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Discussion

Will I Ever Get This?

I am two weeks into my new acutes job at Fresenius and so far I enjoy the work and think I will be very happy here, except...I am feeling overwhelmed by everything on the days that I am in the clinical setting. I get the medical aspect of why things work the way they do, but the machines are soooo complicated, and each nephrologist has their own preferences for how things are done and there are at least 6-8 nephrologists that we deal with, including one who is exceedingly mean and nasty when you aren't right on top of everything.

I keep telling myself that if thousands of other nurses have "gotten" this then I can too, and I truly believe deep down that I probably can, but is it normal to be feeling this overwhelmed at this point? How long was it before the machine didn't look like an octopus and the RO machine like a foreign entity? How do you remember what water needs tested when?

I have a very nice preceptor, and I was feeling pretty good until a couple of days ago I strung the machine and primed it and managed to get the transducer wet and use the entire bag of NS because I forgot to clamp something.

Help! Please tell me this gets easier and it isn't just me! I want so much to be good at this!

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    • Featured Replies

    I remember reading somewhere that it takes 10,000 hours doing something to rewire your brain so that you would be considered an expert. At 40 hours a week that would be 5 years. Part of this involves learning to filter the noise and concentrate on the important signals. Build on what you know as far as nursing assessment and be watchful. 1 out of 4 pts will experience a "crash" in their BP due to a variety of factors. Learn to recognise them. New dialysis nurses get quite focused on the mechanics of stringing the machine but I have yet to see anyone who stuck with it fail to master stringing after 12 weeks. If neccessary ask to come in early and help the techs string machines. Do not be concerned learning the idiosyncrasies of various doctors. Learn the right way to do things, keep up on evidence based medicine and best dialysis practices. Challenge the docs to explain their rationale if it doesn't meet these standards. Your patients will appreciate your courage. Good luck.

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    Yes, it does get easier! I think after 6 months I felt the relief of finally being comfortable with the machine aspect of dialysis.

    I still remember a really good nurse telling me that it's all about repetition when it comes to setting up the machine. The more

    you do it the better you will get.

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    • Author

    Thanks for the support, Chisca and TEXASWAG. After I posted this I was allowed to spend half a day in the chronics clinic doing nothing but setting up machines. Even though I am still far from adept at it or from feeling totally comfortable, just that experience made me feel a lot more comfortable. Now I can actually see myself "getting it" and becoming skilled at it over time. I just keep telling myself I can do it and if thousands of other nurses and techs have it figured out than so can I.

    Thanks again!

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    hi westieluv!

    I feel the same exact way.. I just started at Davita (2 weeks) chronic, and the machines look sooo intimidating. I was terrified. The techs string up sooo fast, and make it look simple. I have practiced maybe 2 or 3 times, just setting up the tubing. I think I can get this, but it will take time. All those little clamps make it harder to me! lol..

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    You're 2 weeks in, give yourself a break :) Yes, you will get this, it just takes time and practice of course..

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    Don't worry about the tech's, you will never be as fast as them. Lol. But you will get it, I remember looking at the machine. And thinking I will never be able to do this. Go in a little early to string the machines.

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