: Over-tightened or vaccume sealed blood line connections and sterile caps. How does everyone deal with this issue? I have heard of several workarounds myself that include: 1. Two metal hemostats to crank the connection (could damage the cvc hub) 2. A glove wrapped around and using a wrench to unscrew the connection (could damage the cvc hub) 3. Sending the patient back to Interventional Radiology to have them remove the sterile caps. Curious to see how others respond to this issue or if you ever run into it at all? I am mainly gearing this towards Acutes, but I am sure it applies to the chronic as well. Thanks! -Brantley

You are right to say the hours are less structured... it is impossible to know how many patients will need running on any given day, especislly if you do multiple modalities (HD, PD, CRRT, Apheresis) However there is more autonomy and a closer working relationship with the nephrologists. Also I just like the hospital setting personally. There is also an on call part to the acutes job for emergencies, someone on the team needs to be available 24/7. I manage a team of acute nurses in Utah and am an acute nurse myself. I am very open with new hires on the requirements and what to expect.