After 1 Year I am SICK of Dialysis

Sun0408, ASN, RN · May 24, 2012

I hear ya, that's why I left the renal floor more than a year ago. Same pts every other week.

Tish88 · May 25, 2012

These patients are very challenging and can be difficult, but not all of them can be characterized as non compliant.I have been doing all forms of dialysis and pheresis for over 25 years and I tell my staff that feel they way you do that it is time for them to go. Sorry to be harsh, but it does not make for a good work environment for other staff or the patients. Just my 2 cents!

Midwest4me · May 25, 2012

I sympathize with you, SuperStarLPN. I worked in it for 5.5 years until I had to get out of it. Very challenging but rewarding work BUT the noncompliance(and there IS a lot of it) gets tiresome...yet I would probably be the same way periodically if I were in those patients' shoes. The problem with being an LPN is there aren't many options out there. As an LPN for 27 years, I've done lots of LTC, MD office, HD, PD, and psych nursing. My favorite was in the MD office environment but had to quit due to low pay. I wish you the best of luck with future endeavors. It's always nice to TRY an area for a year or so.

SuperStarRN · May 26, 2012

I am currently in a bridge program and can definitely tell you that once I am done with school I am out the door! I won't be able to run fast enough. Unfortunately, this is the only job that works well with my school schedule. I will probably stay on PRN I just can't do this everyday for the rest of my life.

SuperStarRN · May 26, 2012

These patients are very challenging and can be difficult, but not all of them can be characterized as non compliant.I have been doing all forms of dialysis and pheresis for over 25 years and I tell my staff that feel they way you do that it is time for them to go. Sorry to be harsh, but it does not make for a good work environment for other staff or the patients. Just my 2 cents!

You'll notice that I said MANY are noncompliant. Not ALL. As far as the environment goes I put on my smile and do my job above and beyond so if there is an unpleasant environment it is not one of my making. I love the people that I work with but the patient population is too much for me. Constant nagging, whining, complaining, woe is me is enough to drive anyone to drink. Kidney disease is not the worst case scenario. The patient who was admitted to the ER with a fever on Monday and expired by Friday has it a lot worse. The diabetic man who stubbed his toe getting a drink of water in the middle of the night last week and no longer has a foot this week is a lot worse off. I'm sure you see my point.

anurseadvocate · May 28, 2012

I think it is unfair to characterize all patients as being noncompliance - there are MANY reasons when patients do not comply with their regime ---- this ranges from non-acceptance of their illness and the need to have dialysis TO LIVE on to inability to pay for either medications or food that is within their dietary restrictions e.g. added protein (powders are costly for some). It would benefit patients if staff (not necessarily implying this refers to you) were more educated as to the psychological effects of one needing dialysis to live --- patients, no matter how bad they feel, must go to dialysis treatments, three times a week, in order to live and not experience severe complications. We, as nurses, if we don't feel well can call in sick... patients must go to dialysis even if they don't feel like it -- it is a hard adjustment for many... ofcourse, you might be in an area that has patients who maybe are drug addicts, etc and who are not responsible etc.. but, please keep in mind that this is a difficult road for patients to travel as well... I always think we need to put ourselves in the patient's shoes for unless we live their life, we don't know what they are experiencing or why they are reacting or acting to a certain situation.. some cases are just that patients have not received the information they need to survive e.g. dietary restrictions, etc.

Trauma Columnist · May 28, 2012

I think however, when the US government declared ESRD to be an auto-disability, we shot ourselves in the foot. Come on, while I agree that dialysis is extremely expensive and should be funded by the government, to declare EVERYONE disabled, gotta love the US!

These pts should be empowered to continue working by offering dialysis options conducive to a work schedule. Or, go to school.

I do realize that the elderly and those that are disabled should receive a check. However, my twenty-something pts should NOT unless they can prove they have another disabling condition.

nurse2033, MSN, RN · May 29, 2012

I have grown to better accept the noncompliant patients. Our job is to support them and help them. The difference is between getting professionally involved and personally involved. Getting emotionally invested in their health is a no-win for a nurse. I get satisfaction when a patient wants to hear what I have say, but accept it when they don't. Although I can't say I've worked in dialysis...

I find the disability sidebar interesting as well. I think it is way overused. With the technology today there is no reason a person with a "back" disability can't work a computer somewhere for example. Soap box off..

anurseadvocate · May 29, 2012

Nurse 2033 --thank you for you comment on accepting the non compliant patient - I have learned over the years there are many aspects to acceptance of this disease/illness whereby one must accept a major change in lifestyle and accept that they must be connected to a machine to live - I am not sure how I would react or act if I needed to go through this emotional journey of knowing that if I did not have these 'tied to a machine treatments' I would die -- it is a huge emotional/psychological adjustment of which often many do not understand -- Many patients, as you mentioned, might not want to be educated and listen to us nurses.. however, those who do, we offer what we can... Those who don't probably are still dealing with many psychological aspects of this overwhelming journey they are venturing through -- I have had patients tell me how their friends have abandoned them or they have had to let go of many aspects of their life due to dialysis, etc..

As far as disability -- the entire setting/reimbursement is way off target as I see it -- when a transplant patient receives a kidney, shortly thereafter they are cut from Medicare -- I think many then can't afford the drugs and then more problems occur --

Perhaps a rehabilitation program should be set up for those patients who can return to work. I have seen many patients, who have not been able to go to a job interview or to their own job due to scheduling of their treatments -- it does happen.. and there are those units who make a huge effort to accommodate patients with jobs --

Dialysis nurses are also caught in the profit world where they have to rush patients in and out and often find themselves in positions of conflict due to the entire environment

Trauma Columnist · May 29, 2012

Just an FYI - Medicare covers the cost of post transplant meds for 3 years. The thought is that within those three years, the pt can return to work and obtain commercial insurance. If the pt is older, then the regular age-appropriate Medicare kicks in.

anurseadvocate · May 31, 2012

I thought I read recently where the 3 year period was cut short and there was discussion regarding such at the congressional level? I might be wrong, but thought I read this..