Par1

I've never heard of a "Shiley" catheter either and I've been in dialysis >37 years. And it sounds like the nurses you work with need to bone up on new developments. Subclavian catheters went out many years ago due to central venous stenosis in that vein causing problems down the line with arm edema and failed fistulas. Also, it would seem like no one should "inactivate" your charting due semantics on the type of catheter. You are correct in that a permacath is tunneled, temps are not typically tunneled and I have seen residents/interns place tunneled lines at bedside so I'm guessing a PA could as well. Just need a chest x-ray to confirm placement. I don't know how I would handle this unless you could find a piece of information about why the switch to IJ vs. subclavian to leave lying around. At the end of the day, it doesn't matter what they are called, it's the purpose that it's intended for that is the main thing.

I've been in dialysis nursing for 37 years and we always see more transplants this time of year. My roommate got a Kidney Pancreas transplant on December 30th. I hate the thought that all these people are giving up a loved one and it is very sad, but so giving to allow organs to be harvested. I always pray our patients do well, but pray for the families that lost a loved one as well.

It is unfortunate that you are not being allowed to stick more patients. The only way to get better at this is to do it. Maybe you could take one patient from each of the pods or areas to stick with the PCT standing by to help you at each turn around. The more confident you are, the better your sticks will be. Always use a tourniquet on fistulas and I use my ring finger above where I am sticking to add additional pressure to make the fistula really pop up. In fact, I rarely use tourniquets as that is how I was trained back in the old days. Even when you are assessing fistulas, try this and see how much better control you have over the area you want to stick. May take some getting used to, but you will be more successful. Best of luck to you - be assertive and ask for more sticking time. You will gain confidence with experience!

I agree with others - try to have a conversation with her, but in the end what she is doing is harassment/bullying. I had a manager similar to this and when I confronted her manager nothing happened. I finally sent a letter to HR and again, nothing happened. Then a year or so later, the manager left, and we were left with an LPN who was horrible and we needed to terminate her. It became a huge investigation by the HR department who wanted to talk to everyone in the unit. I told them my story and how nothing happened, yet this woman was arousing the army! The gal I spoke with was surprised and took this to the head of the department who made apologies to me. I toughed it out because I am almost to retirement and have a great position.

I'm sorry for your pain my friend. I fractured my femur last year coming off a horse and had hardware removal this year due to pain. I also have chronic back pain made worse by some complications with the fracture. Recently asked my DNP for 5 - 10 hydrocodone and she is no longer able to give these to me, but I now have to go to the pain clinic. This is such a problem for me - a 3 hour appointment in the middle of the day when I am supposed to be working. Those 5 norco would likely last me 6 months as I rarely take them and only at night. This is getting ridiculous! Take care and I hope your trip goes well.