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Friday, October 28, 2016

LOVE Relationships in Dialysis Units













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Sunday, October 23, 2016

Dialysis Patient first computer last.....







Quick tips~(Check with your unit first before taking my word for it). Cheers~~

1. Put on all of your patients blood pressure cuffs on first and press the button for a standing b/p. Starting with the patient who will get on first. While these patients are all standing getting their b/p taken by the machine, you will go back to the first one and start taking their vitals and stick them and put them on. Put 2-3 important (vitals) things in their chart and come back to it later (only if that is possible).
2. After you stick your first pt, you should start their TX on the machine and move to the next.
3. After you finish your last pt, you need to go back to that first pt and finish that chart and anything else you have~~













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Thursday, October 20, 2016

DIALYSIS: ASK ME ANY DIALYSIS QUESTION: DIALYSIS, NEPHROLOGY, DIALYSIS T...













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dialysis technicians

Wednesday, October 19, 2016

DIALYSIS: THE STATE IS HERE -HEALTH DEPARTMENT- DIALYSIS










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Tuesday, October 4, 2016

6 Main Reasons Why Some New DIALYSIS Technicians Quit :(

I had to write this post because of the many people I see who spend alot of money on dialysis schools and training. I want to make sure that all technicians still press on and do not QUIT but use this advice to advance in the dialysis world.

I can only hope that centers, corporations and units will be inspired to improve their methods on how new technicians are brought into the dialysis units.





6 Main Reasons Why Some New DIALYSIS Technicians Quit :(

1. Improper Training/PreceptorCorrect training is very important. Learning how to do things the correct way the first few months of becoming a new tech is very crucial. I have seen technicians and nurses who were never trained right in the beginning stages of starting their new role within the dialysis clinic. As a result, those individuals would get written up, and reprimanded often because of the frequent mistakes they would make. This is no joke. I have seen people quit because they see that they can't handle the pressure to do a job they were not properly trained to do. The pressure can come from the patients getting furious and rejecting them, and teammates snares, as well as management complaints.

Example: You shadow a preceptor who only shows you shortcuts, instead of clinical protocols and policy. Or you were only able to shadow someone for one week or two weeks and that is it. If the state health department was to come in your unit and watch you, would they see you making serious mistakes or following the clinical state mandates?

Tips: If you find you are not learning like you should you should talk to your manager about shadowing a few individuals and OBSERVE. You should look at how different techs set up their section, their machine, and handle their patients. If you see a tech that is getting compliments and praises from their patients/teammates and doing things the right way, this is someone you need to be looking at. Ask to watch policy and procedure DVD's that each company has to help you get everything down pact. Also ALWAYS listen to the patients complaints and do your best to help them.


2. Getting their own assignment too soon and are some times alone when handling patients. Up to 3-4 and sometimes 5 patients some new technicians told me they have received after a week of being on the floor. A sole assignment is when a technician will be alone with several patients for one, two, or three shifts, and is responsible for monitoring them, putting them on the machine, taking them off and cleaning the machine afterwards.

Every individual has their own rate of learning and comprehending the course of the job as a dialysis technician. However at-least 2-3 months are needed for a new dialysis technician to really get good at learning about the unit, the policies and procedures as well as putting on and taking off patients appropriately. I find clinics that rush their new technicians out on the floor quick within a week or a month DO NOT CARE ABOUT THEIR PATIENTS. When clinics do this, SERIOUS MISTAKES will HAPPEN. Patients need technicians as well as nurses that really know what they are doing, these are their LIVES and many of these patients have CHILDREN and RELATIVES depending on them to survive.

Example: I remember having to even tell a nurse while I worked in an far per-diem unit, how to put on an individual who had a catheter access without me touching the patient. If I wasn't there who knows what would've happened to that patient. She should've been shadowing a nurse but they were short of staff, she was the only one there and she was rushed out on the floor too soon and these were the results. Was I in the wrong for telling her what to do? No....but some will say yes.... but if I didn't her patients would've suffered greatly.

Tips: Explain to your manager that you don't feel comfortable being given a sole assignment so early without any help. Tell the manager that you are still LEARNING and you don't want to be LIABLE if a bad mistake happens due to you still getting the hook of things. If the manager pairs you with someone experienced then go for it, but if not, I don't encourage you to be in a pod/section all by yourself. Be prepared for patient complaints and anger. Never be afraid to ask other teammates for help and advice as well.


3. Limited Support from Management and Peers.
Some technicians who experience issues on the floor, sometimes turn to management for support, and can't find it because their manager have bad attitudes, or are in on the latest drama and politics. Some managers don't properly resolve the issues that the technician is experiencing with a patient or another staff, and therefore sweeps it under the rug. The gossip, drama and pressure is usually on from other "experienced" teammates making that new tech to feel vulnerable and out of place. Sometimes a new tech could be receiving extreme, inappropriate backlash from the patient and doesn't know what to do other than tell management.

Example: Tech A goes to Mr. manager B's office and asks if he can talk to patient C about ceasing the cursing and disrespect towards them. Or Tech A tells Mr. manager B that they are overwhelmed and need to still shadow someone or if they can work with someone until they are comfortable being alone. Manager B ignores them and tells them " Tech A you are ok, it is not a hard assignment I gave you, try your best, I can't pair you with anyone because I am short of staff"....(manager B sips his steaming hot coffee and fiddles his overgrown beard)..

Tips: If management doesn't have your back period. Only trouble I see, sorry.  My only advice is to make sure you get certified within the time-frame you are at that unit, and find another clinic and transfer. Never leave a unit unless you get your foot in the door elsewhere.

4. Dialysis School training vs. On the clinic floor training differences (techs were not expecting turn-over to be so hectic/death rate/ other factors). Dialysis schools deal with basic and advance studies regarding dialysis and sometimes have their students practice on dummy arms and other means. This is different from actually sticking a person and hearing them scream and feel uncomfortable. Dialysis schools can never really prepare a person for (TURN-OVER). Turn-over is when your 1st, 2nd or 3rd shift patients are coming off the dialysis machines and you have to clean the machines and set up for your next shift patients to get on. Everyone has their own "turn-over" style and this is hard to just learn it without experiencing it and creating your own way of handling it. Some people can't handle the death rate appropriately and some learn to cope. I was one who was caught by surprise when my patients began to pass away, but I had to learn how to cope the best way I could. This doesn't mean that I don't cry, I still do and sometimes go to the funeral.

Example: For instance, you have 4 patients on the machine and turn-over is about to take place. Meaning 1 patient is supposed to come off in your section first. However your 2 patients who are 1st shift patients asking you to come off at the same time. What would you do? Or let's say you have one patient out of the four that you have, start passing out in the midst of the turn-over rush, what do you do?

Tips: Watch my upcoming video on dealing with turn-over issues properly. Also observe how your peers set up their section and do the same and even more. Create pre and post packs and get your circuit lines, dialyzers and saline bags. You don't need to be running to cabinets or drawers when turn-over has started unless you need an additional urgent supply for a patient who is experiencing an emergency.


5. Severe Drama on the floor with dialysis teammates/management/patients. 
Every job has that one person they may not like or who is causing issues for them in one way or another. To be honest with you I've had several individuals over the years who made my dialysis experience as a technician a living nightmare. However I have had to really pray and God granted me some serious grace to forgive them and be at peace. Severe politics and drama is not good in any case, but I have seen technicians quit because of it. I even wanted to quit because of it. This toxic situation was spilling over into the patients, and that was not good. Once patients get involved in the drama you are having with another teammate, you can forget it. Some patients spread that little gossip to other patients in the waiting room, and the whole situation blows up into something unpleasant by the time it gets back to the person who it is about. This is no joke!!!!!!!!!!!!!!!!!

Example: Tech A SUSPECTED that Tech Z was trying to get all the attention from another Tech named Tech T. So Tech A tells one of her patients a lie about Tech Z (to create hate towards her). Tech A told her patient that Tech Z is a evil tech who moves slow and shouldn't let that tech touch her arm. The patient goes out into the patient lounge and tell other patients what Tech A said and now Tech Z is having issues putting on her patients because "they HEARD" some stuff. Now the tension starts between the two techs plus the patients are involved from the "I HEARD" gossip.

Tips: Try to strive for peace, talk directly to that teammate ALONE. Pull them off the floor if a issue starts. Never get loud with another tech on the floor in front of the patient. In some companies and units, you can get written up or suspended, and possibly fired. Sort out your issue with any person face to face. I found the most positive results by doing it that way. Shoot down any rumors and assure the patient that what they heard is a rumor and that you are a professional that seeks to make sure they have A GOOD TREATMENT.


6. Consistent Unfairness regarding scheduling/ratio of patients. I have been through instances where because I was new to a situation, I was a target for work overload. People began to manipulate me into handling their duties and trying to make me think that it was my ACTUAL JOB. I was slyly given additional patients that were other technicians during 3rd shift and didn't notice because I was naive. Only as I became familiar with scheduling and assignments was I able to understand who's who and who is not. You should never be a slave to anyone only follow your job description. I have witnessed new technicians becoming very frustrated with being forced by senior techs and even some nurses to do things they are not supposed to do "all in the name of being new". Some technicians experience unfairness but are too scared to speak up because they fear for their jobs and negative backlash from the three fold cord in the unit (management, patients and co-workers). Example: Newbie Tech H is supposed to have 4 patients for each shift 1st, 2nd, & 3rd. Sometimes the third shift has a low ratio of patients who are scheduled to come in. However there are three techs left in the unit and they each have one patient. Tech H did have only 2 patients for 3rd shift but something was done without her knowing and she ended up with two additional patients thinking they were hers because she was given them(told to put them on). However she put them on the machine but was puzzled as to why she has four and those three techs have one patient. This continued to happen time after time and Newbie Tech H complained but those who made the schedule always had an excuse as to why. This is baloney~ Tips: In the process of learning XY & Z. I encourage you to stand up for yourself in a positive way. Don't allow anyone to talk down to you or disrespect you because you are new. Learn which patients are yours and who is not. If there is an new admission find out if you would have to take that person in your section. Ask questions. If you are called names and laughed at for standing up for yourself, don't pay the jokers no mind. You know at the end of the day they will still have to RESPECT you. Reflection: I remember this one tech came into the unit with a certain respect for herself and she demanded respect in a very calm and peaceful manner. She wouldn't allow anyone to disrespect/overload her with unfair assignments and she went about doing her job. She is still there....why? Because at the end of the day, her day is what she makes it. She made it great by speaking up and standing up for herself.

Thee end~ Hope this blog helps~



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Monday, August 15, 2016

7 QUICK STEPS TO SETTING UP A K, K2 FRESENIUS MACHINE

Now these are only my tips, so don't use them as clinical protocol. Things change all the time in dialysis regarding policy and procedure. What I am sharing with you are the basis of setting up a K, K2 machine. Your unit will tell you how much saline to run through the whole system and if re-circulation mode is still acceptable as well as blood pump speed. 

Now I am not good at drawing pictures etc, but had to do this mini preview so that you can have a clue. 


STEP 1
WHEN YOU APPROACH YOUR MACHINE, YOU SHOULD HAVE ON PPE OR GLOVES.
OUR 1ST FOCUS WILL BE ON THE SALINE BAG. YOU SHOULD NOW TAKE THE SALINE BAG OUT OF THE COVER AND HANG IT ON THE ROD ON THE NEAR TOP OF THE MACHINE. 






STEP 2
OPEN YOUR DIALYZER IMMEDIATELY AND SET IT IN THE HOLDING CHAMBER





STEP 3

NOW YOU SHOULD OPEN YOUR LINES WHICH SHOULD LOOK LIKE THIS. 

YOU SHOULD THEN PROCEED TO PUT THE RED ARTERIAL LINES ON ONE ARM AND THE THE BLUE ON THE OTHER. NOW WE WILL BE SETTING UP THE RED ARTERIAL FIRST. 







STEP 4

YOU WILL NOW SET UP THE VENOUS BLUE LINE IN YOUR HAND. YOU WILL JUST FOLLOW THE BLUE IMPRINT ON THE MACHINE AND CONNECT IT TO THE DIALYZER. ONCE YOU DO THAT, THE END OF THE BLUE LINE YOU WILL PUT IN THE BUCKET NEAR THE SALINE POLE. THE REASON IS BECAUSE YOU WILL BE RUNNING SALINE THROUGHOUT THE CIRCUIT AND THE AIR MIXED WITH SALINE NEEDS TO RUN OUT. 







STEP 5

NOW YOU WILL PUT YOUR RED ARTERIAL LINE NEXT TO THE VENOUS LINE IN THE BUCKET. YOU WILL OPEN YOUR SALINE PORT AND START YOUR SALINE TO RUN THROUGH THE RED ARTERIAL LINE FIRST UNTIL THE AIR IS OUT. THEN YOU WILL SNAP SHUT THE ARTERIAL LINE AND PROCEED TO RUN THE SALINE THROUGH THE WHOLE CIRCUIT TO REMOVE THE AIR AND OTHER PARTICLES IN THE DIALYZER. 











STEP 6

NOW THE AIR SHOULD BE FULLY OUT OF THE WHOLE CIRCUIT INCLUDING THE DIALYZER. SOMETIMES YOU CAN FLIP THE DIALYZER OVER TO MAKE SURE NO AIR BUBBLES ARE STILL IN THE BOTTOM OF THE DIALYZER. SOME UNIT POLICIES ARE DIFFERENT AND REQUIRE EXTRA DUMPING OF THE SALINE ETC. 
NOW AFTER THE AIR IS OUT, OUR NEXT STEP IS TO CONNECT BOTH BLUE AND RED END PORTS TO RECIRCULATE THE SALINE THAT IS LEFT. 






STEP 7

YOU WILL PLUG IN THE TRANSDUCERS ONCE IT IS TIME TO PUT ON THE PATIENT AND THE MACHINE HAS RECIRCULATED AND PASSED THE TEST. AFTER THE MACHINE HAS PASSED THE TEST, YOU WILL PUT ON THE HANSENS (1 BICARB/ACID BATH BLUE CONNECTOR AND 1 DRAIN RED CONNECTOR). THE BLUE CONNECTOR BRINGS THE BATH FROM THE WATER ROOM TO THE DIALYZER THROUGH THE MACHINE AND THE RED RECEIVES THE BYPRODUCTS FROM THE DIALYSIS AND IT GOES IN THE DRAIN. 


SIMPLE! HAPPY PRIMING ~




YOUR MACHINE SHOULD LOOK LIKE THIS ONCE YOU PUT ON YOUR PATIENT.
THE BOX HANGING ON THE SALINE POLE IS CALLED THE "CRIT LINE" THAT IS A WHOLE NOTHER EXPLANATION IN ITSELF. MY MAIN CONCERN IS THAT YOU UNDERSTAND THE MACHINE SET UP DYNAMICS. 








SETTING UP DIALYSIS MACHINE, K FRESENIUS MACHINE, DIALYSIS MACHINE, DIALYSIS PROCEDURE, T 2008 FRESENIUS
I HAVE CREATED A TOTAL OF FOUR GROUPS FOR YOU



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Friday, August 12, 2016

DIALYSIS: It's not all ROSEY as a tech but here's the solution








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dialysis technicians

Saturday, June 25, 2016

Don't rely only your dialysis job/career keep reaching your goals








dialysis jobs



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Friday, May 20, 2016

Mini Dialysis Skit:: What? Honey this book is good!








DIALYSIS



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dialysis technicians

Expert Tips on Becoming a Dialysis Technician is a bestseller on Amazon get your copy~

I want to encourage you all who are interested in becoming a dialysis technician to get this book and put it to action. This book is only 3.99 a steep discount from the regular price of 4.99, and is a big seller on Amazon~ Get yours today~Click HERE


Tuesday, May 10, 2016

Mini Dialysis Skit:: Telling another teammate they were wrong::







DIALYSIS



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dialysis technicians

Friday, May 6, 2016

I've created 2 new dialysis skits::


As time goes on my acting and skit video taping will improve. However I just created these to help you understand how important patient care is. 

In this first video, you will dive into how to handle a rude patient who doesn't want you to cannulate them. 






In this second video, you will experience how to handle a patient who is distressed and feel like giving up because of bad news. 






DIALYSIS



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dialysis technicians