sunfirebsn

The most important thing is to take the time to assess the fistula/graft carefully with your fingers and stethoscope before you put the needle in. It pays to take a few extra minutes doing this instead of spending 20 minutes fixing a bad needle or having to stick the patient 3 times. Pick your spot and make sure there is enough space to advance the needle in (usually 1 inch needles). You will get better with experience, but always remember that everyone, even if they have been doing it for 20 years has difficult cannulations at times!

There was a patient in a clinic I worked at who was on a 1K bath for at least 3 years, she is probably still on it today. Her K was normally over 6 with labs. Under 6 was a miracle! Dietary education from everyone was no use.

You would have to check with the clinic you are working at to get your full scope of practice, they should be able to provide you with a full job description. Rules are different depending on company and state you are in. Where I am work, the LPN we had could not give IV drugs, take MD orders. She could give PO meds, assessments, charting, and other things. Hope this helps, good luck! :)

The dialysis machines can be very intimidating at first, it just takes time to learn them as with anything. It takes about 6 -12 months to feel comfortable in dialysis which is definitely true! There is a lot of new information that just takes time to learn and put everything together. Any good company should have a training program to make you feel competent. I would not think they would send you into a hospital (acute treatments) until you have a good amount of experience. A dialysis clinic in my opinion is A LOT better than working at a hospital (Daylight (no shifts), Sundays off, you get to know the patients, not as stressful..etc). Having critical care experience is a plus for dialysis nursing! I don't know why that person would tell you how much it costs to train a person, that is not your concern (that sounds quite extravagant also). Shadowing sounds like a good idea as the previous replier said. Good luck whatever you decide to do!

It is definitely possible to get hired into dialysis without any experience. I would say it would be best to get a little hospital experience first, since there can be critical issues in the clinic at times and having some experience can help you there. I know an RN who went right into dialysis after graduation and has been there 4 years now. I worked on a hospital floor for 5 months (granted not a long time) and then went into dialysis and have been there over 3 years now. Is the renal floor you referred to acute dialysis? If it is acute, they would like dialysis experience since patients in the hospital are sicker and more fragile and sometimes you are on your own in the patient's room. If you do get into dialysis it will take you 6 - 12 months to feel comfortable, don't stress out! It is a lot of stuff to learn that takes time to understand! Good luck to you!

Hi, I am thinking of relocating to the Reading area for a job, more specifically the Reading Hospital. I was wondering if anyone knows anything about the area or currently works there? I have read some things that say crime is a big problem there and it's dangerous to live there :uhoh21: Any input would be appreciated, thank you!

When patients get a temp cath placed at the hospital and come to the clinic for dialysis there is usually some blood on the dressing. The next few treatments they usually have some dried blood on their dressing and around the insertion site. I think temp caths are in such an odd/uncomfortable position for the patient and I think moving around/moving the wrong way and the way it is taped causes it to bleed some. I have never seen one constantly ooze though or had to get another stitch put in. If it keeps oozing I would think IR would want to re -examine. You could ask dialysis to put some sterile gauze under the catheter dressing to hold pressure. The good thing is temp catheters are not used very long before they want to put a permanent one in.

I would definitely go with the Littman brand, I have used other cheaper ones at work and found my Littman to be sooo much better. I have never used an Ultrascope though. Don't forget to get an ID tag for it and don't set it down for too long!

Look into the UPMC hospitals...I believe Shadyside has a nursing program. West Penn Hospital & Ohio Valley as well. Good luck!

We currently use 1:5000 unit strength Heparin for the catheters, used to use 1:10,000 unit strength until a few months ago after the Dennis Quaid baby heparin issue and then I guess some of the 1:10,000 vials were recalled so our clinics switched to the 1:5000 to prevent any problems.

Hi all, I have been working happily (usually) haha as an RN in Dialysis for almost a year now and this question popped into my head. We have a small clinic, so this gives you a chance to really get to know the patients, which I enjoy doing. They are all so sweet and think they enjoy talking with us and telling us about their lives. Sadly, I think some of their conditions may be declining in the future, so I was thinking about these questions. Do you think it is appropriate? and have you gone to a patient's funeral/viewing and what did their family think? I know a year isn't a ton of time to know somebody, but I think I would go. I don't know whether some of my co-workers would go or not though, probably stating they wouldn't think it is appropriate. I just think in this particular field especially it's hard not to form a bond with the patients. I am curious to see the responses to this so thanks for your input!!! :bowingpur :biggringi

Hi, I took my NCLEX on the 12th of this month and passed with 162 questions. I was expecting it to shut off around 75 or 100 like what mostly everyone I knew was getting & passing with. So, I was beginning to feel a little frustrated after 130 & thought I was gonna get 265. I can't study for weeks for tests, so I didn't change my ways. I studied things that I needed refreshed on for a few days before my test and guess what?? I maybe got about 2 questions dealing with what I had read over! I think there is a thing about studying too much stuff, I know I wouldnt be able to keep it straight or remember half of it. I had ALOT of prioritizing questions & probably only a handful of math & med questions, the rest of them basically felt like what the ?? there are 2 right answers here!! lol I know people who have passed & failed with 265 questions, so it's unpredictable i guess! I'm sure you did fine! Good luck!!

Hi, I took NCLEX for the first time this month on the 12th and passed with about 162 questions. Alot of people I know who passed had about 75, so I thought mine would be shutting off around there or around 100. So, I thought for sure I was going to be in for the whole 265 deal. I did good in school on tests, just nervous about the big one. Someone I know passed recently with 265, although someone else failed with 265, so I guess it's hard to judge. I found out only 48 hours after by looking on the web. I would say though, the less questions you have the better. I'm sure you did fine!! Good luck!! :)

I am currently in my first job- been there since February, and I'm going to put my 2 week notice in tomorrow. It is on an ortho/neuro floor which has turned into mostly med/surg at times, which is want I didn't want to do after graduation but wanted to get some experience and thought I could do it for about 6 months. Well, I came up short of my estimate that I could last, but that is fine with me. It is way too stressful for me to be worth it. I am lucky when I am able to eat there. I have felt the supportive environment decline the longer I've been there and that is sad. I can't wait to actually have a job that I will enjoy going to. What I really want to do is dialysis, and am trying to pursue that path now. If that doesn't work out then, maybe I'll be delivering letters to a mailbox near you!! :stone which doesn't really sound that bad! :)

Hi, as a fellow GN that graduated in December as well and started work in February too, I feel compelled to reply! I am working on a ortho/neuro unit in the hospital where I went to school at, and it is pretty overwhelming!! We do not deal with monitors or intense cardiac stuff, but it is still stressful!! I can tell you that all my classmates that I graduated with (that are in diff areas, cardiac, ICU, med/surg) have all felt overwhelmed/scared at least at some point! I think it is totally normal! Everyone experienced that I have talked to says it takes about 6 months- year to be comfortable and even then there will always be questions to ask! I see things now, even simple things that I never did in school, might be a little nervous, but ask about it and then do it and it usually wasn't that bad. I know when it gets busy it's hard to think sometimes. I would talk to your preceptor about your concerns and see what advice she has. :) Not to cast a negative tone, but as for me, I want to try to get into dialysis-- which from people I talked to who do it is less stressful which sounds good to me(although less $$, but at least better scheduling too-- 7 day stretches stink )!! Well, hopefully you decide on whatever is best for you!! Best wishes & good luck!! :cheers:

He he he..thanks for some laughs!! :chuckle :chuckle :chuckle :roll :yelclap:

That is what I told some of my pts on ortho about the SCD's NurseFirst! lol Some of them agreed it was like a massage and others said like a BP cuff around their legs! I have seen SCD's & TEDS used alot together where I went to school on the ortho floor. Some complained their legs were hot and felt itchy when having both on. The pts didn't usually complain alot about the TEDS, probably the SCD's more. On numerous times, I would find the SCD's on the bed or floor not attached to the pt., sometimes it was a case of not being reattached or the pt refusing to have them put back on. Guess it depends on the pt!

This is just the post I've been looking for!! As a recent new grad, I have talked (to a person when fortunate enough) to different hospitals' HR departments and have mostly experienced the same thing, answering machines machines machines!! and waiting days to a week for my call to be returned. I understand it takes some time to get everything organized but sometimes it makes me wonder if there is a shortage, because they don't seem to be in a rush to combat it. No one has ever been rude thank goodness but the whole waiting game gets old. You know sorry I just want to work at your hospital! I guess it is like that at other places too. Well, I feel a little better now! :thankya:

Hi, I don't know how much my words will help you since I am a new grad (GN) as well, (I'm not sure if you mean GN rates or new grad RN rates, but anywho ) I will share with you what I have come across so far. I have talked to several hospitals in the Pittsburgh area and they were all concrete on their hourly pay rate for GN's, of course I have heard their pay rate for RN's is dependent on experience. One particular hospital had an evaluation in 6 months & a pay raise, then again in another 6 months, then yearly after that. The sign on bonus was not tremendous, but the benefits sounded good. I did not hear anyone in my graduating class talk about negotiating with hospitals, I think most of them took what was offered straight up. The hospital I believe I will end up at (for experience then hopefully to a specialty area quickly :uhoh21: ), has a higher pay rate for GN's, good benefits, and no sign on bonus. Another thing I have learned is HR depts. seemed to be staffed by answering machines and the occasional person. he he Well, I hope this jargon makes sense and helps you out!!

Hi, I don't know how much my words will help you since I am a new grad (GN) as well, (I'm not sure if you mean GN rates or new grad RN rates, but anywho ) I will share with you what I have come across so far. I have talked to several hospitals in the Pittsburgh area and they were all concrete on their hourly pay rate for GN's, of course I have heard their pay rate for RN's is dependent on experience. One particular hospital had an evaluation in 6 months & a pay raise, then again in another 6 months, then yearly after that. The sign on bonus was not tremendous, but the benefits sounded good. I did not hear anyone in my graduating class talk about negotiating with hospitals, I think most of them took what was offered straight up. The hospital I believe I will end up at (for experience then hopefully to a specialty area quickly :uhoh21: ), has a higher pay rate for GN's, good benefits, and no sign on bonus. Another thing I have learned is HR depts. seemed to be staffed by answering machines and the occasional person. he he Well, I hope this jargon makes sense and helps you out!!

Hi all, I just recently graduated from a diploma program this month and I"m still trying to decide where I want to work at, I know it is a little late. Most of my classmates are doing med/surg even if some of them don't want to. Med/surg has not been my favorite area, the patients were great but the stress was greater, I realize every job is stressful though. I think I am more anxious and nervous than anything if I was to try that, I only went up to 4 pts. a few times and thought that was enough! lol :uhoh21: I know most people I talk to say do med/surg for 6 mths. or 1 yr., but I don't think I can. Two of my classmates are going straight into the ICU & CCU, I can't imagine that! So, the areas that really interested me through school were OR and dialysis. I always thought the OR was interesting even before school. Even though we only had 2 days of the OR, I thought it was neat & blood & open organs didn't bother me! We spent a few hours at a dialysis clinic, I think I liked that since it was less of a hospital setting and the nurses seemed less stressed (it probably went crazy after we left since it was calm while we were there!). Also, my friend's sister graduated from my school a year earlier and was working there, I talked to her about it on several different occasions and she loved it (she told me that she did not want to do med/surg either after grad.) SO, here are a few questions I pose: What other fields did anyone go into after school that weren't med/surg?? Is it possible to be hired as a GN into the OR (I have heard it mentioned that they do in Pittsburgh) or Dialysis (chronic I suppose, since I gather acute is more for the experienced??). Any other comments about OR/dialysis or just any general advice would be greatly appreciated!!! :) Sometimes, I wonder if nursing was the right choice, I have been told I will do fine, but since I am having a hard time deciding right now, I'm just not sure anymore. Also, this may be a duh! question, but after you graduated did you feel like you didn't know enough? lol Again thanks for any advice ( hope to get some at least )