Question

Ingrid Smith is a 66-year-old female who has been on dialysis for six months. She is finally getting used to the demanding schedule of spending most of three full days a week preparing for her treatments, traveling to and from the center, and discomfort of being on the machine for hours at a time. She does not like that it takes her away from her grandkids and the comfort of her own home so regularly, but that is a sacrifice she is willing to make. Ingrid has struggled with her weight and her diabetes for a long time. She has been trying to keep all these new rules and restrictions with her diet straight, but it is complicated and her memory is not what it used to be. Lately the dietitian has focused on her consumption of mac and cheese. Apparently, it is bad for her for all kinds of reasons, but this recipe is her claim to fame, it is the one that everyone asks for when she is providing food for events like church functions and birthday parties.

On top of all the stress she is feeling with the changes to her lifestyle that kidney failure has created, she has a deep fear of needles and dreads every time she has to be hooked up to the dialysis machine. Even though it is much easier having a fistula in place, it is still the worst part of her dialysis treatment; even worse than the nausea she feels during treatment. Ingrid is new to your facility. She has expressed that the dialysis staff at her previous facility treated her as though she did not care about her own health or treatment plan, and they were not understanding of her fear of needles. She does care about her health; she wants to watch her grandchildren grow up, she doesn't want her health to keep spiraling down, and she would like to eventually get a kidney transplant. She knows she needs to stay healthy to do all this and feels she has been trying her best to follow the complex rules and endure being hooked up to the dialysis machine.

1, In thinking about your role and how you would interact with Ingrid, how would you ensure she had a warm welcome to the clinic, and show empathy towards her situation knowing what you do about her dietary struggles and fear of needles?

Answer 1

Good communication and maintaining good therapeutic relationship is very important role of the nurses. When a nurse is in charge for the patient, then it should be start with warm greet and introduce herself to the patient first. This will helps to start interacting with the Ingrid. The nurses role is not only giving medication or administration of medication but also provide holistic approach care. In this holistic care approach, there is include the provision of psychological support to the patient. So, the nurse should always greet the patient whenever he visits the hospital, start sharing the procedure steps, and explain that is will be a little painful while inserting a needle. The nurse should ask what the patient feels and what he wants. The nurse should listen properly to the patient and provide a response to it. The nurse should explain that the patient to be strong and repeatedly check the condition in between the intervention also. The nurse also discusses how the patient is maintaining the dietary pattern and explain the need of maintaining the good dietary pattern base on the condition of the patient. Explain that maintaining good dietary patterns and doing dialysis will help the patient to prevent from complication. This shows the patient a sense of warm welcome and understand his/her situation.