GeauxNursing

Are you talking about doing in home hemodialysis? Or peritoneal dialysis? Because those are two very different roles. The home hemodialysis nurse goes to the patient's home, sets up the machine and does the treatment for the patient, and then leaves and goes to the next patient.

You have to be patient with yourself. Everybody learns at a different pace. It can be very anxiety causing when you are expected to set up a machine during turn over. Do they not have machines in the biomed office that you could practice on? Seasoned techs and nurses on the floor can forget what it's like to be a new person. They will try to rush you as much as possible, but you have to say if you are not comfortable yet. All you can do is keep practicing everyday. It will become second nature, I promise you.

Platins. Carbo. Think carbo, creat.

I currently work for a four physician oncology group in Dallas. This is my first job as an RN, with 12 years of dialysis as an LVN behind me. I am the clinic nurse for one of the physicians. We do clinic together, I fulfill his orders of medication, Imaging, chemotherapy verification, Labs. I request lots of records and review them. Our clinic also administers chemotherapy, which we mix. So 3 days a week I am mixing and giving chemotherapy. I am very busy as his nurse with office visits and follow up. And the chemotherapy room is very busy as well. I do triage as well, for the chemotherapy and non chemotherapy patients. I love this job a lot, everyday has something a little different. And it also allows me to build a good relationship with my patients, which I am used to from dialysis. It is a very busy office, there are probably 20 of us who all work together.

Our clinic had standing orders for BP notification to dr as well as holding epo, or giving prn clonidine.

Do u have experience in dialysis? Are you referring to a home henodialysis job? Like doing treatments in patient homes? Ive done that for the past 3 years as lvn. Loved it. Great pay, flexibility, but i had no benefits. Just getting my first RN job in oncology after doing dialysis for 12 years.

I assume LPNs can charge in your state? I'd be nervous, too. Allroach your manager. If they have integrity, they are looking for another RN to cover in the mean time. Are you in a bay with patients as well? How many chairs in the clinic?

2 shifts are give or take 10 hours. For the RN. You have to stay in the afternoon till all patients are gone. Depending on transportation, this could be a wait. Not completely unlikely for a patient to sit in the lobby an extra hour waiting for their ride. On physician round days, my nurses stay closer to 12 hours, charting new orders, making appts, etc. So, 10 hours is a rough estimate.

In that case, you are not doing assessments, you are doing data collection. You shouldnt have to asses heart or lungs. The rn does that. You are just checking temp, edema, asking for shortness of breath, documenting heart rate, and presence of thrill and bruit. The machine will tell you the start time, you can go back and look that up later. I honestly start the tx, write down weight, start time, starting bp, temp and then move on to the next patient. Do your machines not automatically carry over the blood pressure lines to the computer? That saves time, too. On ours, once the bp takes, it generates a whole line of bp, art and ven pressures, tmp, uf removed. Then you can go back to it later and type a note. If youre in the middle of something else. .

My habit is: turn off the blood pump, clamp the 2 big lines on the patient end as I'm about to connect the patient, then immediately clamp the saline line. Clamp, clamp, clamp. Detach the lines from each other, and hook up the patient.

She was kept there so long because the clinic was short on pcts. Its a shame. She had to go to the regional director to get her training started.

Depends on management. My clinic hired a new RN, new to dialysis. She was in a bay for a year before they started training her as a floor nurse. She was a PCT for all intents and purposes. Paid as RN, but still. She wasnt hired to be a pct for a year. I would have left.

Mine took at least 2 months if i remember correctly.

Davita in our area is now using a Mix Master, a tech who travels and mixes acid. There has been way too much waste over the past couple years from PCTs mixing acid while trying to run a bay. It is just too much for them to do, unless they are required to come early or stay late and focus only on this task. Which wasn't feasible with the budget. Mistakes are made, acid is wasted. So they now have just one guy do it. If the Bio med is not in charge of mixing acid in a clinic, the Mix Master comes in.

I was trying to give vanc today through the venous chamber, too. I kept getting Down-line occlusion alarm on the pump. I got so frustrated. I do not care for the Nipro dialysis lines. I ran it through the NS pigtail pre-pump.

Of course they recommended LVN first. They just want your money. I got my LVN there back in 2009. It was only 18K back then, I cannot imagine how much it costs now. Get your ADN if you are choosing. Or, go to WGU and get your BSN. Steering clear of DNI is the best bet, though. Sorry.

The machine belongs to the company but stays at the house. All supplies delivered.

Staff assisted hd. I'm an lvn and i go to the patient's house to do their treatment. It is a real thing.

I'm in Dallas. I started January 2015. We will be done in June. I recommend it over UTA because they care more about work experience, pre-reqs completed(not just sciences), they do an interview to select for placement. UTA denied me because of science gpa. You have to be flexible. Labs are every 3 months or so, on 2-3 consecutive weekends at el Centro. Clinicals are mostly at Lake Pointe in Rowlett. If you have some medical experience you have an advantage. The school work depends, again, on your experience. The classes are hard. It is independent work essentially. You follow the course pacing guide, you keep up with assignments and papers. You take the exam at an ATI testing center. Most classes require an exam and some papers. In total, I think I have written about 12 papers. You can complete the class as fast as you like. Some classes take 8 weeks. I think there were a handful of classes that I did in a week or less. Each term is defined by semesters, so as long as all classes are done in that time frame you are good to go. You can work ahead, pending approval of your student mentor, but ultimately you are still on a 2.5 year program, you cannot finish early, in that sense. What other questions?

I am in a Dallas cohort right now. Please don't shut us down!! lol. But seriously, I agree with the person who said that it is up to the state admission panel to decide who gets in. Maybe they are being too lenient. I feel very prepared to rock the NCLEX, and I still have a little less than a year to go. I notice a difference in myself and my colleagues. There are those who work hard, and those who do not. It shows. WGU gives the resources to be successful, but one has to work for it.

You are correct. You will work as a pct, setting up machines, putting patients on, monitoring them, giving meds. Taking them off, cleaning machines and starting again for the next shift. Then you'll learn how to start the water system, mix bicarb and acid, do water checks, bleach the system, disinfect machines. You'll do medication reviews with patients, do other tasks to help the RNs. Basically working like a dog. Because you do pct stuff as well as nurse stuff. In my clinic the LVNs were expected to function in either role at any time.

I see this is an old post. I have now taken 4, I think, ATI exams for various wgu classes. Psych, CACI, casal 2, probably another one.

That has happened in my clinic before. We would get a wave of really crappy CVCs for no apparent reason. We started using tego capa and it actually became worse. Our medical director actually ordered heparin locks for all tegos. Like I said, no apparent cause. They would run fine for a few treatments, then start getting sluggish. And with the tight control over activase, we couldn't keep enough in stock to properly run our pts. We were only allowed to have 1 dose in stock per Davita. How effective is that??

Home hemo pt of mine is highly sensitive to cannulation. Tried the creams, sprays. Currently uses Id lidocaine (i know). Tolerates the stick okay I suppose. Last 2 treatments he had described burning, tingling all up and down access arm, increasing as treatment ticks on. It has happened occassionally with his last nurse as well, hitting that nerve (i presume?) and he practically jumps out of the chair. It was all I could.do to get the needle.out without him pulling back so hard and prematurely dislodging it. I know he's sensitive, but I also know that there is not much I can do with nerves located at the access. Trauma, looking for your ideas here, what are we looking at? Meeting with surgeon to discuss moving access? Is there any type of surgical procedure that can silence the nerve or something? I can Honestly say in my 10 years I haven't had such a case. I identified "the nerve area" about 2 weeks ago and stayed away from it. But last night I found.another area, same problem. We cut.tx short last night bc he refused to adjust needle or.be restuck. Tonight it went in okay but after about 30x minutes it started creeping up on him and he asked to end tx, again. I asked.him if he thought I was sticking him wrong and he said no, it's just one of those things that happens to him. Thoughts please? Thanks. Let me.add, it is a forearm graft, inner aspect, running horizontally. Arterial distal, venous proximal.

2.5 year program.