MsMort

Do the PMHNP program only and start looking into some CBT training. It's what EBT indicates as the most helpful for so many disorders.

You raise some interesting points here. Great post. I've worked at 2 different facilities. One allowed visitors in the dialysis centers while patients were undergoing dialysis and one did not. In my opinion, the patients at the center that allowed family and friends to visit (one per patient) seemed more satisfied and accepting. Family and loved ones also seemed to understand the importance of supporting the concepts of compliance. Not sure about the wisdom of enforcing the "no visitors" policy or why that ever went into effect. I've heard (and argued) all the HIPAA and infection control issues with the management and debunked all of them. Unless patients are stacked like cordwood, (which is something I can never agree with), I see no reason for this policy. How do others feel? As far as your stethoscopes are concerned, what do your providers do? Do they carry their own stethoscopes? I'm an NP and I do. I clean it frequently (wipe off the diaphragm after each patient). I also use covers. I have seen a patient whose kidney function was recovering nicely after AKF (cr down to 1.7 with a BUN of 21) but because of UF standing order of decreasing dry weight by 0.5 kg each treatment, became dehydrated, hypotensive after each treatment, and went back into AKF. Charge nurse "afraid to contact the attending because he left orders that he wanted his patients so dry their toes curled!" Thank goodness, not my patient! But so sad. Not recovering now. Be alert!

Sorry. Not ALL patients on dialysis have hypertension. Remember that patients are all individuals and need to treated as such. Leaving standing orders and nor reviewing them can put our patients' lives and futures at risk. Never assume.