sherryg0

this is probable too late but here goes. I love dialysis because I can utilize my skills with cardiac care, pulmonary care and nephro care with a physician who appreciates this. I am expected to help with the difficult sticks and evaluate possible stenosis. Our unit comes with piped in Bicarb and Acid so we don't have to carry 5 gallon jugs with fluid in them. I take call on the weekends but never have to work past 8p.m. I usually don't do poop patrol but will if necessary. It is an infection control issue in a closed unit with patients only separated by a curtain. I must understand the lab results and when to notify the MD so my critical thinking skills are always a plus. In PACU (which I have also worked) you may get a good physician and you might not. At least in dialysis you usually work with one or two who know and respect you. In Texas where I work, the state regs determine nurse to patient ratios and are strictly followed. These are SAFE RATIOS. In PACU they may or may not be followed. So here are the pros and cons as I see them. Feel free to pm me for particular info.

I am from Texas and our regs will not allow more than 12 pts per RN with 3 techs for this many patients. Less techs = more nurses. If the clinic were to fall below this and was visited, they would be out of compliance.

I just have one question? Are you a fairly new nurse? If so, study, study, study. If not, call on your experience. You KNOW you are a good nurse. Your previous patients tell you so.. First you must learn to string the machine and then you learn about the patients. The phoenix is just another machine. Try to memorize the steps and then complete them in order checking as you go. I think your PCT is trying to hurry you.. DONT let her. Take your time and do it right, The speed will come with time. I am a DON in a dialysis unit and have been in dialysis two years. I did acutes for 1 year before coming here. I've seen nurses that made it and some that didn't. The ones that did used the above to help them. YOu are in training. Take your time. It should take at least two weeks to get the stringing down. Do you mind me asking what state you are in? Sherryg

My experience was with my Mom who is 66 years old and has poor circulation in her legs. She had a episode of severe pain in her right leg with loss of pulse. My sister and I took her to the hospital where she was evaluated by an RN who confirmed that she didn't have a pulse in her right leg from the knee down. She was seen by a doctor in the ER 3HOURS later. She laid there in excruiciating pain without any pain meds. As soon as the doctor saw her she was rushed to XRAy for an angioplasty with stent placement. Which leads me to my next question. I am a traveling nurse who has been offered a DON postion 900 miles away from my mother. She gets around pretty good even with emphysema, but I still worry. I know that a career is important, but she won't move in with me or my brother preferring to stay AT her own home. Any thoughts?

Dear Picc chic: What a great name! I am in central Arkansas and would like to know if you know any Picc certified nurses in this or any surrounding states. Thanks for the informative posts. sherryg

In my state you contact your local insurance agent. If you have car or house insurance, he can give you a quote since you are already a customer. Thanks Sherryg

Dear Retired: I have done the leg work of becoming an independent, but I haven't had any luck promoting myself in my area. Do you have a sample letter that you send out or do you contact each nurse manager directly? Thanks Sherryg

Dear neph: I also work in an acute setting where we have one Prisma machine. We have had numerous problems with it (computer wasn't functioning correctly, etc) which clotted the catheter where we couldn't give them their blood back. The nurses in the units were very reluctant to attempt to run them after we went home on call. WHERE do you give the Calcium chloride back if you use citrate as a anticoagulant? We have a Quinton with a third port and was told by the Prisma inservice personnel to put the Calcium chloride there; but when I called the help desk about multiple clotting (which was the machine by the way) I was told that this is not recommended. VERY frustrating. NEED MORE INSERVICES. These are slow in coming from the gambro company Sherryg

Dear Wyoming: What group will help me become independent in California or Arizona? Is there a collection of nurses that are independent connected by membership to any organization? Thanks for the reply in advance