MizChelleRN

You'll want to stress your abilities to lead others, to hold your team accountable for policy and procedure. You'll want to emphasize your ability to make smart clinical decisions quickly, how you are in an emergency, and extra attention to detail.

Sometimes "panel interview" just means the manager pulls in some of the other employees (so they can feel you our as a potential coworker!). Sometimes a couple managers get together because we're both hiring and we interview you at the same time and fight over who gets to hire you (!). Sometimes I pull education in to interview with me because the second interview for me is with them, so we cover your first and second interview at the same time. It's just like any job interview. Relax, breathe, take your time and be yourself. You got this!

I'm managing incenter. It's a huge challenge but I like it.

What a great memory, posting these a few years ago. I did end up in management and I love it! It's challenging but I found my niche. Love it.

I was blessed that my employer told me, apply for unemployment, we will not fight it. Just get better. And they were true to their word. Not bragging about it, but I didn't realize that isn't usually the case. Curious to see what others say.

Can someone explain this one to me? Maybe it's dialysis 101 but I honestly don't remember. The details probably don't matter but the patient had no reason to run yellow amp. (Good AVF, long run, 14g, etc) usually set to run even, no fluid gains between treatments. Always had us scratching out heads as to why he still ran yellow. Someone suggested flushing/bolusing to make the UFR >300. Lol and behold, green amp with UFR of 350. I can't figure out why this is? I thought with high flux dialyzers, you didn't need a min UFR. Or was it all just a coincidence?

First, let me say, I LOVE that our subforum is really active lately! I am so passionate about dialysis and networking ideas with fellow nephrology peeps. So.....recently I had a conversation with a colleague. We were trouble shooting ways to get fluid off of a hypotensive patient. We put the usual stuff out there, cold dialysate, uf profiling, na modeling, IUF treatment, etc. And he brought up that the patient was on the largest size membrane, possibly there is too much volume outside of his body, perhaps the dialyzer was contributing to the bp dropping. Doesn't add up to me, but would love to hear your thoughts? Is it significant enough to make a difference?

Oh and I wanted to mention watching what the kecn is doing with those dialyzer fibers clotting off.

This is a great conversation. Not sure either if it "prevents" clotting, but it gives me a chance to clear the drip chambers so I can see what's going on with them. If they are getting thicker, with blood sticking around the walls of the chambers, the saline will wash it out. I like your point with the low platelets, are they really going to clot anyway? And the saline sodium content was a good point.

I've used a continuous infusion to prevent clotting before too. I've seen it hooked to both arterial or venous lines. I prefer hooking to the venous line, bc I figure art line clotting is less likely bc it's so close to the patient. Hooking it to the venous line keeps that venous drip chamber watery, diluted. But it won't stop a clotted dialyzer. Actually I prefer a good hard manual flush so you can evaluate how thick the drip chambers and dialyzer headers are getting. But for time issues, I like the infusion flushes. Plus the patient will not overfiltrate if the manual flushes get missed. Oooooh so that raises this question: do you set your goal pretreatment to include the 1500 cc of saline you intend to give, or do you add 200 to the goal every time you give a 200 flush?

I never want to feel again, what you feel now. It may be the scariest, worst moment of your life but I promise it will produce love, happiness and success beyond what you can dream today. Stop being controlled by your disease. Join the fight and let's get on top of this. Much love.

You can always pop over to Nursing Specialties- dialysis and renal nursing :)

Agree 911 should have been called but honestly she was probably seen way faster the way it actually happened.

Especially as the charge nurse earlier that day rolled her eyes and sighed "ohhhh that patient"....and then went on to come at you like that. Plus you said you and your preceptor were floats to that unit that day. Seems they could have come to you, told you what the patient said, and said just don't bother with that patient the rest of the day. I would have removed the nurse from the case JUST so the patient didn't escalate. Then that's that. If you were a floater, you were probably never going to see that pt again anyways. No need to "add it to your file". Hopefully the note added to your file clearly indicates what a PIA and how non-credible this patient was.

Thanks I needed to hear a lot of these things. I'm a newer manager still trying to find my style.