Just started working with home dialysis patients. Just wondering how other nurses handle problems with compliance, such as patients not bringing in treatment documentation, problems with achieving adequacy and anemia goals related to no shows and non compliance. Why are dialysis providers pushing home therapies? It seems that when patients don't follow through, the nurses are blamed.

Just started working with home dialysis patients. Just wondering how other nurses handle problems with compliance such as patients not bringing in treatment documentation, problems with achieving adequacy and anemia goals related to no shows and non compliance. Why are dialysis providers pushing home therapies? It seems that when patients don't follow through, the nurses are blamed.[/quote']

I hope this isn't the case, I'm starting in home hemo in May.

Just started working with home dialysis patients. Just wondering how other nurses handle problems with compliance, such as patients not bringing in treatment documentation, problems with achieving adequacy and anemia goals related to no shows and non compliance. Why are dialysis providers pushing home therapies? It seems that when patients don't follow through, the nurses are blamed.

Home Dialysis is a medical treatment, not a jail of punishment. If you are curious, most of my family is in Nursing. Many problems are due to not giving enough dialysis. Dialysis should not be given just three days per week. Many Nephrologists have suggested a bare minimum of four days per week.

I hope you don't give up. I moved to home 2 yrs ago from acutes & I love it. And hopefully you have a mentor or someone with experience. If you're on your own, don't feel alone. Many of these problems are shared by other clinics. We spend a lot of time making calls, we educate & re-education about some of the same things all the time. Different pts have different areas of non-compliance and sometimes it takes a long time to get to the bottom of the real problem. Thus the importance of really getting to know your pts & their challenges. Yes, we get gigged on lots of things that sometimes we 'can't control', ie "how do we get their Albumins up". We do our best, this month we are cooking meatballs to have at "clinic" and providing a recipe. Each meatball provides about 10GM protein. The albumins are our biggest challenge....reminder calls about appts help with getting documentation etc.

Keep up the good work & do your documentation to get credit for taking good care of them.

Sometimes you need a lot patiences for your patients! I have been in home therapies for 2 years and I love what I do but you all patients at some point need reminders and retraining. Each month when they come in I do education w/ them so their skills stay fresh and I can gauge how much has been forgotten or if they are getting lazy w/ hand washing or disinfecting the transfer set. Home nurses might not be running from pt to pt in the hospital on the HD floor but we do a lot of teaching and encouraging some times that can become tiring if someone isn't listening! Good luck!