gollybabbler

There's also the concept of "backfiltration", (paraphrasing work info here) which is the movement of fluid from the dialysate compartment of the filter into the blood, and can occur with minimal fluid removal & when the TMP is low; potential contaminants in the dialysate can be transported across the membrane. This is why minimum UF is used, instead of turning it off completely.

This is a funny thread, great stories. Here's a dialysis one: Had trouble getting needles in; still at pt's bedside, explaining this to doc by saying, "She's a tricky stick," meaning only that the needles were hard to get in. But the pt took it as an insult!

Wow, that's a hard one. I don't know if this is true in your case, but consider your non-verbal communication- it may be that since you are learning, your face does not show the "appropriate" expressions your preceptor thinks should be there, and that may be why she is saying these things about you. I'm not saying you're doing anything wrong, please don't think that, I'm just saying that you may be leading her to believe that you are defensive, etc just by your non-verbals- face, posture, tone and the like. I'm saying this because when I am learning something new, I look mean, but it's only me concentrating on learning. So now, instead, I just smile, and have a kind of light tone, and people "get" me better. I hope this is making sense & is helpful.

Oh, long story short I did not have the skills at the time to deal with the "difficult" people I worked with in IS, but did not realize it at the time, so I was extremely stressed. Now doing acute dialysis, and regretting my stupidity almost every day.

I agree with the post above- it's trading one type of stress for another. I used to work ICU and loved it until I needed a break. Now I'm in acutes, and although the hours are just about killing me, the pace is better than ICU. We are on call from twice to five times in 4 weeks (depending on staffing), all on Fri-Sat- or Sun for now. You have to be really flexible, and dependable too, because the same amount of work still has to be done for the day if there are callouts. And I find myself working alone a lot, which suits me, but it may not be for you. Good luck!

Very good info here, thanks to all. I would just like to add that I've kept track of certain statistics since I started in dialysis (over 2500 patients served!) and the clotting rate is about 10%- we do not prime with Heparin and boluses are rarely ordered. A sister group does not even use Heparin in their catheters any longer.

Well, if you look at the quarterly profit reports, Davita usually keeps improving, and the company keeps growing worldwide, but there seems to be a consistently high turnover for RN's in acutes and chronics. I can honestly say I've never (in many, many years) had such high and regular bonuses as I do now. I don't know anything about Fresenius, except we had a nurse who was wonderful, who left us for Fresenius-not sure why. Let us know how it turns out. Good luck!

From a former IS nurse- Project Management skills are very helpful too. Good Luck!

I'm just wondering if they have a high turnover, if maybe that's why they didn't seem picky- again, no reflection on you. It is very nice to work close to home. Good luck!

Hello- I knew an experienced dialysis nurse who did dialysis-travel assignments all over the country, she even went on a cruise ship doing dialysis. I've never done traveling, but I do in-hospital dialysis, and I can tell you it is a very good skill to have. Be aware that in-hospital dialysis is very different than the chronic setting. Maybe do share days if you are interested. Some units take new grads, some don't. I wish you good luck!

My mouth dropped open when I read your post! I would have the same issues as you do with lifting so many very heavy bags over my head. I'm hoping it is possible for you to fill them less, but then you'll have twice as many bags. I honestly do not know what I would do with this, all I know is I could not physically do it without seriously hurting myself. I'm in pretty good shape, but bad body mechanics is just that. I had a related problem- we had to use a portable RO (for dialysis) that was very heavy and low to the ground so you had to bend over while pushing it up long, long hallways, and it was killing my back. I emailed my boss about it repeatedly because I knew it was just a matter of time before I was injured. Nothing happened, but at least I had it in black and white exactly what the issue was, for what that was worth. I wish you the best!

When patients come to our unit (in-hospital dialysis), we have to put a sign on their bed if they are on isolation. A patient once asked me what the sign said. After I told him he replied, "It should say 'Alms for the poor'."

Oh! Duh! I didn't look at the dates!

Such good advice on this thread for you. I was in the same boat, except I had nursing experience when I started doing dialysis, but I really, really hated it. I told myself I would stick it out for a year, then re-evaluate. Turned out I'm glad I stayed, it's been over 5 years now. I figured out and fixed- not the problems themselves, but how I was reacting to the problems, and my stress level went way down. See if you can find a co-worker that you can use as a sounding board / resource/ helper-type person to get you through the worse days, if you decide to stick it out. Good luck!

Just wondering- some of the patients probably couldn't get there as well. I used to feel horribly guilty for calling out, even when I was sick; but now I know I am not pretending, or making excuses- I am usually very dependable & only call out when I have to call out, so I don't sweat it. It's a sign you are conscientious, though, OP, and that's a good thing.