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Chisca RN

Dialysis
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Chisca has 37 years experience as a RN and specializes in Dialysis.

Chisca's Latest Activity

  1. Chisca

    Is tape considered a restraint in this situation?

    In Tennessee it is as Muno describes. Procedurally necessary.
  2. Chisca

    IV Albumin administration.

    It would help for about 2 hours. You are dealing with a nutritional problem.
  3. Chisca

    Acute Dialysis Nurse Opportunity Dilemma

    If you have a pulse and are a warm body they will hire you. No problem.
  4. Chisca

    New RN over overtime

    Might want to think about plan b.
  5. Chisca

    Acute Dialysis as a New Grad?

    You have to be pretty independent to do acutes as you are called out to do ICU patients. The ICU nurse will still be responsible for patient care but it can be daunting to walk into the ICU setting with no critical care experience. The problem with dialysis, as a nurse, is the lack of any balance between your personal life and the requirements of the job. I frequently have to do 12-16 hour shifts and no one understands that you don't know exactly when you will be home. Clinics at least offer some balance. Acutes offer long hours and lots of call. Pay may be low but you will make up for it by all the overtime. Whether you want it or not.
  6. Chisca

    Dialysis and Diabetics

    Dialysis solutions used to have 200 mg/dl sugar in the dialysate bath that would somewhat protect the patient but now it is 100 mg/dl. For some patients that is not enough to protect them during a treatment. Tell me you gave insulin before a treatment and i will be checking their blood sugars hourly.
  7. Chisca

    Dialysis and Diabetics

    Glucose molecule slightly bigger than water molecule so sugar is easily removed during dialysis treatment. I would recommend NEVER give a patient insulin before a dialysis treatment.
  8. Chisca

    5th e-Cigarette Death Reported As Illnesses Double

    Inhaling heated gases damages your lungs? No way!
  9. It is a blessing you were fired because it sounds toxic where you were working. I am quite aware of my patients lab work and this dialysis knew the labs. I am also aware of any IV access or lack thereof. What happens where i work is the dialysis nurse calls the nephrologist to extend the treatment time so the blood can be given. You were left holding the bag that the dialysis nurse created by their negligence. Handoff from dialysis nurse should have covered lack of transfusion and you should have called whoever ordered the transfusion and informed them of no IV access. Not your fault and if anyone should have been fired it was the dialysis nurse. Hang in there, it will get better. One door closes and another will open.
  10. Chisca

    productivity

    How else can you run a factory if you don't measure productivity?
  11. So in your facility only dialysis units can give blood? No IV access is a MD problem and should have been dealt with earlier in course of stay. Don't see how you are at fault.
  12. Chisca

    Tube feeding and hemodialysis

    Thank you to KeepinitrealCCRN and MunoRN for voting, for the rest of the 311 slugs who viewed this question and didn't respond, why not?
  13. Chisca

    Tube feeding and hemodialysis

    Not specified in the standard orderset.
  14. Chisca

    Tube feeding and hemodialysis

    Postprandial hypotension is a drop in blood pressure after eating a meal. Stomach distension is the trigger as the body shunts blood to digest the food based on this signal. No distension and there isn't a signal. Bolus feeding would trigger the response but trickle feeding does not. If you do hold the feeds during dialysis the risk is a dramatic drop in blood sugar as you are depriving the patient of glucose as the dialysis machine is removing glucose. The glucose molecule is slightly bigger than a water molecule and during a 3-4 hour treatment I have seen sugars fall up to 200 points. If your patient has any liver issues and can't convert fat to glucose the fall in serum glucose levels will be more rapid. European and asian countries routinely feed patients while on dialysis while the US and Canada do not.
  15. Chisca

    Tube feeding and hemodialysis

    Trying to determine what ICU nurses are doing with tube feeds when dialysis occurs. Hold feeds or keep them running?
  16. Chisca

    ‘Hemodialysis Access 101

    Nice little interactive tool designed by Dr Namrata Krishnan to teach nephrology fellows about dialysis access. Enjoy. Hemodialysis Access 101