Everyone is Important in Dialysis Care


When one thinks of dialysis, one might not consider all the hard work and dedication that goes into taking care of each individual kidney failure patient.

Each employee plays a special role in this demanding field. Each role is specific, but at the end of the day, it is all about making a patient feel their best, emotionally, mentally and physically.

Discussed below, are three very important roles that play a part in a kidney patients life. The social worker, dietitian and advanced practitioner all have different duties to fulfill each day, but without one a patient would not be able to feel their best.

The Role of a Nephrology Social Worker in Dialysis

By Laura M. Blackwell, MSSA, LISW

In general, the role of social worker is to provide services to enhance or restore functioning capacity, to promote social change, and to assist with problem solving. In other words, social workers facilitate change to improve quality of life and well-being. Given the world’s vast diversity in culture, geography, age, class, and lifestyle choices, quality of life is a highly personal and complex issue. In the medical arena, those factors are further complicated by the impact of injury or illness on the patient, family members and service providers. In nephrology, the role of social workers encompasses all of these aspects with skilled methods in key areas for the benefit of all involved.

Skilled Service Methods

Because of the End-Stage Renal Disease (ESRD) Program established by Medicare, a qualified nephrology social worker is a required member of the treatment team at all dialysis and transplant facilities. The unit social worker helps patients adjust to chronic kidney disease (CKD) by providing skilled service methods, including education, supportive counseling, and concrete services.

In education, the social worker can help patients and their families understand and follow their treatment plan. For example, the social worker can help patients design a personal strategy to adhere to their renal diet, fluid limit, treatment time, and prescribed medications and achieve improved outcomes. The social worker also educates patients about available options and factors to consider when making decisions about transplant, dialysis methods, online websites, caregiver support and services for the elderly.

With supportive counseling, the social worker can help patients and their families find ways to cope with having kidney disease and dialysis. Social workers can address any barriers to coping and relieve any burdens interfering with patient satisfaction and success. Common coping issues include feelings of depression, dealing with grief and loss, problems with family members, bother from anxiety or worry, difficulty sleeping, struggle with behavior problems, the cycle of alcohol and drug use, challenges of adjustment, fear of death or dying, and confusion or concern about upcoming medical procedures.

For concrete services, the social worker can help patients and their families find resources to deal with tangible problems. Resources are numerous and diverse including exercise, housing, utilities, insurance, medication, home care, living will, employment, transportation, travel with dialysis, financial assistance, and continuing education, to name a few examples.

Key Service Areas

In dialysis, social workers help patients adjust to CKD by providing a range of service methods in several key areas. Disease management is addressed by making sure that the patient has the tools, skills and resources to manage their treatment. Quality of life is assessed by reviewing kidney disease quality of life scores with the KDQOL-36 survey and screening for depression. Functional rehabilitation and continuation of life goals is achieved by setting small goals to help renormalize each patient’s lifestyle. The adjustment of family and friends is realized by helping patient’s assess how family and friends are doing and providing education and resources for all of them to better understand and support the patient’s management of CKD. Each patient’s satisfaction with their care is assured by assessing what the staff is doing well and what they could do more of to help the patient live well with CKD and feel more comfortable overall.

As long as people continue to face adversity, social workers will continue to provide a critical role—to improve quality of life and well-being—in dialysis and in the world at large.

Laura Blackwell is a nephrology social worker at several Ohio units. She welcomes your comments at LauraBlackwell@DialysisDynamics.com or visit her on the Web at DialysisDynamics.com.

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