Buttonhole in-center

Does anyone have any first hand experience with the buttonhole technique in-center done by nursing staff? It seems like it would be more difficult and uncomfortable for the patient for a nurse to remove the scabs and then find the tunnels. The reason I say this is because a home patient told us that removing the scabs can sometimes be irritating when he does it himself. So, if a nurse did it she would have even less of an idea of what is causing him discomfort. Likewise, eventhough I have read that the patient is the best one to place the needles since he will get the same angle each time, he said that the needles usually do not go right in- he has to prod around until he finds the tunnel. Again, doing this to himself, he knows the exact amount of gentleness to use not to hurt himself. But with a nurse doing it, it would seem that the nurse could not be as accurate and gentle since she can not feel where to go like the patient can. It really seems that it would be difficult for a nurse to do this at all without causing the patient discomfort and/or pain. I can see where a nurse could start the initial sticks to form the tunnel, but after that it doesn’t seem that the nurse could place the bh needles as well as the patient.

Perhaps there are some caregivers who place the needles for their family member on home hemo. Wondering what your experience is. Also, it could be that some home patients or in-center have bhs that are very easy to get in and are not irritated by someonelse removing their scabs.

Hi Heather
I am sure if you had the same nurse or carer doing it each time there shouldn’t be too much of an issue. But there is no guarentee that a dialyzor will always get the same nurse is there.
When I started buttonholing myself i fussed over getting every little bit of scab off but I find a lot of time it is impossible. It is irritating to remove the little buggers and i don’t think I would enjoy the experience of anyone else doing it very much. It is a bit like when you are getting someone else to take a splinter out of your foot! I am a dreadful patient at that too.
I am sure a good nurse or carer could feel their way into a buttonhole with experience. Ypu just know when you meet any resistance and pull the cannula back ever so slighty or swivel it a tiny bit back and forth and bang you are there. Definitely NO prodding needed though. Think of it as similar to pierced earrings.