I had the privilege of taking care of a lovely lady who really meant a lot to me.
I felt so bad for her because she wasn’t much older than me, and after years of being (admittedly) non-compliant with her diabetes, she had now been admitted with stage 5 renal failure.
She came in only after being discharged the day before, and she was clearly in fluid overload.
We were diuresing her (giving her diuretics to help her body get rid of excess fluids) to no avail. She had a visit from a nephrologist (doctor that specializes in kidney care) and a surgeon, and they told her they were going to put a shunt in her arm and start dialysis. She was clearly very scared – scared to the point that she was going to refuse to even have dialysis done.
A Little Education Goes a Long Way
I spent hours with her over the next three nights basically educating her, explaining (what I could) about her disease process, dialysis, the risk and benefits as well as nutrition and everything else she wanted to know about.
I also spent a lot of time speaking with her daughter regarding her care as well as sharing the fear and the same education I had given the patient. I can say that she did finally agree to have a temporary catheter placed, and she started hemodialysis (HD) –
and after only three visits, she became a new person.
She could walk and was off her oxygen and had normal size extremities and could wear her favorite shoes.
Effectively Communicating a Patient’s Needs
She thanked me many times over for the time I had spent with her and the education I had given her and her family. She also thanked me for communicating her needs and fears to the doctors as well as arranging for her to have a nutritionist consult.
It really bothered me because we see so many bad things happen to people who have no options, but she had an option.
She just needed communication, education, trust and time – and I feel that’s what she got!
-Karen R. York, RN-BC
About Karen York, RN-BC
Karen is a clinical nurse in 5A Med Intermediate Care at WakeMed Raleigh Campus.
About the Take 5 Program at WakeMed
The Take 5 program was designed by a nursing unit council to demonstrate the impact that nurses/staff can have in improving patient satisfaction and experiences.
With the “Take 5” concept, WakeMed nurses set aside time on each shift (five minutes) to sit with their patients to talk about non-task-related topics. Nurses are then encouraged to write a brief narrative about one of their experiences to be submitted each month for review.