04.08.2009
I cannulated my very first AV fistula today. It was a success. About the only comment from my patient, Richard, was that he found me to be rather slow. I was quick to explain (and also honest about admitting that he was right) that I was being very careful about the entire procedure so that I would cause him minimal pain and discomfort. Which was very true.
I likewise confirmed that simplistic training videos on fistula cannulation techniques are just that, and that real-life cannulations are infinitely more "tricky" and dynamic. There really is no substitute for good (and substantial) hands-on experience with this procedure.
My learning curve, I observe, becomes steeper each day. I commit less mistakes (none in setting up the blood lines) in priming the lines and dialyzer, terminating the machine side of the session, and almost none when removing the fistula needles (there actually should be none as this is a phase fraught with risks of possible injury to the patient). I'm becoming more confident of myself with my newly-acquired skills.
I'm also increasing my interaction with the facility's patients, becoming more aware of their concerns (they're mostly about the financial and physical toll dialysis treatments place upon them); their diverse social strata (kidney disease does not distinguish between rich or poor, male or female, young or old); their behavioral idiosyncrasies (some are grouchy, some are stoic, some are full of exclamations during cannulation, some are so good-natured and good-humored that they are able to crack jokes during their treatment sessions). I see all of them as poor, unfortunate, brave souls who inspire me to be good in my craft so I would be able to give them the kind of care they want and need.
I cannulated my very first AV fistula today. It was a success. About the only comment from my patient, Richard, was that he found me to be rather slow. I was quick to explain (and also honest about admitting that he was right) that I was being very careful about the entire procedure so that I would cause him minimal pain and discomfort. Which was very true.
I likewise confirmed that simplistic training videos on fistula cannulation techniques are just that, and that real-life cannulations are infinitely more "tricky" and dynamic. There really is no substitute for good (and substantial) hands-on experience with this procedure.
My learning curve, I observe, becomes steeper each day. I commit less mistakes (none in setting up the blood lines) in priming the lines and dialyzer, terminating the machine side of the session, and almost none when removing the fistula needles (there actually should be none as this is a phase fraught with risks of possible injury to the patient). I'm becoming more confident of myself with my newly-acquired skills.
I'm also increasing my interaction with the facility's patients, becoming more aware of their concerns (they're mostly about the financial and physical toll dialysis treatments place upon them); their diverse social strata (kidney disease does not distinguish between rich or poor, male or female, young or old); their behavioral idiosyncrasies (some are grouchy, some are stoic, some are full of exclamations during cannulation, some are so good-natured and good-humored that they are able to crack jokes during their treatment sessions). I see all of them as poor, unfortunate, brave souls who inspire me to be good in my craft so I would be able to give them the kind of care they want and need.
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