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Patient clinician communication 7 principles
Effective patient clinician communication
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As part of the community clinical rotation students were required to attend one day at a dialysis clinic. The clinic that I had the opportunity to attend was the Regional Health Outpatient Dialysis Center. This visit allowed me to shadow a nurse to gain a better understanding of the dialysis process and also perform non-invasive skills, such as blood pressure and temperature readings. As part of the clinical assignment, the students were required to interview a dialysis patient to gain a better understanding on issues such as the patient’s quality of life, coping mechanisms, health maintenance, and support systems.
Discussion
Interview Process
The dialysis clinic is set up much different than I had expected. Prior to going to the center, I pictured many different patient rooms or dividers where the patients could sit in privacy during dialysis, however, that wasn’t the case. When I walked into the clinic, there were many different reclining
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chairs, approximately 35-45. I had a clear eye on almost every patient in the clinic the minute I walked in. There were curtains that could surround the chairs, but none of the patients had the curtains closed. The atmosphere was very high paced, there were nurses going back and forth from the nurse’s station to the different patient’s chairs. The setting was a factor I had to consider prior to introducing myself to the patient. The patient I had the opportunity to spend time with was a 73-year-old female with stage 5 chronic kidney disease. Instead of asking one question after another, I felt it was more appropriate to have a normal conversation with her. This helped relax the tone of the conversation rather than making her feel like I was just trying to complete an assignment. When I introduced myself, I pulled up a chair; this allowed me to sit at her level. This also made it easier for her to hear me because she was a little hard of hearing. We spent quite a while talking and I was able to learn a lot about her and her feelings regarding the dialysis process and how it has affected her. The patient’s affect was appropriate for the situation; she would smile and laugh if something was funny. Yet she would seem upset about some issues, but she was never flat or withdrawn during these times. The setting was not private; there were patients on each side of us and the clinic staff was constantly walking by. However, we managed to still have a very personal and meaningful conversation. After learning more about the patient, I found out that she is a retired respiratory therapist. She worked in many states, such as, North Carolina, California, and Tennessee, but she settled in Rapid City and worked at Regional Hospital for almost 10 years. The patient was diagnosed with chronic kidney disease in November of 2011. She attends dialysis three days a week (Monday, Wednesday, and Friday) for 3-hour sessions each time. Coping Mechanisms According to Giddens (2013), “Coping mechanisms are stress management efforts” (p. 291). The patient mentioned that if she is having a hard day or feeling upset regarding living with chronic kidney disease, she finds an activity to keep her occupied. This helps prevent her from thinking too much about a specific situation. Some of the activities she mentioned that help refocus her thinking are to call her sisters from North Carolina, read a book, water her flowers, and spend time with her cat and dogs. She has two dogs and one cat. She mentioned that she is unable to spend too much time in the sun because she will began to feel dizzy and nauseous. Therefore, she copes with this by spending a large portion of her day under her covered deck. She loves listening to the birds chirp and watching her dogs play outside. She also plants flowers in hanging planters every spring and she enjoys taking care of the flowers each day. The patient has never been married and she seems as if she enjoys living alone. However, she stated that if she does feel lonely she will call her sisters and they will spend hours on the phone talking. The patient did not display any negative coping mechanisms. Quality of Life Many aspects of the patient’s life have changed since beginning dialysis almost 5 years ago.
As far as the patient’s emotional life, she stated that the diagnosis affected her more in the first couple months following diagnosis than anything. She talked about how she was so scared for the unknown and not knowing what was going to happen to her in the future. Mentally, she was very depressed in those first months. As became more educated on chronic kidney disease and dialysis, she started to have less fear and began to have hope for her future. Now, she feels that she has adapted very well. One of the major fallbacks in her regards to her emotional status was when she got denied a kidney transplant a couple years ago. She said she went back to having feelings of hopelessness and depression. She said she was always tired, sad, and had no energy. She had talked to her doctor about the situation and she was treated for depression. Now, she is no longer on antidepressants and has learned of positive ways to cope when
upset. Dialysis has also impacted the patient’s physical quality of life. One of the hardest things she talked about that have changed is not being able to go on long walks with her dogs outside anymore. She stated that she when she is outside for too long she starts feeling sick. She also stated that she often has pain in her joints, which makes it hard to complete certain activities at home. I recommended that she find an indoor place where she is able to walk and get exercise, such as, the mall or YMCA. She thought this was a great idea. The patient has never been married and never had kids. When we talked about her friends, she stated that she has some in Rapid City but she rarely sees them. This is mainly because dialysis requires a very strict schedule. She comes every Monday, Wednesday, and Friday for three hours in the middle of the day. This is typically from 10am to 1pm. It seems as if she has spent a majority of life alone and doesn’t mind it. She does not have family in South Dakota; the only family she spoke of was her two sisters in North Carolina. Therefore, when each party has free time they are sure to call each other. However, she did talk about how she would like to move closer to her family, but is having a hard time selling her house. She also mentioned that she hasn’t traveled to see her sisters since her diagnosis due to her dialysis schedule. Health Promotion
The article has been well organized and written. Mackay clearly states her rationale for writing the article and provides a valid reason to hold up her article with sources. Within the introduction section, the authors present worrying statistics of Americans affected by kidney disorders. Moreover, the author provides the disadvantages of dialysis with only Kidney transplantation being the only option. The author relates the topic to the readers...
According to my studies, Ms. Mendoza should avoid jobs involving strenuous work activity. Maintenance of optimal health is essential for her due to her being on dialysis since she is predisposed to anemia, have lowered resistance to infection, and experience fatigue. Additionally, the case study didn’t mention if she has loss of vision but most diabetics experience vision loss which impacts the ability to perform job functions .To help Ms. Mendoza , maintain a life-long program of well-being, including a well-balanced diet and an appropriate exercise program, hospitals employ a team of professionals consisting of the treating physician, dietician, medical
Being diagnosed with a chronic illness is a life-altering event. During this time, life is not only difficult for the patient, but also for their loved ones. Families must learn to cope together and to work out the best options for the patient and the rest of the family. Although it may not be fair at times, things may need to be centered on or around the patient no matter what the circumstance. (Abbott, 2003) Sacrifices may have to be made during difficult times. Many factors are involved when dealing with chronic illnesses. Coping with chronic illnesses alter many different emotions for the patients and the loved ones. Many changes occur that are very different and difficult to get used to. (Abbott, 2003) It is not easy for someone to sympathize with you when they haven’t been in the situation themselves. No matter how many books they read or people they talk to, they cannot come close to understanding.
This case study which is taken from Robert M. Veatch’s Medical Ethics book is about a 5 year old girl, who from the last 3 years, has been suffering from “progressive renal failure” which...
Ms. Bardsley functions as a hemodialysis liaison and leader in clinical practice with the following roles: charge nurse, preceptor, and mentor for her colleagues. She is the resource person for the Hct-Line monitoring tool. The tool is used to monitor patient’s fluid removal during treatment to avoid hypotensive episodes associated with decreased perfusion to the heart. She routinely monitors the patient outcomes which to date has resulted in 0 admissions. She recently updated the policy to make it more user friendly for the staff and to maintain staff competency.
Kidney stones they say “is as old as malady”. Due to the fact that it was found in mummies of over 700years ( kidney analysis). Remedies for kidney stones could be achie...
When I think about the moments leading up to my diagnosis I remember feeling weak, confused, shaky and sleepy. I did not notice that I had began sleeping throughout the day. My body was craving soft drinks like soda and juice but not food. Days would go by and I eventually fell into a deep slumber that I found myself only waking up from to use the bathroom. I knew something was wrong and that if I did not get to a hospital it would get worse. Nothing could have prepared me for the life changing diagnosis I would receive.
After further multidisciplinary team meetings with the involvement of John the treatment option of automated peritoneal dialysis was implemented (NSF 2004). Once the Tenchkoff catheter had been inserted, education and training completed John was ready for discharge home.
Kuther, N. (2001). Improving compliance in dialysis patients: Does anything work. Seminars in Dialysis, 14(5), 324-327.
This article describes the choices for treatment: hemodialysis, peritoneal dialysis, and kidney transplantation. It gives the pros and cons of each. It also discusses diet and paying for treatment. It gives tips for working with your doctor, nurses, and others who make up your health care team. It provides a list of groups that offer information and services to kidney patients. It also lists magazines, books, and brochures that you can read for more information about treatment.
To the majority of Americans, dialysis is a confusing process that they will hopefully never have endure, but for hundreds of thousands people, it is a daily fact of life. According to US News and World Report, “In the United States, almost 400,000 people undergo dialysis every year.” (Gordon, 2012, para. 4) Their lives revolve around receiving dialysis three days a week for three to four hours per treatment, usually at an outpatient clinic. While dialysis can prolong the end stage renal disease (ESRD) patients’ life, the three day a week trudge to this clinic can feel like and endless cycle of discomfort and inconvenience. Fortunately the ESRD patient has more than one option, namely, peritoneal dialysis.
For this assignment I had the pleasure sitting down with Emily Petermeier and getting an insight on what the real nursing world is like. Emily graduated from the University of Minnesota School of Nursing in May 2015, and got a job at Fairview East Bank Hospital. This interview really helped me understand what it is like to be a new nurse and the dedication that I have to have going through nursing school and throughout my career. In the interview you will see the perspective of Emily’s endeavors after college and insight for future nurses or nursing students.
The kidneys are responsible for several necessary functions, which include maintain proper blood pressure levels, filtering toxins and wastes from the bloodstream, excreting the waste through urine, contribute to the production of red blood cells and producing a variety of essential enzymes and hormones. Approximately 30 percent of cats develop kidney disease during their lifetime; many of these cases will progress to kidney failure. When the kidneys fail to perform properly, the cat 's life is at risk.
On these occasions, I rely on my nursing assessment, evaluation, and interventions, collaborative skills, and scientific knowledge to make sound clinical judgments for the benefit of my patients. As a hemodialysis nurse, I will persevere to comply with innovation in nursing practice, EBP, research, and education. I believe growth requires generation of innovative, improved ideas and practices for the betterment of the organization and patient satisfaction. For this reason, I will embrace technological advancements; empower front line staff to embrace change and innovation; and motivate staff to be change agents on the floor with the aim to provide better quality of care for our
My mother has suffered from a rare kidney disease called glomerulonephritis my entire life. This disease eats away at my mother’s health, leaving her mostly bed-ridden and depressed. My father is a store director at a local grocery store and has been for twenty-seven years.