diabo

Have any of you had experience with neonatal dialysis? I assume it was peritoneal.

Hey folks. At 77 years old, I have retired from nursing and am now living in Eagle River Alaska with my wife of 48 years. 10 minutes from my three grandkids. When I began this thread I was curious about the Tablo system, having never seen or heard of it. I kind of grew up on Baxter, then graduated to Fresenius after starting the inpatient unit in Tifton, GA. Many of my reservations about Tablo have been addressed here. I so appreciate the knowledge and experience, and always have on this forum. I especially enjoy when concerns or questions are answered with such respect and thoroughness. Working in dialysis certainly has challenges, but as it is in most nursing positions, there are patients who are just scared folks and rightly so. Dialysis is similar to hospice in a way. It's basically a terminal situation. By showing genuine empathy and professional care, we certainly help the overall unfortunate state they find themselves in. Thanks for reading my rambles over the years. Keep up the great work. Steven

Sounds like you made the right choice, Marshall. Just be open. There are some good opportunities out there. You are wise to read the fine print. Just try not to get too bored. (:0)

Thank you

Haha. Yes I "backed out the door" quickly, which means I gave a three week notice until they found a replacement. This was in the early 90's. I was in training to be a nurse manager. It was a small privately owned unit and the owner (in his 70's) didn't see the need to implement any changes. He was one of those "I can beat the system" kind of guy. He eventually got closed down after it was discovered that he was running acutes without an RO. Yep using tap water. Always remember your oath for Do no Harm. That covers sins or commission as well as sins of omission.

In the case of a lawsuit your license would be on the line. Be thankful for your training and experience, but don't hold out for changes. Been there. I started at one private unit, and the first day the PCT drew up the iron (Infed in those days) and handed me the syringe, which I refused to administer. She said that she always did that to"help" the nurses. She was about to draw up insulin when I said "Whoa". I backed out the door as quickly as I could.

Well said.

Great care is needed when removing the needles. Since the bevel is razor sharp, even slight side movements can cut the access and therefore greatly increase the bleeding time.

Thank you. Great education

I just looked on their web page. QB-400. QD 300 circuit volume 140 ml. I have no personal experience with the system, but it seems to be gaining in popularity.

They are used in their large acute/inpatient unit. This is Alaska Regional Hospital, part of HCA, one of the nations largest healthcare providers. I don't know what their other hospitals in HCA are using, but I think it's a good trend.

Is anyone familiar with the Tablo dialysis systems? My son is head of ER in a large hospital in Anchorage. He said the hospital uses this.

One week I worked 72 hours in inpatient dialysis. Tough, but I got paid well. We must never forget that “Do no harm” also covers psychological harm. The patients should be made to feel that they are special and not just a routine number. Given their lot in life, they already feel insecure. Always give them your best. They don’t need to see frustration and dissatisfaction from the nurse. They don’t miss much. You need to move on if you can’t make each patient feel safe and special.

I must disagree that OR nurses are not empathetic or caring. There are nurses with that description in all fields. Sounds like dialysis will be a good fit for you. There is plenty of room for caring and empathy. Caring for this population can be very rewarding as you get to know them and their families. After all you'll see them three times a week. Many of these folks live in fear and respect tough love especially when accompanied with a great smile and a generous dose of humor. We need nurse like you.

Obviously an upper arm fistula or graft is out of the question, especially because of the location of the anastomosis. The blood flow should never be cut off for any reason. This includes holding pressure to stop the stop the bleeding, or improper use of clamps. In the latter, blood flow should be confirmed above the clamp. Personally I feel, and many doctors agree, clamps should never be used because of the possibility of damage to the access.