New Sticker
So the shift I’m on right now at dialysis has had some changes recently.
so what, right?
Well when you’re sitting in a dialysis chair with an artery that would normally be deep in your arm running right under the surface of the skin, and a tech is approaching you with two very large needles in his or her hands, you sometimes experience terror. Over the years of dialysis and hundreds, perhaps thousands of sticks, you get a feeling for what you like, and what you don’t.
Dialysis patients are VERY aware of what techs pay attention to their jobs, and which just float through. Which are there for a pay check, and which realize the importance their job has in each and every patients life.
It’s always a little terrifying when you walk in, and your normal FA isn’t there (the Facility Administrator, usually an RN), nor is the normal floor nurse, and the tech who was "new" 2 months ago is now the most experienced person on the floor.
Understandably you want to make darn sure the person about to stick you realizes the implications of putting that needle in your arm.
Unfortunately too often they haven’t a clue. They figure that if something goes wrong, the nurse will fix it.
wrong answer
I’m all for people learning, and I understand people are going to make mistakes. But I firmly believe it should absolutely be drilled into these people the importance of their job, and the importance of taking some pride in it and doing it to the highest standard possible.
Just last week we had a new nurse training. Let me setup this scenario for you:
I walk in and notice not one, but two new nurses. The nurse that I do recognize is not our normal shift nurse, but the substitute one who is just filling in for a few weeks. Of the three techs, one is someone I consider "A list" (someone I trust to stick me, who takes some pride in their work). Of course I’m always a little worried to see new nurses, because I’ve seen things go "south" a few times here, and I realize the importance of having not only an RN on the floor, but having one who has experience with, and an understanding of Emergency Medicine. Amazingly, some do not. Granted, my only experience with medicine has been as a patient, and a brief stint as an EMT … but I’d like to think I understand a few things about the mechanics of the body, and the mechanism of injury itself.
So back to these weird nurses…
Sticks go fine, treatment goes fine… everything’s great. I’m saying to myself "see Jonathan… you had nothing to worry about."
Well the new nurse (who has zero dialysis experience) comes over to take me off of the machine. She puts her hand on my arm right where the needles are, and starts palpating around. I practically jump out of the chair. She keeps feeling around, mind you, she’s pressing very firmly into my arm. I try to maintain composure and ask her "what are you doing?!" She then explains that she’s read about the "thrill" we fistula patients have in our fistulas. For those not familiar, the fistula surgery essentially connects the radial artery in the arm to a vein near the surface. As it develops it becomes a large thoroughfare for blood, and actually "buzzes" or vibrates which is called the "thrill".
She had read about it and thought she’d start grabbing around my arm to feel it.
WHAT?
THERE ARE TWO 15 GAUGE NEEDLES IN THERE MA’AM!
I couldn’t believe that someone could make it through two years of nursing school, and not understand the mechanics of dialysis enough to realize that aggressively pressing on someones arm wasn’t a good idea when they had two large needles sitting in an artery.
After feeling those puppies bottom out a couple times against the bottom of my fistula, I was relieved that the tech who was "teaching" her finally stepped in and said "He’s kind of a soft touch guy… maybe you shouldn’t do that." I thought to myself "no… tell her that what she’s doing is downright dangerous."
Thankfully nothing happened —-
Fast forward to Wednesday (two days ago).
One of the techs here has been giving me a hard time for months that I don’t let her stick me. It’s kind of a joke around here that I only let certain people stick me. A few techs I think understand it, and see that it’s not me being a jerk, it’s just me being scared, and wanting experienced people to stick me, since "newbies" tend to have trouble cannulating me.
Well this newer tech had the respect to ask me Monday if she could stick me on Wednesday. I was so impressed. Rather than making fun of me, or making a joke out of it like everyone else does, she approached me as a professional, and understanding my concerns asked if she could stick me. Of course I said "yes" (I am not a jerk… )
Wednesday was her day to shine, and shine she did. The sticks went fine, and today when I arrived she was ready to stick me again.
I let her
With the pump running @ 450, I have a venous pressure of about 150 (that’s pretty good for me).
Of course now the jokes are "oooh, you’ll let soandso stick you but not me?"
I just keep thinking to myself "act like an adult who cares about my well being and I’ll have no problem with you sticking me."
Or: "stop watching American Idol in the patient chairs, and maybe I’ll let you stick me."
Or: "don’t answer your cell phone while you’re putting patients on and maybe I’ll let you stick me."
And don’t even get me started on these new needle guards….
I’ll need something to write about over the weekend.
Hope you enjoy yours