noob. first post.

[TrishaHDnurse]

I'm not on dialysis. I don't know what it feels like to be on dialysis. I became a dialysis nurse one year ago because it pays $10 more per hour than my ICU job did. We had added a fourth child to the family, and if I didn't change jobs it wouldn't be worth it for me to work outside the home due to childcare expenses. I only do inpatient dialysis currently... most of my patients are chronic dialysis patients who are admitted to the hospital for infection, fluid overload, etc. A lot of times, I do a patient's very first dialysis. It's pretty difficult to explain to someone what dialysis feels like if you've never had it done to yourself. Most patients are anxious. I try to imagine what I would feel if I were in their situation. Without writing a book, I could sum up the past year and say that this job has changed my life... mainly the past few weeks but in general I do not look at my patients the same. I kind of feel like there's really nobody advocating for the dialysis patient.
* "They're on dialysis, they're supposed to feel crappy." No. As a physician you're taking the easy way out just by thinking this.
* "That guy is a drug seeker." No. He's in freaking pain. Whether it's physical pain from a medical condition or physical pain stemming from depression, it's still pain. He wants to feel numb. To feel nothing is better than pain. Maybe you should try a different antidepressant. Something. So what if it's his 20th hospital admission... If YOU give up, why wouldn't he?
*one of my biggest pet peeves is when doctor's do the "huddle rounds" outside a patient's room and nobody comes in to talk to the patient. The patient should be in charge of their care. They need to be involved. They need to know test results. They need to know why they are getting medicine... fyi I am giving you this Aranesp/Procrit because your hemoglobin is 9 and our goal is 12.

...... and I just got called in to do an emergency patient... guess I'll post more later!   
Trish

[Willis]

Thank you! You're the kind of health care provider we all dream about! 

 

[willowtreewren]

Your patients may have no idea what a gem you are because they are new to dialysis. But you are what every patient should have in regards to medical staff!

 

Welcome to IHD. 

I'm sure you will learn much from the patients' perspectives here.

Aleta

[MooseMom]

Hi Trish.  I'm really glad you joined our community; it shows that you really do care about your patients.  Anyone who has ever had any kind of health issue (and that's most of us) can identify with the concept of uncaring doctors who see you more as an interesting case (or not) than as a whole person.

The "dialysis community" is gradually finding its voice.  With diabetes and CKD rising to epidemic proportions, more and more people are ending up on dialysis, and we are not all feeble in both body and mind.  We are learning more and more about dialysis and the different options that are open to us.

We are encouraged by our medical staff to work "as a team", to be our own best advocate and to educate ourselves about our illness and about dialysis.  But at the same time, we are still shunted to the sidelines and are labelled as "non-compliant" or some other fancy term for "troublesome" when what we know to be true clashes with what we are told is "best" for us.

I know that right now, you are doing incenter D only, but it may be worth your while to learn about home hemo (ie NxStage/nocturnal home hemo) so that you may be able to identify which of your patients might be good candidates for this type of therapy.  You probably already know this, but the standard thrice weekly, incenter modality with the two-day layoff statistically gives the worst clinical results for the most people.  It just doesn't provide enough dialysis.  Yes, there are patients who need to have the extra care and attention that comes with inclinic dialysis, but there are plenty of others who would do fine at home.  This would free up inclinic resources for those who need it, and it would result in better fluid and K/PO control for the home dialyzor.  You could make an enormous difference to many of your patients if you could help your clinic identify home hemo candidates, if you haven't already.

I know that being a dialysis nurse can be just a job like any other.  I realize that you did not have any special calling but that you changed jobs for better wages, and that is certainly fair enough.  But I also see that your life has been changed by your new experiences, and I'm sure your patients are grateful.  Reading through all of the posts on IHD will give you an even better idea of what life is like for the renal/dialysis patient, and the greater insight you have, the better advocate you can be; that would be invaluable.  But let me assure you that you do not have to be on dialysis in order to give the best care possible.  You don't have to know what it feels like in order to be able to show simple human compassion and to want to relieve someone's suffering.

Wishing you all the best with your patients and your fourth child.  Please post often; we really value the membership of those people who give care, not just receive it.  Thank you so much for taking the time to come and get to know us.  We are very grateful.

[monrein]

  to IHD and thank you for your compassion on behalf of all those patients you work with.  Having you in their corner is a huge blessing whether they know it or not. 

[jbeany]

Welcome Trisha! 

We're always glad to hear from professionals.  Feel free to join in the discussions and we'll help you learn as much as you can about what it's like in the chair!  We need as much dialogue between us as we can get.

jbeany, Moderator

[Ang]

 

[peleroja]

Wow, what an incredible nurse you are.  So glad you found us!

[TrishaHDnurse]

Thanks! Sorry for the rant.... I think I will look into home hemo. I asked another nurse about it last night and she said I'd probably have to work in a clinic for at least a year.... not sure why, I would think being able to do a patient's dialysis in the hospital with no orders and no call back from a doctor would qualify me, but oh well... I didn't sign up for clinic work because I feel like there are so many problems with the way clinics are run, and I have no power to change anything, I would just be frustrated on a daily basis! I'm really not an angry person.....

I've only had one or two patients in the hospital who were doing home hemo. They were healthy. I was reading this the other day and found it interesting: http://www.thedoctorschannel.com/video/3548.html
it makes sense that daily dialysis would give the best outcomes... the patient that was telling me about her home hemo in the hospital was doing 6 days per week, 2 hours per day from 6am-8am and she had the rest of the day to do what she wanted. just makes more sense.

[looneytunes]

Hi Trisha and welcome!  So glad you are one of the good ones!   

[Rerun]

Hi Trish, it is nice to have a caring nurse out there.  You might look into clinics.  Not as much stress and most of us do well.  You won't have the extreme needy ones there. 

Thank you for joining.

Rerun, Moderator