Hi. I’m new as a dialysis nurse. If the treatment nearly ends, How many minutes are left before we lower a patient’s blood pump? I’ve seen some colleagues lower the blood pump from 300 to 180 20 minutes before the dialysis ends, and some lower it by 10 minutes, but as for me, I lower it when 5 minutes are left. I lower the pump to 250 first then after two minutes before it ends I lower it to 180. Please correct me if I’m doing it the wrong way.
Hi, do you mean when you’re drawing post-dialysis labs? The blood flow and/or dialysate flow rates do not need to routinely be lowered at the end of every treatment. Your P&P should have exact instructions for how/when/if to make adjustments at your facility before doing bloodwork. The two ways I’ve (personally) done this was to finish the prescribed treatment, wait for the machine to flip into dialysate bypass, lower the BFR to ~100mL, run for 15-60 seconds, draw post from arterial, rinse back. The other way I’ve done this is to complete the treatment, wait for the machine to flip into bypass, do NOT lower the BFR, run the pump for 3-5 minutes, draw post from arterial, then rinse back. The bypass part is pretty important because if the dialysate is still flowing right before you draw the post-labs, the blood is going to be too clean and the post-BUN will be inaccurate. I have not seen this done without being in bypass or with treatment time remaining. Have you read the Core Curriculum for the Dialysis Technician? I know you’re a nurse (me too!) but if you’re new to dialysis, it’s a great starting point for understanding the how and why of most things. If you’re seeing inconsistency in how things are being done in your clinic, tell your manager. If you’re unsure of how you’re supposed to be doing things, tell your manager. You may (in your newness) have uncovered something that is being done incorrectly and that needs to be acted upon. Here’s a link to the Core Curriculum. It’s an awesome resource. We know that because we produce it! 
Core Curriculum for the Dialysis Technician 7th Edition