thelittlenurs

I read them now , but it is still not clear to me whether the patient should not be receiving EPO due to uncontrolled hypertension or just held if the patient has a high blood pressure episode. I have a patient who comes in with high bp consistently and stabilizes toward the last hour of treatment, I give it then, but would this mean he/she shouldn't be receiving EPO at all? The nephrologist and NP are aware that this pt comes in with high BP btw.

Thanks for your reply! We have these flimsy crappy stethoscopes, one for each machine, I am able to hear bruits well and lung sounds, but for some of the more obese patients I can barely hear heart sounds. They don't want us to use our personal stethoscopes for infection control purposes. Yes you're right I need focus on my nursing skills as an HD nurse. I was surprised to see that our previous charge nurse was running the Vancomycin infusion fast !!! Im like have you heard of redman syndrome??? I realized some nurses do not have experience in other areas of nursing but I'm sure administering Vancomycin over 60 minutes was a question on our nursing board exam. Also, I haven't found a policy that states Epogen should be held if BP is high, do any of you know where I can find the literature about the effects on blood pressure from IV Epogen administration?

Hello all, I am a HD in an in-center dialysis center, I have been working in HD for 8 months now and feel that I'm doing well for a new HD nurse, still I know many challenges will present themselves. Anyway, what are some of the challenges you experienced nurses see with new nurses and some of the mistakes that should be avoided??? I forgot to clamp the saline bag once and never did it again, of course I was rushing to get patient on that time. I'm past the point of making careless mistakes and up to speed with machine setups and put on/off times. But I just know that as soon as I start to feel like I have an easy job, I'm proven wrong.

Thanks for the response! So a medication nurse /team leader is responsible for pre and post-assessments / prescription treatment verifications, giving all meds for patients (about 8-14) and putting on CVC patients. My techs are wonderful, they are experienced, once in a while when they are falling behind I step in and help with returning blood, taking out needles or holding sites.

So , I requested a transfer to a different in center hemo clinic . I work for one of the the big two. I started as a bay nurse (4 patient pod) in Aug 2016. I was rushing, and I would leave home sweating and with a sore back. I even had 3 sessions with a chiropractor. I was basically a tech, oh and taking out the biohazard containers , which meant lifting, I was so unhappy, but I am glad I requested a transfer to be a medication nurse. It was a great move , I have now been at my new clinic for a little over a month and it's so much better. However I am glad I got experienced in cannulation and setting up machines. So, for many of y'all who run a "bay" and don't like it, there are other roles out there for you. It has taken some adjusting to, as they run the clinic differently than the previous. I am so happy where I am and who I work with too. I feel like a nurse again. I am in some ways intimidated with this new position as I my role is also to be a team lead. I have begun to review the training I received when I started, I want to feel confident that I can resourceful to my techs and patients. Could you guys suggest which nursing organizations I can join and any other tips you have for a new teamlead/medication dialysis nurse?

I am an new HD nurse , just got off orientation this week :) During my training, I had a patient who was uncomfortable, her back was aching and she wanted to reposition herself, she asked me to put her legs down to do that and I thought I was helping her by doing that . Well she started feeling short of breathe, I asked her if she wanted oxygen and went and got it. I let my preceptor know about her complaint , so she goes to see her and noticed legs down. She quickly acted and had me lay her supine , while she gave 200 NS bolus. She explained putting her legs down caused the BP to drop. So now that I'm on my own I recalled the situation , but I still am not sure and I'm hoping someone can answer this. When is it okay to lower the legs? Is it good for when the BP is high and is it only ok to lower the legs right after you return the blood???

Thank you for your reply and the advice! I am nervous and excited at the same time. I have been told it is a very fast paced nursing job and I'm not scared of hard work , I just want to be safe and efficient. I'm in the Houston area, the demand for hemodialysis is high, there are not enough clinics to cover the need. The position I applied for is for 14 hours x3 days a week.

Hello, I am interviewing for a HD nurse position with one of the big two. I don't have dialysis experience, my question for you dialysis nurses is how to get organized with having 12 patients? Any words of wisdom for a nurse starting HD nursing?

I hope not, I am available mostly on weekends and this is a Saturdays-only case. The manager mentioned they don't have many nurses available for weekends.

I am not a new nurse, sorry forgot to mention that , I graduated in 2008, have done telemetry,postpartum, and school nurse. I am working PDN PRN and during my breaks.

I am new to private duty nursing, I have not been assigned my first case yet but I had a visit with the parent and patient. The pt is a 12 yr old with cerebral palsy, wheelchair bound, G-Tube fed , pretty much total care. I have no experience working with medically fragile pedi patients, but I think will be able to manage. What kind of advice do you guys have about working with a similar patient? Also I am small and need assistance with getting her to the bed for diaper changes. The parent has a lift assistive device that she will show me how to use (if they decide for me to be the PDN). I would only be working with this patient once a week. The parent mentioned she felt other nurses wouldn't interact with her as much.

Hello , This year I want to leave my school nurse office to have lunch in the teacher's lounge or another room that is not the clinic. Any suggestions on how to make that actually workout? My principal supports me and agrees that I should be able to close the clinic. Last year , I would eat lunch in my office, I closed the door and had an aide (office) stay in the clinic. This didn't workout too well, most days I would work during my lunch due to high volume of students coming in. I know realistically I will be interrupted from lunch for serious/emergency situations but I would like to be able to have at least 20 min of uninterrupted lunch on the days that there are no serious injuries or emergencies. Even with the aides help we would end up seeing many kids for injuries and vomiting, everything seems to happen during lunch /recess. I see about 25-35 students per day. I forgot to mention , the aide retired and they did away with her position. What should i do different this year? I am thinking I should start off by letting the staff know that I will have a set time for lunch and not to send any students unless absolutely necessary. But how can I cut down on clinic visits during lunch and recess??