summer4me

Learning dialysis is no different than learning any new clinical/technical aspect of nursing. For most with "letters" by their name they assume the expectation is they must know it all because of the RN ststus. Give yourself a break. IF?? you like the dialysis field, but are having issues with the technologies, be honest with your F/A. If like any job, you don't feel the support or wish to assist to meet your training needs, they have a boss too. Your nursing skills are numerous and each one is another addition to the expertise you will bring to the comprehensive critical thinking skills needed by any dialysis nurse. Learning the basics is a must so you can progress forward... If you are learning better from the 2nd mentor than ask to remain with them because of your learning needs that has nothing to do with the other person. There is no shame in wanting to master the basics correctly & asking to br given that opportunity.

Lidocaine administration should be in your policy & procedures at your unit. Our P&P is 0.5ml-1.0 ml via TB syringe given intradermal like a ppd just under the skin at the avf or avg area you have chosen to cannulate. ONCE the needle bevel is under the skin, aspirate to make sure no bld return and inject at least 0.5 under the skin. Cover with a 2x2 and massage gently for a few seconds. Continue with your cannulation at or very near the injection site. Lidocaine burns on injection so don't inject too slowly. With patients that have been receiving it for awhile the area gets tuff (Scarred) & sometimes you feel you are injecting against a brick wall. We try to incourage pt's once cannultion is not difficult with their access to bypass the lidocaine. We use the emla cream also. We are going to the buttonwhole technique to be able to eliminate the use of either. The confidence you have in yourself with cannulating will come across as you get more confidence. Don't let anyone make you cannulate a new access and observe as much as you can. Listen to the access with a stethoscope also befor you attempt to cannulate. Hang in there. A more experienced staffer or trainer should be assisting you & a nurse shoulkd have taught you this. It is unfair for you to be trying to figure this out on your own. Hope this helps.

Dialysis nursing is a speciality, & it has been said by many, you either love it or hate it. It is one of the hardest jobs in nursing there is but to me it is also the most rewarding. A good solid meg/surg background with ICU/CCU/ER skill set is needed but with a great training program, your professional growth can soar Any nursing job is as good as the team you work with & the attitude you carry, not just in dialysis. As a manager, I have found nurses who stay, love the aspect of evaluating the whole patient. They do not get hung up on I'm a nurse I should know this when just starting. The expectation should be that of show me, teach me so I can be an asset to the team. The technical aspects of the machines can throw some nurses and they don't give themselves time to grow. A nurse that can be a team player & mentor PCT's do well. MANAGEMENT is responsible to clearly define the expectations of the team and AND ASSURE that it's clear that no one is more important than the other. To make sure "the wheel turns w/out any cog's to break down the team and ensure that each staff member is made aware what makes them important to the whole process. Anyone thinking of going into the dialysis field, I would strongly recommend going to a few different clinic's and observe for a few hours, especially during peak times. Hope that helps

For thise interested, you might want to check the figures on who & how many units & patients of fmc & davita. Been associated with all 3 & Davita by far is the best.

Associates degree nursing (2 yr degree) go to school 2 full year round