silverfoxxy

What are current FMC policies now, Davita policies?

How long and what type of training is given to those with no dialysis experience?

How else could one get a copy of this manual that is put out by Amgen.

TBRooks. When returning blood you can let the saline return on its own or with your hand, squeeze the bag. Not sure why some do it, guess they figure it is time saving. Are there parameters i.e. BP will be 20 pts higher when you return blood?

Take a look at their financial reports that will tell you something!

want to know more about how fmc looks upon epo dosing. and, other companies.

What are the various policies on epo dosing .. As of April 06, monitoring of epo by CMS will be when hgb is 13. Am curious how various units are monitoring? Is BP evaluated when dose is increased? Who determines when to decrease epo amount? FMC policy? Davita policy? Thanks.

Nephro: You sound like you are certainly seasoned and your education is appreciated. All patients have draws done on Monday and returned on Tuesday except for the afternoon shift which the post labs come back on Wednesday. Thank you again

What are your standard procedures for when a patient's URR drops, let's say, ten points from 73 to 63 in a month. What I don't quite understand, as well as many of my corworkers is that if this pre/post lab draws monthly are done on one day how can that show the general monthly value overall, isn't it for just that one day? So, let's say on Monday they are drawn would that result be the same as one drawn on Friday of the same week? Also, the 2008K machines one can see the Kt/v which when compared with a blood draw for that same day, there is often a difference i.e. machine 1.3 lab 1.0 Just curious what your facility does to increase patient's URR... besides increase time or bfr. Thanks.

I can not understand why some units use the same bath on every patient. To me, this is not individualized care and all patients are being treated the same without due consideration of what their K+ levels might be. So, if a patient's K+ is 6.4 or 3.0 they would both receive a 2K.. For me, I think that is not ok, not at all. Patients have enough difficulties and ot have to be even more careful with their K intake when the bath, for instance is not coinciding with the levels just is not ok. Just my opinion! Even new to dialysis, it still does not make sense.

What about contracting yourself to one of the larger i.e. FMC, DaVita? You can ask for more money and pay your own insurance and benefits. Might work. Have met alot of traveling nurses and they love it as they have said they do not have to put up with the BS that goes on in the units. One told me that she tried to direct techs in doing procedure correctly and telling techs wrong dialysate bath but the attitude was 'who cares'. Have heard alot of negative stories of units from traveling nurses (who left for that reason).

Thanks Amy and Nephro.

This particular patient, over a year. But many patients are not educated for many reasons, as well as staff not being able to take time to provide full education. Many patients (older individuals) might not understand fully details. Patients who are asked questions like 'do you want me to flip the needle'? when they do not even understand what flipping the needle means or when it should be done are placed in a situation they should not be in often. As rushed as we are many can not take time to educate.

I would also like this information. One of our patients had slight pain in the area of fistula during dialysis. One tech suggested flipping the arterial needle. I was surprised as the tech asked the patient, "do you want me to flip the needle?". I wondered why the tech did not further explore reasons for the pain or explain the patient about flipping. How can a patient answer a question when they do not understand procedures? I want to know as much as possible in order to educate.

New to dialysis. Squeezing bag referring to fistula not cath. Some staff have said ok, others say learned not to squeeze. What causes BP to be elevated after return of blood when BP good during treatment? Like to get others opinions as many in units do not have alot of experience and are new.