Jump to content


Urology   (122 Views 2 Comments)
by aarnigo aarnigo, ADN, RN (Member) Member

1,419 Profile Views; 24 Posts


I'm a new grad starting my first nursing job at an outpatient dialysis unit. This might seem really silly, but I need help cannulating patients with fistulas and grafts. Sometimes I get them, and sometimes I don't - some other time I just need to push the needle further to get a backflow. I had instances where patients have weak pulses and backflows won't show initially. I guess my confidence is just at a low because of this and would like to hear tips on how to better stick patients.

My preceptor have taught me to hold the fistula/graft - i've seen people pull the skin taut with their thumb and index finger. Sometimes I wonder if I'm pushing the needle way too superficial or if I'm not pushing it deep enough to reach the access.

Even with removing the needles, I have a hard time timing the pressure with the gauze and the removal of the needle while engaging the lock. I know it's going to take a lot of practice, but I would like to hear what everyone has done to make these tasks easier for you!


Share this post

Link to post
Share on other sites

diabo has 16 years experience as a RN and specializes in hemo and peritoneal dialysis.

121 Posts; 2,905 Profile Views

Practice practice.  Your smile and confidence will assure your patient.  Removal technique is most important and is not always emphasized enough in my opinion. It needs to be taken out as straight as possible with no pressure until it is out, or the razor sharp needle can tear the vein .  Even a slight tear can greatly prolong the clotting time.  As your confidence grows you will speed up and it will become second nature.

Share this post

Link to post
Share on other sites