Farkinott

It's her placenta for heaven's sake. A friend of mine had a homebirth and buried the placenta under a tree in the yard. Weird 4 me but an important part of their spiritual pathway. Who is hurt? Answer is noone! Lighten up! Marc Townsville

I precept new grads a couple of times a year. It doesn't matter whether you have 5 minutes experience or 10 yrs dialysis is a whole new field. I embrace new grads as well as oder nurses that have decided on a job change. If u are keen and willing to learn then u will do well. marc

As I previously said. We always dump the prime. marc

We always "dump the prime". It is only ever returned if the pt is clinically dehydrated or hypotensive.

Try Clexane (enoxaparin)

I worked with a Filiponi nurse years ago and at that stage she had to undertake 8 weeks of supervised practice for no remuneration. I don't know if she ever got her licence. It is easier for others from countries where the study is a lot closer to Australia's. good luck though!

I think male nurses are different because we tend to talk in plain language! I can recall an incident where one of my female colleagues was asking a confused old man if he "wanted to go for a wee?" After watching her vain attempt for about 5 mins I went and asked "hey mate, do you want to go for a pi**?" Instant success! A greater ratio of males does keep the bitchiness on a lower level as well.

I agree with DeLana. It's hard to tell if anyone will like renal work. Two qualities/skills are a must though. You need good assessment skills and need to be a skilled observer.

Our unit rule is 1kg per hour maximum and isolated UF (eg. 1000ml in 30 min) if they are really overloaded! 6% sounds about right though.

Just type kt/v into dogpile.com (search engine) and you should find enough information to keep you happy:nuke:

Thankfully my facility has a zero violence policy. Crap is just not tolerated and the higher ups (by law) have to enforce this policy. As for the infected catheter. That guy will just get sicker and sicker until it is removed. Why don't you just refuse to use it as it is poor practice to continue using an infected catheter especially as the guy has a good AVF. Your medical staff need to grow some balls!

We don't use unregulated staff like PCT's. My dialysis unit is staffed by BSN's only!

Default Re: How are male nurses perceived? "My experience has been that they are perceived the same as females...by ability, not the hardware under the uniform. Your statement about the "very senior" nurse may answer your entire question.....the oldest generation of nurses may have a more difficult time with accepting male nurses, just as some of the older generation of doctors have a problem with women doctors. If a nurse is what you want to be, go for it and don't pay any attention to what she said. Nursing and doctoring are partners, but they are also very different." BRAVO tazzieRn!!!!!!!

My experience has been that they are perceived the same as females...by ability, not the hardware under the uniform. Your statement about the "very senior" nurse may answer your entire question.....the oldest generation of nurses may have a more difficult time with accepting male nurses, just as some of the older generation of doctors have a problem with women doctors. If a nurse is what you want to be, go for it and don't pay any attention to what she said. Nursing and doctoring are partners, but they are also very different. BRAVO!!!!!!

Thankfully if I feel I cannot deal with a patient because i have issues with who they are or what they have done my organisation accepts that and I wil be reassigned. If you loathe someone and can't provide a level of care that you would to any other client then you need to acknowledge that and make note of it to your superiors. As nurses we are human and we need to acknowldege it.

There is nothing wrong with trying a bit of Lasix in this situation. To be honest though the dose needs high! Try 500mg-2g!

It sounds to me like you guys were either putting yourselves under too much pressure or "the system" is not supportive in allowing you to learn. My unit uses preceptors with each new staff member for at least 6 or 7 weeks (i.e. working every shift with them after one or two weeks of being supernumary). I know many nurses with many years of experience in high tech places like ICU and they go to water when faced with working in the renal unit. It is so hard when going from a place where you are skilled and capable to somewhere where you have to learn a completely differnt set of skills. I love my job and love teaching and helping new staff members to get up to speed. The nursing woorld would be a much nicer place if we we all just a little bit nicer to each other and stood up for ourselves and our colleagues.

If the permacath itself is infected it must come out. Nothing wil fix it.

I use the "open" method on all my patients with fistulas unless i am running off in a hurry as I will never be caught with someone shooting blood back into the saline bag. With permacaths/vascaths we always use the "closed" method as the risk of serious infection is so much greater. Overall though, it is up to personal choice in my unit as to whether you run off open or closed with fistulas. I don't like squeezing the bag though due to the inherent risk of damaging the fistula. There should be no need to do this with a catheter due to the lower pressuer in a large vessel

You are just trying to be a safe practitioner. I work for government health and crap like that would not be tolerated! Well.........maybe it would but if you made a stand there are avenues to deal with that kind of pressure and harassment. Stick to your guns! Good luck! Marc

BP, obvious odema, what is the client;s ideal body weight? If they have vomiting and diarrhea play cautious and remove only the wash back. Get an expererienced colleague and talk about your assessment with them. Marc

Over here haemo encompasses a global nursing approach. I don't believe you will be "hobbling" yourself by starting in haemo. If you can pick up skill quickly in an area like haemo you can pick up skills anywhere!

time

We always do an oral and visual assessment of our chronic haemo patients. It doesn't take much to observe them walking into the unit. Are they short winded? Do they have obvious odeama? Many of my clients are Aboriginal or Torres Strait islander and they "hide" the excess fluid centrally or it shows up in the eye orbits, not in the ankles as with caucasians. Also looking at their weight and BP pst dialysis from the las few runs is vital. I never start dialysis unless I am sure my prescription is basically right.

The dear lady could last weeks and weeks depending on her oral input. She is to be admired for making such a strong decision as a life on dialysis (especially for those older people who have lived a full life) is nothing but unnecessary maintenance. She probably has more energy now due to the epo and the fact that (from the facts provided) seems to have peace in her mind. Love her and suppot her but try to remember that death is a natural part of life. Regards, Marc