Putting the Pieces Together for Patients


By Stuart Mott

Envision yourself as a new hemodialysis patient. You are asked to arrive at the dialysis clinic before the sun even begins to rise. You arrive with little sleep and are called into the unit, escorted to a chair that seems to be on the outer reaches of the universe, and are expected to spend the next four to five hours of your life there, every other day.

Not only are you tired, you are numb and unsure of what is expected of you. You are afraid of what the day will bring—possibly fluid overload and not feeling well physically.

A nurse approaches you carrying what appears to be an unending pile of forms. He/she sits down next to you and asks you to begin signing the consents that places your life in their hands.

You have had to start dialysis without delay—having had a dialysis catheter placed just days ago. The nurse/technician connects you to the dialysis machine, and you are in disbelief about what is happening to you. You see your blood being taken from your body and sent to a machine to be “cleaned.” All around you are new sights and deafening sounds that burden your senses. Some way or another you manage to complete your dialysis session and before you know it, several weeks have gone by and you are being sent back to the hospital to have an arteriovenous (AV) fistula/graft placed.

Yet another strain on your daily life. However, you have the nurses and technicians telling you that this is the “best way to go.” You are introduced to the dietitian, social worker, vascular access nurse, nephrologist—with everyone imparting more advice and information—with you becoming more and more overwhelmed.

Look at what the social worker has to do, initial admission notes, initial care plan, initial psychosocial assessment, and progress notes care plan.1

As the weeks go by you start to become more accustomed to your dialysis treatment regimen, learning more about your disease process, and focusing on how to develop, protect, and preserve your fistula/graft.

Before you know it, the day arrives for your first cannulation. The dialysis staff approaches you and imparts the most feared word in dialysis, “I’m here to stick you today.” As health professionals, the correct terminology should be, “I’m here to cannulate you today.”

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