The Role That The Dialysis Patient Can Play In Ensuring High Quality Care

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Have you ever felt, "My nurse is unresponsive and I feel like my well being is the last thing on his/her mind; it is all about the profit." Or have you thought, "Whenever I bring an issue to my nurse's attention s/he always seems oblivious and is unable to solve my problem." Some even suggest that, "My nurse does not listen to my concerns and I never fully understand his/her directions because s/he is not clear." Well, you are not alone!  These questions were adapted from various Dialysis Facebook discussion forums and came from real people who are suffering  similar frustrations. Believe it or not, nurses are the lynchpin connecting all facets of dialysis patients' healthcare. Some people are unclear about how important it is to cultivate a quality relationship with their dialysis nurse, when in fact, s/he is one of the most important people  to convey the day-to-day issues arising during treatment whether In-Center, Home Hemodialysis or Peritoneal Dialysis. The problem is that if you happen to be assigned to a nurse who is not functioning effectively, you could experience setbacks in your treatment or occurrences that can threaten your very life. 

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If you notice that your nurse has less time to actually listen to your concerns, has a lackadaisical attitude in dealing with challenges you bring to his/her attention or an unwillingness to properly address your full medical needs, you may want to highlight this in a Quality Care Evaluation, discuss the issue with your nurse directly and/or talk to your Nephrologist.  If none of these measures are effective, encourages you to request another nurse immediately because it is that important. 

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Dialysis is not like most areas of nursing where you see the nurse infrequently. Typically, dialysis patients see their nurse much more frequently than does the general public. As a person on dialysis you should receive and insist on the highest quality of care because your nurse must be prepared at all times to act professionally.  There is no question that good open communication with your primary nurse limits your stress and ultimately improves your health outcomes.

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A good nurse possesses excellent personal communication skills. They must follow-up on issues of concern that you have and ensure that your concerns reach the right members of your healthcare team capable of solving those problems. You should look to your nurse for support and s/he should be able to anticipate your medical needs. A dialysis nurse should also be able to contend with periodic issues of  pain and suffering and should be able to express empathy and compassion as well as give comfort.

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It is critical for your nurse to have a high sensitivity to detail. One mistake in putting you on a dialysis machine or giving you medication, or assessing your labs could be very costly so nurses should not skip steps or make careless mistakes. From reading your lab results correctly to remembering the nuances of your specific case, there is nothing that should be left to chance in nursing because attention to detail can literally be the difference between you living or dying. This point cannot be overemphasized.

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Whether it is changes to your schedule, talking to your family, soothing your concerns, dealing with a doctor, or managing the facility staff, nurses must have good problem solving skills. Creativity in solving an array of problems is a trait that your nurse must have, and will likely need to be ready to respond quickly to emergencies and other situations that will inevitably arise.         

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A great relationship between you and your dialysis nurse is one that consists of mutual respect. Lay down your personal boundaries and feel free to openly discuss concerns with your nurse. S/he should remain impartial at all times and mindful of confidentiality requirements. But above all else, your nurse should respect the decisions that you make for yourself and about your body. So the next time you have the opportunity to evaluate your nurse, give it some time and think carefully about it because the feedback you give can improve the dialysis care you and other dialysis patients will receive.

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"Top 10 Qualities of a Great Nurse." NursingLink.
"2012 Fresenius Medical Care: Patient Satisfaction Survey." Fresenius Medical Care
Belcher, Lynda Moultry. "The Effects of a Bad Nurse Manager." EHow.