Looking after Dialysis patients during a hospital admissionRegister Today!
This is a discussion on Looking after Dialysis patients during a hospital admission in General Nursing Discussion, part of General Nursing ... Renal patients get a bad press by healthcare professionals, and it bothers me. So just for the 5...by madwife2002 Asst. Admin Aug 7, '12Renal patients get a bad press by healthcare professionals, and it bothers me.
So just for the 5 mins it takes you to read my thread I want you to imagine you are a hemodialysis patient……………..
You can’t drive to dialysis because you feel so ill after dialysis you might not be able to drive home. So you wait patiently either for a relative who is getting really fed up with driving you there and back 3 times a week, or for transportation who are either too early or too late.
Then you arrive at the dialysis center and have to wait for your dialysis chair-they are always busy at the dialysis center, because they never have enough staff and the patient before you needs his sites holding for longer than 10 mins.
You get weighed and you’ve put on too much, so you have to listen to the lecture of what you must do to not drink so much! For the 100th time. Don’t the staff notice it is over 100 degrees outside
You eventually get to sit in your chair and it takes another 20 mins before you actually start your treatment.
Then the hours begin, there is a television but it doesn’t work well. The patients around you are sleeping or complaining.
The staff are running around and don’t notice you and don’t have time to talk because they are so busy.
You notice that Fred or Alice are not there today, when you ask everybody is secretive because they don’t really want you to know that they have died, because for the last 2 years they have sat next to you.
There might be a bit of drama you can enjoy, but the machines are always alarming and you can’t move your arm in case you pull at the needles stuck in it.
Those 3 4 or 5 hours are so boring and it is so noisy
Then you come off the machine, hold your needle sites weigh yourself and go wait to be picked up.
Transportation is late, so by the time you get home you’ve been gone 6 hours. Now it is time for a nap.
The next day of your life you spend recovering from dialysis treatment and the day after that the cycle begins again………………..
I cannot imagine how horrible it must be to spend up to 7 hours which includes travelling and waiting time, to be tied to a chair and have dialysis.
We complain if we have to sit in a car for a couple of hours when we are travelling to somewhere nice.
Just imagine for a second that every other day for the rest of your life you have to sit in a chair and travel for 4 hours.
They have lost complete control of their life and if they don't dialyze then they die.
Then to add insult to injury they have to have needles stuck in their arm 3 times a week, they cannot eat what they want, they cannot drink what they want and they have to be talked down to every treatment by nurses who half the time do not even try to understand what they are going through.
I have had the privilege of working with ESRD patients for many years and the amount of unruly patients I have looked after is almost zero! I have found if you listen to them, that is all they want. They are frightened and angry, plus they look around the dialysis unit and what do they see?
They see 20 other people tied to a chair, in various stages of deterioration. Doesn’t seem like they have a lot to look forward to.
Oh and most of them are labeled 'non-compliant' words which are frequently used to describe patients who eat the wrong food, drink too much and miss dialysis sometimes.
Half the time they are on dialysis because we have decided they didn't look after their BP or their diabetes.
I wish I was so perfect that I could say I do everything I am supposed to do all the time.
If we as health care professionals actually took time to meet the patients face to face and listened to what they have to say instead of telling them what to do, maybe just maybe we could actually reduce the 'unruly' patient.
23 years as a RN-13 years in renal nursing has taught me that healthcare professionals are very dismissive of pts who have renal disorders.
I honestly think we are frightened of them because we do not really understand the renal system. We are only human after all and we tend to shy away from conditions which seem complicated.
Looking after the chronic renal patient is unique and many friendships have been forged over the years. A deep sadness and loss is felt by the staff who have looked after them for so long.
There is so much to be gained by looking after chronically ill patients, I just don’t want us to forget how important they are by labeling them.
So when a patient who is on dialysis is admitted to your floor take a moment to understand what they go through week in and week out, do not be afraid of them, they can tell you more about dialysis that you can know.
They are very well educated patients, who are demanding but they have lost a lot of control of their life and when they demand they are taking back a little bit of controlLast edit by madwife2002 on Aug 18, '12
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- Aug 7, '12 by Been there,done thatThank you for that much needed perspective.
- Aug 7, '12 by iluvivtIt's true I have often thought and seen firsthand how grueling the whole process can be. I also find that in this type of setting you do tend to get attached to your patients. I spend many hours with my home care patients giving very long infusions of IVIG and have noticed how much I truly care for them. In the hospital it is much more fast paced and more difficult to develop those type of attachments.
- Aug 7, '12 by classicdameI worked in-pt dialysis a short while and really enjoyed the patients. The atmosphere in that center was lively and upbeat. We had a warm meal waiting and headphones for those who wanted to sleep without being disturbed or watch their own TV show or listen to music. It hurts to watch them get sicker. God bless the nurses who care for this patient population.
- Aug 7, '12 by CuddleswithpuddlesThank you so much for your vivid and passionate words.
A thing I consider very curious: Some nurses I have met have a breezy attitude towards patients undergoing dialysis within the hospital. There is often the notion that these patients are out of sight and out of mind for 2-4 hours they are in dialysis, or that they are magically "fixed" when the session is done. The renal system is mindbogglingly complex for me and my thinking is that these patients need more surveillance by the primary nurse, not less.
When I really think about it....
Having your blood pulled out of you, whirred into a machine, purified, altered, having the very basic chemistries of your fluids changed, most of the time correctly but sometimes not, then returned to you with a healthy dose of anticoagulant and hopefully no nasty microbes that have just won a one-way trip to the Cancun that is your warm, immunologically-compromised body...
It blows my mind.
- Aug 7, '12 by sheilahdeeThank you so much for this post. I feel like such a sap, but this brought me a few tears. My father is on his fourth week of hemodialysis. He is fortunate enough to be able to do it at home, and he has an amazing nurse who is full of love and compassion for her patients. Even though my dad overall feels better being on dialysis, it still takes so much out of him. on top of that, they are having trouble with his venous line. It has infiltrated three times in the past two weeks, and he is feeling discouraged, and of course pain. His nurse left yesterday just devastated because she feels like she is causing him the pain, and it's all her fault. Which shows me that she cares. It's hard to find, even harder when you are doing in center dialysis. anyway, now I'm just rambling, thank you for this post!
- Aug 7, '12 by MJB2010I enjoyed working in dialysis, all the things I did not like were not related to the patients. I enjoyed the patients and getting to know them and their families. I liked knowing their routines and having certain social groups of patients who enjoyed spending time together. It was very hard when you lose one. Hard on the staff and other patients, everyone feels the loss. We were not secretive about it, we grieved together. I did not like the long 16 hour shifts, the constant understaffing, and the assembly line mentality. There are a lot of good people working in dialysis and with dialysis patients, so don't assume we are all dismissive and don't get it. Many of us do get it. I know I can't speak for all.
- Aug 7, '12 by FlareGreat post! I just learned my brother in law will begin dialysis next month - you've touched on many of my concerns for him. Perhaps this can help us start a dialog.
- Aug 7, '12 by nursetaminatorThis was wonderful. Thank you.
- Aug 7, '12 by RN58186I have been a renal nurse for over 20 years - have worked renal since I graduated and would never work in any other specialty. I have never worked on the hemodialysis unit, but I totally understand what you are saying. I know the ups and downs of dialysis, the feeling awful because they need to dialyze, then the feeling dragged out because they did. Too often I have heard other nurses say that they are a renal pt because they were "obviously totally non-compliant" and that they would rather look after any other pts than renal pts. Personally, I have learned so much about the human spirit from my patients - it boggles my mind that they can still smile sometimes. I work in outpatient transplant now and it is so nice to see some of the pts I have watched endure dialysis for years finally get their kidney and to see them become healthy again is awesome. I will take my renal pts any day thank you!