The purpose of this study was to compare the effect of the buttonhole method to the traditional method of cannulation on time to hemostasis, needle stick pain, pre-needle stick anxiety, and aneurysm size. Forty-five participants from two naturally occurring groups were accessed at four monthly intervals from a chronic dialysis unit yielding 170 units of data. Results supported the buttonhole method of cannulation as advantageous as opposed to the traditional method of AV fistula cannulation.