Quote from ktwlpn
actually,'twas my DON whom declined my request to invite someone from the dialysis unit for an inservice- :stone
Geesh... that sux.
OK... the patient certainly has the right to choose whether or not to continue with dilaysis. We have a similar situation.. the patient really hates coming to dialysis and being in that chair 4 hours three times a week, but his sisters refuse to listen to him and won't let go.
But being competent, A&O, etc. means he has the right to make that decision for himself. Usually what happens is the patient and the doc have a discussion first. (the patient must specifically request .. and make it a point) ..must tell the nurses at dialysis he requests to speak with the doc re his concerns/wishes. Then the doc gets with the family and explains the patients wishes to them... CLEARLY. And they hash it out somehow... it's out of our hands after that. Usually it's between the dilalysis DON or NM, the social worker and the head nephrologist for the dilaysis unit.
If the family wishes info on how things are going at dilaysis for him, they need to makle an appt. or just stop in and see the NM/DON of the clinic... that's the only way they can satisfy their concerns. We are always open to meeting with concerned family, answering questions, and addressing their concerns. Never a problem, and I expect it would be that way at his clinic as well... ( it SHOULD be, anyway !!!)
Also, much depends on the size of the dialysis clinic he goes to. If it is one of those big ones.. like three shifts, and 50-100 patients, etc., then I can see where he would feel neglected... these huge clinics have always appeared to ME to be "assembly line" care. I could never work in one of them.
Our clinic has only 28-30 patients.. 12 chairs. We run two shifts, 10 - 12 patients per shift. And even though we stay quite busy, we do still have time to connect with our patients and fuss over them, carry on and joke with them, and make that all important contact... let them know we care and are interested in them as PEOPLE, not just patients. In the larger clinics, it's a whole different story. Sad, but true.
And yes, even our patients often whine about having to wait on their transporters, etc., but I figure hey... there is so little independence left in their lives... so little that they can actually control..(at least for those who do not drive or are in LTCs)... it's GOT to be difficult ! We're pretty good at getting around the little gripes and fussiness simply by being "family" with them. Again.. a smaller clinic can do this.
I's strongly advise the family to meet with the clinic's NM and social worker to fully discuss his care re dialysis. But if there's no POA or DPOA, etc., the patient's wishes should be heard... the clinic NM should be listening and getting with the patient's nephrologist and social worker on this !
Hope I have helped a little, ktwlpn...