What's not okay is that he simply cannot sit in the chair long enough, still enough. We have YET to complete a full 3 hour run. This isn't the worst thing in the world, because we've been mixing in some PD as well, but we need to get his sessions during training longer, so I get the learnin' time I'm supposed to have to become successful as a Hemo Nurse. :) So, today, we tried doing it in his wheelchair. Fail. Tomorrow, we are taking a heavy duty camping cot to try having him lie down while he dialyzes. Keeping still is so important when you are using sharp needles, but if you have to fidget, well. Can you say infiltration? So, to try to keep from doing it again, we are changing things up.
Yesterday, our machine came in to the clinic. They loaded it all up in the back of our truck, and when I got it home, my Dad and I brought it in, and worked on setting it up. Below is a photo. This isn't the complete set up just yet.
I drive a huge Nissan Pathfinder, and the boxes -barely- fit. Barely. And it wasn't ALL the boxes. (I learned this today when Ruth brought me a whole other stack of boxes.)
What you see above is actually more than one machine. In days past, home hemo dialysis patients had to hang big bags of saline fluid to use, because you need high quality water. Now, the big base you see above makes it for us. It's called the PureFlow Pro SL, and you mix your saline in that in bags they provide. Saves lots and lots of lifting, for which I am extremely grateful. On top is the 'cycler' or NxStage System One. (Called a cycler because it cycles your blood through.)
I couldn't figure out all the connections (without all the pieces and parts, that makes sense, yes?) so today, I promised myself I'd take a photo of the machine we use at Wellbound. Or rather, the back.
So tonight, when I go to finish setting up ours, I'll have a roadmap! Yay me!
Anyhow, back to training. I set the machine up myself, with guidance from Ruth. It's important to me at this stage that I do as MUCH as humanly possible, with them looking over my shoulder and thumping me on the head from time to time when I ask silly questions repeatedly. (They don't, but they probably should. I'd likely remember better.)
I decided while we waited for the machine to prime (this part takes 15 minutes of non working time) I would set up the stuff Carol would need to stick hubby. I wasn't really sure I remembered it all, but this is what I gathered whilst the ladies were helping a patient in the next room.
It sort of sounds silly, but I was pretty thrilled that I was able to do it. For me, it's important when I am learning something that I don't just learn it by rote. I need to understand WHY I am doing what I am doing, and WHAT I need things FOR. Today, I was able to think through the entire process of cannulation, and gather the right items. Score!
When it was time to start hooking tubes up, I asked Ruth to simply watch me, and talk to me about them. I didn't want to know 'Hook the blue to the blue'. I wanted to know 'Hook the blue to the blue, because that's the venous line and it'll take the blood in to clean it.' And bless her, that's exactly what she did. I asked endless questions, and I may even remember an answer or two.
His pressures stayed great during todays session, until his heart rate jumped to 151. BP was a little low, so we gave a saline bolus and the world was again right. (Saline Bolus: Small infusion of saline given into the bloodstream to help raise his blood pressure. See, Mercedes, I do listen to you!)
We rolled along with the book learnin' until John was just too uncomfortable in the chair to be still, and unhooked him. I did it mostly myself today, until my fingers get used to holding and pulling and such all at the same time. I have no issues at all pulling one needle, but pulling them both is a bit more difficult. When we pull his needles, we have to hold a gauze pad on the hole for ten full minutes to allow both the outside and inside to form clots. (Because really, no one wants to have a Carrie moment if they don't have to.) The needles also have a guard on them, that you slide on as you slide the needle out to keep from sticking yourself, and it just adds a bit of dexterity to the whole thing.
I asked far more specific questions about the numbers lights and bells and whistles today, because again, I don't just want to know what to do for a certain alarm, I want to understand WHY I am doing it.
John and I are working hard at being good to one another. We find ourselves growing frustrated with each other through this process, and I think it's less about either of us doing anything wrong, and more with each of us struggling to get through this. For him, he feels like a burden, and helpless to not be a burden. He feels like he lets me down when he can't sit still long enough. For me, I don't learn from books as well as I learn from DOING things, so when it's time for book learnin', any distractions cause me to completely lose my train of thought. So I don't seem terribly patient when he needs something, because I really want to make sure that I get this right, and I feel sometimes like it's too much to take in. I felt the same way when we learned PD, and the PD cycler, so I -know- I can do this, and I KNOW they won't send me home if I'm incompetent, it's just a matter of patience and time. So we talk about these things driving home, and so far, we're doin' okay. :) (Although I tease him a LOT about 'hey, one little air bubble buddy. Just ONE!') Probably morbid humor, but it's who we are.
Tonight, we'll be doing some of NxStage's online training, and taking some tests. Big fun! Grab some popcorn.
No comments:
Post a Comment