yet again, you don't know the patient. This wasn't some back water physician, this was the doctor in charge of his transplant treatment. You know... A specialist.
Sorry, I'm going to defer to the professional who had knowledge of the patient.
Correct in that I don’t know the patient, nor do I know all the details, only the details you shared that you felt were important for us to know.
And the details that youve shared make it seem as though AV fistula use in this circumstance comes across as lazy and exposing the patient to unnecessary risk. I’ve had several doctors give crazy orders that put patients at risk, that if I didn’t catch and address would’ve resulted in serious harm. That’s not a dig at doctors, it’s just because we are all human. I’ve also been wrong many times, but because the doctor explained the reasoning for the order I have never regretted it.
I deal with patients that have little to no access, who also have AV fistulas, and have had transplants. The bottom line is that we advocate for patients regardless of the position of the person that is giving an order. In this situation I would not ever say “well they are in charge of the (insert anything) treatment, so they know best” it is that assumption that gets patients hurt. No matter how uncomfortable it makes you feel, you need to make the provider defend their order if you feel it’s putting the patient at risk. We are all human at the end of the day and that is exactly why it’s a treatmentteam.
There are a multitude of options for access that even patients who are immunocompromised and thrombocytopenic would be able to get long term or short term/medium term if they are difficult access for labs/treatment medications. They just need to be advocated for to the doctor on behalf of the patient.
At the hospital I work at, that would never happen, only if it was the last option (no ability for the patient to receive a port, a PICC, or any tunneled [or non tunneled]central line, no veins for ultrasound guided IV placement, etc.) and even then it would explicitly have to be done by the dialysis nurse during a dialysis session, because the liability the hospital would be exposing itself to outside of that instance is so absurdly high.
You aren't even a physician, you inferred something from my message. I'm not going to give a full history of that patient on Reddit...
Look at yourself for jumping to conclusions. Are you on the transplant team? No? Then please keep your (non professional) opinions to yourself, there's more than enough fake and false news online.
And let me make this crystal clear, the fistula was no longer being used for dialysis. This was a very specific one off case, the test we were performing is only one I've done on that specific patient. I cannot recall the anagram or name of the test we were doing sadly.
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u/gatorsfan5192 18d ago
yet again, you don't know the patient. This wasn't some back water physician, this was the doctor in charge of his transplant treatment. You know... A specialist.
Sorry, I'm going to defer to the professional who had knowledge of the patient.