Needed Education For The Hemodialysis Staff

This author’s personal perceptions concerning patients facing a lingering terminal illness, have been shaped by over 20 years of critical care nursing experience. Facing death and illness on a daily basis requires self-examination and a high degree of comfort with one’s own mortality, limits and values. Constant exposure to the fragility of life forces respect for the whole person and the people who love them. A general approach to patients who are actively dying is to allow them to define what they want and need during this time. The nurse’s role

There are two different options evident concerning Mrs. Boswell’s treatment options. While considering both options, it is important to teach the family in depth the effects of the dialysis treatments along with her other chronic illnesses. The first option is to discontinue dialysis treatments and place her in a hospice facility. In hospice care, the goal is of focusing on minimizing pain and suffering, rather than to cure. Going to hospice care would allow Mrs. Boswell to forgo her stringent dialysis treatment and provide her comfort measures allowing her to endure her illnesses with optimal pain reduction. Along with treating the sole patient, hospice care allows for family to be there throughout the whole process while being provided bereavement support. The book p. 234 says that nurses play a pivotal role when tending to patients with notable poor outcomes, bringing attention to caring and not curing.

Ms. Mancinho continues to strive for excellence and patient care improvements in her position as staff nurse in the hemodialysis unit. She is currently the primary nurse for five of our chronic dialysis patients. All of her primary patients exceed recommended adequacy guidelines and maintain patent, infection free arterial venous fistulas/grafts. While participating in monthly interdisciplinary care plan meetings, she makes suggestions that have led to positive outcomes such as: changes in dry weights, reviews of patients medications with the nephrologist to facilitate warranted medication adjustments as needed, referrals/close coordination with other disciplines such as podiatry and wound care to prevent infection/amputation in patients with advanced vascular disease, and endocrinology for educational purposes for well controlled blood sugars. She is able to quickly assess subtle changes in her patients to then notify the charge nurse and physician for appropriate guidance in facilitating positive patient care outcomes. Through her acute assessment skills she prevented an access from clotting. Prevention of clotting leads to extended longevity of the access. She applies the nursing process to systems or processes at the team/unit/work group level to improve Veteran care. She worked with flow in the new unit which led to better patient care and staff satisfaction. She developed the time out policy: a requirement for

Patients that qualify or use palliative care also have a terminal diagnosis but usually have a longer life expectancy than those with hospice. The definition for hospice and palliative care is something many nursing students learn during their program. Young-Ran, Min, and Kyoung-Soon (2015) found in a study that 70% of nurses in a general hospital setting that had cared for a terminal patient had no prior education or training for palliative care. Nursing education continues to evolve in attempts to better prepare nursing students for life after their program completion. Attempts to better familiarize students with end of life care some programs are using simulation. Simulation has been found to be an effective method of teaching when related to high stress and emotional situations (Moreland, Lemieux, and Myers, 2012). It is great that there have been attempts to increase the amount of education in this specialty area especially since 76% of dying patients are receiving nursing care at time of death (Moreland, Lemieux, and Myers, 2012). Now it will be important for current nurses and educators to continue to increase the amount of information provided in nursing programs and to novice nurses about hospice and palliative specialty

Ms. Conlon applies the nursing process to systems or processes at the unit/team/work group level to improve care. Deirdre has been the primary nurse for 6 hemodialysis patients. She has involved patients and families in monthly interdisciplinary meetings to promote self-efficacy and quality of life. With the help of the interdisciplinary team Deirdre has worked collaboratively to address and reinforce nutritional needs, social/family issues, barriers to care, and safety concerns. All of her primary care patients have maintained a goal of 100% for dialysis adequacy (benchmark is 85%) and a vascular access rate of 100% and dictated by KDOQI standards.

Ms. Cetiner has been an RN in the hemodialysis unit for the past 6 years. She provides excellent care to our Veterans, and consistently functions in a professional manner with staff, patients and families. She was part of a unit I CARE award presented by Dr. Mayo-Smith for quality and commitment to our Veterans. She demonstrates competency in the utilization of the nursing process as evidenced by the accurate assessment, plan, implementation, and evaluation of patient care in her daily practice. She developed a unit diabetic foot

1.1 Caring for patients at the end of life is a challenging task that requires not only the consideration of the patient as a whole but also an understanding of the family, social, legal, economic, and institutional circumstances that surround patient care.

Caring for patients at the end of life is a challenging task that requires not only the consideration of the individual as a whole but also an understanding of the

Caring for patients at the end of life is a challenging task that requires not only the consideration of the patient as a whole but also an understanding of the family, social, legal, economic, and institutional circumstances that surround patient care.

Dr. Bowron also incorporates the opinions of his fellow professionals to embolden his ethos in this article. Nurses, in his hospital, share with him the desires of the elderly to embrace natural death rather than being subjected to medical advancements such as dialysis.

Nurses: Assist the patients and families to cope with the end-of-life process such as assessing and

The assessments of the patient in an end of life situation must occur frequently as to detect rapid and/or minimal changes in the patient’s condition. It is also the primary nurse’s role to report any and all changes to the multidisciplinary team, including the family members.

It is important to remember that care of the patient does not end when the patient dies. After the death there is still work to be done in the form of comforting the bereaved family members. It has been reported that some

The American Nephrology Nurses’ Association (ANNA) is the professional association that represents nurses who work in all areas of nephrology. The ANNA was established in 1969, as a nonprofit organization. The organization promotes excellence in and appreciation of nephrology nursing so a positive impact can be made on the lives of people living with kidney disease. Members of the organization practice in areas such as hemodialysis, chronic kidney disease, peritoneal dialysis, acute care, and transplantation. ANNA believes that the demand for quality nephrology patient care will continue to grow in the future, particularly with the variety of changes occurring within health care. The American Nephrology Nurses’ Association acts consistently on their own core beliefs, including the responsibility of nephrology nurses to enhance the quality of care delivered to people with kidney disease. As an organization, the responsibility to provide the educational programs necessary to create, preserve, and augment competence in practice is their purpose. In addition to their values and purpose, the organization has outlined their desired outcomes. These include: more interaction and commitment of members to ANNA; more diversity in age, race, and gender, as well as professional levels and subspecialties. The ANNA believes that nephrology nurses are in a unique position to enhance the quality of care delivered to individuals living with kidney disease. The organization offers continuing education, with a focus on nephrology, in hopes of creating a larger impact on the care of these individuals. The ANNA believes that continuing education is essential to the development, maintenance, and augmentation of competence in practice. As well as, a team-based approach and inter-professional collaboration as the basis of

As a dialysis nurse I am tasked with providing pre and post treatment assessments for each patient and through these assessments I identify if there are any patient problems that must be managed. These problems can include access issues, such as clotting or infection, fluid related problems and many others. If a patient is short of breath or complains of chest pain prior to