While working in the renal clinic as the care manager this past year, I accepted an Informatics Nurse position, which started in September 2017, navigating duo roles. Renal (nephrology) nursing is a very specialized area of nursing directed towards individuals with kidney disease, and their family. According to the National Kidney Foundation, more than 30 million Americans- one in seven adults has chronic kidney disease, and most don’t even know it. My responsibilities were to work alongside with the nephrologists, caring for those veterans whose health are compromised by kidney disease or failure, as well as those undergoing hemodialysis or peritoneal dialysis treatments. Large number of veterans seen in this unit has multiple comorbidities. …show more content…
Issues at hand are veterans who are on hemodialysis and have a vascular access such as a fistula, graft, or catheter for their treatments. Often these dialysis accesses are compromised by some type of failure, which prevents them from getting their required dialysis treatments 3 times a week. The action plan that is designated for the renal nurse is to coordinate care from the outside dialysis units, to placing a descriptive note in the CPRS system, and getting this information to the nephrologist, who will then place a consult in the system for procedural approval. Once the pending procedure is approved, the veteran can be seen at an outside vascular access facility. The next step is to coordinate care with the Utilization Review department to expedite care, and follow up with the outside dialysis unit to assure them that their care/finance will be provided by …show more content…
This veteran had presented problems for himself 4 years ago when he refused to return any calls from the renal department, and missed several renal appointments. During that time, the veteran passed out while at work, and was taken by squad to the hospital, where he then was placed on hemodialysis. Since then, he has improved his overall quality of care by identifying problems that contributed to his renal failure such as hypertension, diabetes, and other related issues. This veteran comes to each Kidney options class and presents his story on how being on hemodialysis has impacted his life. By doing so, he is able to reach out to other veterans who are faced with this same dilemma and are very apprehensive. The outcomes of my CKD classes, veterans have indicated that they have a better understanding of their kidney disease, which has provided them to be more involved in their health care. I have provided surveys after each class and have notice more feedback with phone calls that has increased from 30 to 70% of these veterans are making progress in monitoring their blood pressures by reporting consistent blood pressure results, monitoring their diet, and addressing other contributors to their disease. Most of their attitudes has changes as they voiced that they have a better outlook of their future. I am an advocate for health
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.
It has also developed numerous courses that are intended to provide information and tools that may be needed to approach both significant nursing care and patient care issues. Given the scale of the population suffering with chronic kidney disease and the diversity of backgrounds in which patients are found, this curriculum may be of benefit to nurses caring for nephrology patients in many settings (ANNA, 2015). It supports, promotes among its members, and sponsors nursing research intended to develop evidence-based practice and to advance nursing science (ANNA, 2015). It strives to provide nurses with leadership opportunities, and encourages nurses to seize opportunities to advance and refine their leadership abilities (ANNA, 2015).
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.
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.
The purpose of this assignment is to demonstrate my reflection and understanding in the Role of the Mental Health Nurse in an episode of care supporting and promoting the recovery of service users. According to the National institute for Mental Health (2004) recovery is a process to restore something or return to a state of wellness, is an achievement of quality of life that is acceptable to the person (Ryan 2012).
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...
When I was working as a bedside nurse in the Emergency Department, in one of my duties I was not satisfied with the treatment plan made by a resident doctor for XYZ patient. He entered intravenous KCL (potassium chloride) for the patient. The purpose of that medication and its dose for that patient was not clear to me. I assessed patient history and came to know that a middle aged patient came with the complaint of loose bowel movements, vomiting, and generalized weakness. His GCS (Glasgow comma scale) was 15/15, looked pale but was vitally stable. I exactly do not remember about his previous disease, social or family history but I do remember that he was there with his son. According to the care plan, I inserted intravenous cannula, took blood
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
In this reflective essay, I will be using the Driscoll’s model of reflection to talk about how my knowledge of quality nursing care has improved since the commencement of this module. Quality nursing care has helped me develop various nursing strategies that will guide me in my first placement and throughout my career in nursing. Furthermore, it has taught me about communicating effectively with patients, I have learnt about verbal communication such as paraphrasing when communicating with patients to ensure that what said is properly understood. I have learnt not to make assumptions about patients and putting them in the middle of their care, taking into account their preferences.
The following essay is a reflective paper on an event that I encountered as a student nurse during my first clinical placement in my first year of study. The event took place in a long term facility. This reflection is about the patient whom I will call Mrs. D. to protect her confidentiality. Throughout this essay I will be using LEARN model of reflection. I have decided to reflect on the event described in this essay since I believe that it highlights the need for nurses to have effective vital signs ‘assessment skills especially when treating older patients with complex medical diagnoses.
To improve my understanding of maintaining my capability for practice as a RN, I set a goal to learn in depth from my classes, related units, and through interacting with my friends and tutors. There were many setbacks on the way, but as I became more acquainted with the matter I began understanding better. In this reflection I’ll use Gibbs reflective cycle (Gibbs, 1988) to address my experiences as a student nurse in fulfilling the maintenance and capability for practice. Description Through tutorials, lectures and simulation classes every semester, our practice is enhanced and maintained so that the skills and knowledge we learnt is always nurtured while new ones are gained.
“The ultimate value of life depends upon awareness and the power of contemplation rather than upon mere survival” (Aristotle, n.d.)
I am working as a staff nurse at one of the Integrated Management System (IMS) accredited hospital in Sarawak since 2014. I qualified as a Registered Nurse with a Diploma in Nursing in year 2007. My first year I have been working in a multi-disciplinary ward. We cover a range of specialties including minor and major surgeries. The health care team in my ward consists of 1 Unit Manager, 20 staff nurses and 15 care assistants.
The following essay is a reflective account on an event that I, a student nurse encountered whilst on my second clinical placement in my first year of study. The event took place in a Fountain Nursing Home in Granite City. I have chosen to give thought to the event described in this essay as I feel that it highlights the need for nurses to have effective communication skills especially when treating patients that are suffering with a mental illness. Upon arriving to the Nursing home for the second time on Thursday November 14,2013; assigned the same patient as before. On meeting my patient the first thing I noticed myself doing without even thinking about it was giving her a visual inspection. Before nursing school I never really looked at someone at face value and inspected him or her physically. While interacting with my patient I felt as if I was taking to my grandmother, it was very comfortable and easy. Her neurological assessment was good, she had eye contact with me, was able to follow some simple commands such as showing me her hands and squeezing my fingers. Being in the nursing home-made me feel like there was so much medical information to acquire, I viewed it as my own personal practice space for my nursing skills. When taking with my patient she reflected on her life a bit and her stories made me get emotional. The Patient, admitted to the nursing home as a permanent resident after the death of her husband.
Chronic Kidney Disease. Mayo Foundation for Medical Education and Research, 2014. Web. 20 May 2014.