Soooooo... how many kilos did YOUR pts. come in OVER after the holiday?

Hellllllo Nurse, BSN, RN · Apr 22, 2003

Many of ours were way over, but w/ very low B/Ps, clotted catheters (sent 3 out yesterday), etc.

It's been so rough at work, I can only describe it as hellish.

jnette, ASN, EMT-I · Apr 22, 2003

Yep...it's been wild here, too. We have one SWEEEEEEEET little lady who's been there ever since before I have.. she's 92 and just as spry and kind and sweet as can be... she clotted off last Friday.. we sent her on to the hospital to the surgeon two hours away.. he was supposed to declot her and have her back in a day or two.

Welllllllll... guess what? He FORGOT to see about her ! :eek:

So this little sweety spent her entire Holiday weekend plus yesterday in the hospital for NOTHING ! When she could have been home with her family enjoying Easter.

Hope the doc had a nice one with his....grrrrrr.

Hellllllo Nurse, BSN, RN · Apr 22, 2003

That is awful.

We had a sweet lady die unexpectedly.

Her machine was all set-up, and she didn't show for tx, which is unlike her. A co-worker called her house and was told "If you want to see her, you'll have to go to the funeral home. She's dead."

!!!

This lady seemed to be doing much better last week. She really was looking good. Her death was such a surprise to me.

I worked inpt hospice for 4 years, and was not bothered too much by the pts dying. I mean, they were expected to die.

In dialysis, though, it bothers me. I thought that I'd be working with a healthier, more stable group of pts in chronic dialysis vs. hospice. You know what? Not really!

jnette, ASN, EMT-I · Apr 22, 2003

I'm sorry about your patient, Helllo.

I, too, am always saddened when ours pass away. Each is different. We had one man there 12 years. Others are there only a year or less and die. I can't count on two hands how mant of our patients have passed away since I've been there. Then again, we still have a good number who were there when I started 6 years ago. They really are NOT healthy, by any means... but they are living, and appreciative of that fact. Several even work, and go on vacations, etc. Just all depends on what other issues are going on with them medically.

I always have to remind myself of what our DON tells us.. we can't CURE them... but we sure can help them enjoy what's left of their lives and give them that much. And we do. We really get into our patients. They truly do become like family, and it's always sad when one passes.

Dialyzin' Dar · Feb 25, 2004

I've been on hemo for over 8 years... I've seen many patients pass, a few of them in the treatment room with me. I was young when I started hemo (23), and it was really hard going to dialysis because everyone was so sickly. I don't know how some of them can keep going, when it seems that no matter what they do, things just keep getting worse and what little physical abilities they still have are being taken away from them bit by bit. I sometimes feel guilty for my relative good health when I look at my fellow patients-- I can leave the unit after dialysis and go home like nothing happened, but most of the other patients are exhausted after treatment and never really get to recuperate before it's time to come to dialysis again.

For the large weight-gainers, the feeling is, "I don't have too much longer to live, anyway-- why shouldn't I eat and drink what I want during the holidays, because this might be my last year on this Earth!" I understand that it's frustrating to get the weight off of a patient only to see it go right back on over the weekend, but they're not doing it just to tick you off-- they do it because they feel it's a hopeless situation. A lot of patients I've talked to at my unit are fatalistic and fully expect that their health will get worse-- unless you can change that mindset, I don't think you'll ever win the fluid/diet/treatment battle.

jnette, ASN, EMT-I · Feb 25, 2004

I've been on hemo for over 8 years... I've seen many patients pass, a few of them in the treatment room with me. I was young when I started hemo (23), and it was really hard going to dialysis because everyone was so sickly. I don't know how some of them can keep going, when it seems that no matter what they do, things just keep getting worse and what little physical abilities they still have are being taken away from them bit by bit. I sometimes feel guilty for my relative good health when I look at my fellow patients-- I can leave the unit after dialysis and go home like nothing happened, but most of the other patients are exhausted after treatment and never really get to recuperate before it's time to come to dialysis again.
For the large weight-gainers, the feeling is, "I don't have too much longer to live, anyway-- why shouldn't I eat and drink what I want during the holidays, because this might be my last year on this Earth!" I understand that it's frustrating to get the weight off of a patient only to see it go right back on over the weekend, but they're not doing it just to tick you off-- they do it because they feel it's a hopeless situation. A lot of patients I've talked to at my unit are fatalistic and fully expect that their health will get worse-- unless you can change that mindset, I don't think you'll ever win the fluid/diet/treatment battle.

Hello Dar ! :)

I thank you for your input... it is sooooooo important to have input from "the other side".

And you know what? I DO agree with you ! Points well taken.

Oh, we fuss at our dear patients, but never angrily or mean. They KNOW it is our JOB (and our HEART).. that wants to keep them well... for as long as possible. I have greatest respect for our patients, because I KNOW the sacrifices they must make in order to maintain what health they have.. and as you say, some do not have much health at all.

And yet... even our "noncompliant" patients do agree... when they do follow the fluid recommendations as well as the potasium/phosphorus issues... they truly DO begin to feel BETTER ! And if they can at least feel BETTER for what time they have, it is worth SO MUCH ! To themselves, AND to us ! Because we like to see them feeling "well".. and therefore happier.

You are so correct in the "fatalistic thinking"... I can understand that fully... with my head AND my heart.

And still... we have patients who have been on dialysis going on twenty years.. some working, and vacationing... these are the ones who do tend to be more careful with the regimen. Much depends, of course, on co-morbidities.

Again, I do thank you for your insight.. what a pleasant surprise ! :kiss

talaxandra · Apr 9, 2004

Okay, I know this thread's a couple of months old, but there're so many interesting discussion's that it's hard to keep up-to-date.

We had a personality-disordered dialysis (acute-on-chronic) patient who was a major headache, abusive, wouldn't stick to anything like a fluid restriction however well it was explained, would go into APO at the drop of a hat...

Anyway, he was sent home for out-patients HD and kept coming in progressively heavier - the winning weight was three weeks after discharge, after three days off (missed his regular slot), when he was 22 kilos/48.4 lbs over his dry weight! You could check his JVP from the door!

Most bizarre thing? About a month later his figures had improved so much they stopped dialysis and now he's fine.