I became a single parent in 1989 I finally left an abusive marriage, I was now going to move on with my life and follow my dreams. I always wanted to be a nurse as we often referred to ourselves in 1989, we were also called RGN's in the UK which meant for my American friends Registered General Nurse. Now shortened to RN! I dunno what we will be called in the future!
It was ageist at that time I was 27 and was considered very old to be training as a nurse, the average age was 20yrs old. I was the only parent in the group! We had two male student nurses in our group of 20, it wasnt all that popular to be a male nurse in the UK, I still think that there are far more male nurses in the US than the UK. In those days male nurses were seen as career RN's who would only climb the career ladder rather than be ward RN's, they would progress into management very quickly.
The truth is having a child and working as a nurse is difficult and nobody should go into it lightly without a lot of soul searching and questions.
You have to have excellent child care and back up in place. For me the safety and security of child care was the most important thing in my working life, but at the same time I was rare in those days to be a working single nurse. There were no considerations given to you if you were a mom, you really had to apply yourself to work harder and prove yourself. I felt I had to outshine the single girls because I was a mom and I was expected to be a burden.
You would hear comments about other RN's who had children for example 'Why should they have Christmas Day off because they have children, everybody loves Christmas day off'
For 19 years I never ever asked for Christmas Day off, if I given it then I was very grateful but if I didnt I would suck it up.
I have carried with me for 21yrs the fear of asking for Christmas Day, just incase it was thrown in my face that I wanted special consideration because I had children.
Of course we had Christmas but it wasnt always the 25th December, and we enjoyed ourselves thouroughly.
Many of my collegues didnt even know I was a mother, we hardly had anytime to talk we were so busy. If you were seen to have any down time the 'charge nurse' then called 'Sister' would soon find you something to do somewhere. So even if you didnt have anything to do you would make yourself look busy.
Home life was scarce but we packed in as much as we could.
In the Uk we had fantastic vacation time even as a student nurse 7 whole weeks, we worked full time on the ward and studied or supposed to in the evening! We had exams and papers due in every 6 weeks and you could only fail once the second time you were out!
I do feel my son missed out on me being an RN I didnt have the same time or energy at home that I displayed at work.
I did remarry to a wonderful man but I remained a single parent because my husband was in the Navy so was deployed a lot of the time. So childcare, afterschool care continued.
The stress of being a parent and a nurse is unbelieveable, everytime the schools are on vacation I panicked worried about how I was going to manage to work. Then every cough, cold and fever I would worry if it was going to last days and I would have to keep him home.
I always made sure he had the best of everything, and for many years I was lucky enough to have a self employeed mother who would help us out in the summer.
I want to share this poem my son wrote to me today I am so proud of him and it made me feel better after the punishment and guilt I have put myself through the last 21 years.
To My Mum I am sorry!
Our time together has been quite rough
In fact its been a ride
Our love for each other is quite tough
But ill never leave your side
I allways wanted you to be proud
Ill do anything to make it happen
We may scream and shout so loud
But it hurts me and im deeply saddened
I don't mean to be the way I am
Ive really tried to change
Ive tried so hard in every way I can
It hurts from my heart to my brain
Please forgive me for the things I have done
Because I will allways love you my beautiful mum
Ive never held anything against you
Ive never ever felt bitter
I have so much love for you
And for dad and my sister
I just want the best in life
For everyone that I know
I love you and never though twice
Your more beautiful than the snow
I never want to hurt you again
Im so sorry for the past
I promise you that I will change
And we can set that in a cast
Please forgive the things I have done
I just want to move on with you as my mum
As I sit and write this for you
Its pains me deep inside
I can feel the tears pouring through
It been a rollercoaster ride
I made bad decisions as a little kid
I didn't treat you right
Im so sorry for the things I did
I just want to make things allright
I don't really know how to grow up
But im trying every day
Sometimes my feelings they blow up
Im sorry I was made this way
Please forgive the things I have done
I love you with all my heart and soul because you are my mum
Written by Ben ******* 22/12/10
QUOTE=jdub6;8720120]Oh good, renal/dialysis is my weak spot for sure. I have tons of questions...trying to think of what I need to know the most...
1. Can you describe the dialysis procedure, what you do when the patient arrives (assume outpatient unless you don't know about that) until you send them off
This is a huge question, one that takes about 6 hours from start to finish-When a patient comes to treatment you would do vital signs, the RN would do head to toe assessment looking for signs of fluid overload, they would be weighed and the target amount of fluid calculated. Arm if fistula is used would be cleaned and needles inserted, pt's prescription would be dialed into the dialysis machine and then the lines would be connected and dialysis commenced. Pt should be monitored every 30 mins vital signs taken, access site visualized at all times. Once tx has finished the patient is disconnected from machine, needles are pulled, access is held until hemostasis occurs, then the sites are covered with either a bandaid or gauze. Pts vital signs and weight is taken and pt is discharged home.
2. What is ultrafiltration and why/for whom is it used?
Ultrafiltration is defined as controlled fluid removal by manipulation of hydrostatic pressure. Ultrafiltration in dialysis is the removal of sodium and water from the blood. Dialysis patients have ultrafiltration; some of the patients need more fluid removal than other patients.
3. How do you access an AVF? What type of needle do you need? Is there a difference between the venous and arterial access equipment? Are the venous/arterial access points all in the same place each time and if so what landmarks do you use? What are things that would be indications of problems, reasons not to use a fistula or to stop using it, etc.? What would you see in a fistula that is clotted? Any considerations for the first time you use a new fistula?
You access an AVF with fistula needles; there are different size needles used on average a 15 gauge needle is used. Needles have blue and red wings for venous and arterial identification. Where you place the needles depend on what method of cannulation is being used. Each treatment the AVF should be examined looking for signs of infection, feeling the AVF for thrill and listened to the AVF for the bruit. If there is no thrill or bruit the fistula should not be accessed as absence of these could indicate the fistula is clotted. Lots of considerations for first use of fistula-experience technician, one needle, size 17 gauge needle, lower blood flow rate.
4. What do you dialysis nurses consider to be the best/easiest form of access to use (which type of catheter, fistula, etc) and which type or protocol of dialysis is best and easiest for you and the pt?
The best access without question is the Fistula. I don't understand what you mean about protocol
5. When people refer to arterial and venous ports/needles for dialysis, and when we see what I think of as a typical dialysis cath with two lumens, usually one red cap and one blue, are those lumens or (or needles for a fistula) actually one in a vein and one in an artery? My impression is that fistulas are mixed arterial/venous blood. Honestly, I don't know exactly where the catheters end. Do the red and blue caps indicate arterial and venous, as in other parts of medicine? And, again, does the arterial port/line actually end in an artery, or a vein?
Catheters end in the heart. Red and Blue in dialysis indicate venous and arterial
6. Can you explain how you use the catheters i.e. do you flush them prior to access and if so with what, which port do the inbound and outbound/return lines go to? After use, how do you flush the lines?
There is a whole process for using catheters, and accessing catheters. Many steps are involved, what in particular do you want to know about accessing them although it may differ from company to company. In bound and outbound lines are really called venous and arterial lines. The venous side of the catheter attaches to the venous line and the arterial-to-arterial line. The arterial line takes the blood out of the body to the dialyzer (kidney) and the venous line returns the cleaner blood to the body. After use you flush the lines with Normal Saline