What should EVERY nurse know about Dialysis

Specialties Urology


I am a dialysis nurse turned home care nurse...live in a rural area that recently has had a dialysis center open (I work there PRN). With this opening the local home care agency has seen an influx of dialysis patients...and due to conflicts of interest I can not be their primary home care nurse. I am planning an in-service focusing on basic need to know info on dialysis patients and care needs. So I ask you, the dialysis nurse....what do YOU wish EVERY nurse knew about the dialysis patient?

Specializes in Dialysis.
NDXUFan As a dialysis patient, 99 percent of this information is true, but, not always.

I remember an attending who would tell the house staff, after they were dumbfounded by some clinically challenging situation, that the patient "didn't read the book". You, sir, didn't read the book. :)

Yes, Chisca, not every dialysis patient follows the book. :) Now, it is time to set up my machine for my nightly Nocturnal dialysis and I need to go to the local grocery store for some low sugar Orange Juice. :)

Dialysis patients are the most stubborn people that I have ever met. They know what they are supposed to do and the diet that they are supposed to follow but most of them could care less. I have found that you have to over look a lot of things in order to stay sane. Some patients love to be educated but most of them could care less.

In every situation on this earth, there are costs and benefits. Clearly, you see the benefits but are unaware of the costs. In the 19th century, housing reformers were appalled by the housing conditions for most or the vast majority of immigrants. The reformers saw the benefits of higher quality housing. Yes, that higher quality housing was available for a higher price than the immigrant was willing to pay. Yet, the immigrant was saving to send money back to the Old World, for a better education for their children, or to save and start a business. This just did not happen in the United States, but in many other nations as well. However, to the housing reformers, the "benefits" that they proposed, were clearly superior to the goals of the immigrants who had risked their lives to come to the United States. In fact, more people died coming to United States from Ireland than did on the slave ships from Africa, 22 percent to 9 percent. One of the largest dangers in this world is the arrogance of the highly educated. They and the housing reformers believe that their choices because of their education is superior to the choices of the immigrants. Housing reformers asserted that better housing was available because of their actions. However, this is false, rising incomes produce a wider variety of choices in the world.

Many people will tell you how the public schools are great for your children, while they send their children to Sidwell Friends(Clinton, Obama, Biden, and numerous other members of the Democratic elite). Bill Gates proclaims the greatness of the Common Core education push, yet, Common Core is not addressed in the school that his children attend at Lakeside School in Washington, where the tuition cost is in the neighborhood of $28,500 per year.

I am curious, NurseonTheway, how you would respond to numerous lectures about not drinking as a diabetic with a raging thirst? If you are curious, the cause of diabetes is unknown(John Hopkins, Mayo, Cleveland Clinic, and numerous other academic medical institutions). Over 90 percent of individuals who work in dialysis have admitted that they could not follow the renal diet. The vast majority of dialysis personnel admit that they would choose home dialysis for themselves, while sticking other people in a dialysis center. The therapy that is being offered by Fresenius and Davita is very sub-par at best(Indiana University Home Dialysis). If you need or want a transplant and would like to buy a kidney, that is illegal. YET, the very same group of people who stated that buying kidneys with money or any other fiscal exchange, should be illegal, are the very first people to check and scan the wallet of someone who wants and needs a kidney transplant. A number of the Indiana University Home Dialysis Nursing Staff have admitted this is total and complete hypocrisy.

The two people who have the most to benefit or lose from a transplant are donors and the individual who gets the kidney, not arrogant third parties. Why are third parties making these kind of decisions when they do not have anything to lose?

If you are serious about eliminating the problems of kidney failure and dialysis, propose and push for reforms, so that these issues are eliminated. First, propose Nocturnal Dialysis programs. If you did this, problems with kidney failure will cease and desist. Second, greatly speed up the process for kidney transplants and drop the hypocrisy. This issue is between the person getting the kidney, the donor and the doctor, as it is repeated endlessly for abortion rights.

You can stay sane by not treating dialysis patients as children or as ignorant fools. The IU program treats us as adults and they do not have any of the behavior problems of Davita and Fresenius. I worked as a police officer for a large metro county and I can tell you that dialysis personnel have some very serious control issues. Most of my family is in Nursing and they would be appalled by the treatment of dialysis patients. What about discharging dialysis patients for nothing more than asking about their treatment plans? Criminals have more rights than dialysis patients, yes, I do know what I am talking about....... With some of the abuses that dialysis patients have told me, I would making sure that I would call the local prosecutor and those individuals would be going to jail. In domestic violence cases, in the majority of local jurisdictions, the charge results in automatic arrest. If some of the actions of dialysis personnel were in a DV case, they would be going to the slammer.

My last question is, "Would you be willing to live the way that you dictate to others?"

It is just like the people who cry about slavery, bashing Europeans while using European moral standards.

Specializes in Med surge, ob,pediatrics,GYN,dialysis,ER.

Try being on the receiving end of patients that bash you for trying to help them be autonomous with their disease. This practice spoke of above does not happen in every center...I assure you.

Specializes in Renal.

It really depends on the patient. We dont recommend a full meal because of possible BP complications but a snack to help diabetic patients is fine.

Never said that it did.

More individuals who were in need of a kidney transplant have died on the kidney transplant list have died than U.S. Military personnel who lost their lives in Vietnam. Now, we have over 100,000 people on the list who need a kidney and this list is growing each and every day. How could anyone think or believe that this current policy is a good one?

People respond to incentives and since there are no incentives, they are not responding.

Specializes in Quality, Cardiac Stepdown, MICU.

It's sad and unfair, but people without money don't get organ transplants, because antirejection meds are expensive, and people who don't have stable finances and a place to live and insurance to pay for these meds are less likely to be successful stewards of their organ. With such a short supply, decisions have to be made. It SUCKS and I hate it, but I understand why it's that way.

Specializes in Dialysis.

Wealth of information on transplant centers in the U.S.

SRTR -- Scientific Registry of Transplant Recipients

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