Loveyourkidneys

In texas that is against regulations.

It's hard when they have no insurance but their addiction keeps them from working. Another FAIL of our healthcare system.

Thank you.

Where would I direct someone who had a family member finally agreeing he needs inpatient rehab for meth addiction? He is 35 with no insurance. Thanks you for any advice or direction.

Why not the rolled gauze? Never heard that so I'm curious. We have two hero grafts at our clinic. Maybe I'm doing it wrong [emoji37]

If you have supplements like nepro (like ensure for renal pts) give them that. Protein and sugar in it. We also have popcicles in fridge and candy. In reality you most likely aren't gonna have a lot of "groceries" in an out patient clinic. Well unless you work where I do where one of the techs keeps it all in the fridge and cooks her meals there. Lol We do have a glucometer in clinic for sure! Depending on type of glucometer depends when you QC them. Our policy is when you change solution or strips (which I change together and throw out together 90days after opened) or the meter has been dropped or its suspected it might need it. I typically do it weekly.

We do weekly hgb and pt/inr (if on Coumadin) Bimonthly hgb calcium and phosphorus Monthly Cbc with diff, cmb,alt,ast, tsat, urr, glucose, hepb antigen Quarterly tsh, hgba1c, Pth,ferritin hepb antibodies Annual includes a few others I can't think of. Aluminum is annual and psa on men over 50 We draw our labs routinely on second tx of the week Our new pt admit includes all routine annual lab with hepb core Chart that you told patients to bring meds and they didn't. :) We do access flow tests the tx after monthly labs. That way we don't forget them. And we can compare urr and access flow drops. Our doc does foot checks on rounds. By that I mean I check them he documents. I am very spoiled to that! Our dietician is the only one to open a care plan the. We fill in our parts and print it out for signatures. Oops I just realized you said Fresenius people. Lol. I work for us renal. But that's how I do it. :)

Texas regulations: charge nurse can have 12 patients. Not sure where 18 is allowed?? That is too much

Stay out of the coil when cannulating and don't let their bp bottom out or it will clot. NEVER EVER EVER EVER CLAMP ONE. EVER!!!! They have this as a last option. Take the time to hold sites.

I have been working in dialysis for 5 years and I in no way know it all about dialysis. I learn something all the time. But I'm inquisitive and need to know the why behind everything. I personally wouldn't want a manager who didn't know anything except "book info" about dialysis. It's a real art learning it. No degree can teach how it really flows out there. I definitely think a manager should be a competent safe floor nurse first, then charge nurse then manager.

Just wondering if anyone knows specific amphetamines that dialyze off. They have a short half life right? So maybe it's just "time for a fix?"vitals are WNL start of tx or possibly a little high. 3 hrs in... Bp is off the chart and non responsive to clonidine.

We have a fairly new patient who tested positive for amphetamines in the hospital but denied it. Lately she comes in fine but 3hrs or so into treatment she gets ridiculous acting nervous and jittery and wanting off NOW. QUESTION: Can we be dialyzing drug off and forcing her body into withdrawal??

I work at an outpatient dialysis clinic. We have two huge bulletin boards. I like to keep them cute yet educational. (12yrs in preschool before nursing school) any resource ideas?

Report and redness or pain. You should listen before sticking EVERYTIME (however it rarely gets done in the real world) report any hand numbness or pain on access arm (although it isn't alway abnormal) report excessive post tx bleeding for more than 2-3 txs. Arterial side should always sound louder than venous side. If you can't tell which side is arterial occlude at the anastomosis and then listen. Venous should be almost absent bruit with occlusion. Tourniquet should be used with fistulas. Always alway always butterfly tape your needles down. And never allow PTs to cover the access with blankets. They will gripe and whine but eventually comply. Chart EVERYTIME you ell them to keep it uncovered if they are one of those that cover it. We coded a lady should dislodged her venous needle. Charting pt education about keeping uncovered saved our tails :)

It's says a lot about your work ethic which your coworkers appreciate.