When I was still orienting as a dialysis nurse, I encountered patients who were very supportive of my training. They allowed themselves to be stuck by me. Of course, little did they know that I am not a novice at all when it comes to sticking needles on patients. My training as an anesthesiologist makes me even more experienced than the one "teaching" me. But I do not advertise this fact. I was advised by people in the office that I should not tell my patients that I have a medical degree because they may start "consulting" me and I could be charged with practicing medicine. So I was very careful about this. It pleased me when patients thanked me after the session and told me that I did well.
When I was already doing dialysis on my own, it was a different story. I had to build my confidence along the way. There were good days when everything ran smoothly, from the machine to the treatment of the patient. And there were bad days.
I remembered one particular instance when I went into a patient's room, introduced myself in a nice way (I always try to be pleasant just to establish good rapport). The patient looked at me arrogantly and started asking questions. How long will his dialysis be, how much am I taking off him, how long have I been working as a dialysis nurse. Perhaps the biggest mistake I made was admitting that I have started dialysis just a couple of months ago. He started bossing me around, demanding I take off 6 liters from him despite my better judgment. When I stuck him with the needle, he started shouting that I was sticking his nerves and it was hurting. I got pissed off and raised my voice and said, "Hey, stop panicking. It's not like I just learned doing dialysis yesterday. I know what I am doing. I am not sticking your nerves. Look at that backflow of blood. Your nerves will not show that." He stopped and calmed down. But I was already hyped up and upset. I could stick needles to his neck if I want to, I thought. If looks could kill, he would have been dead by then because I was giving him dagger looks. I guess that must have scared him, despite his huge physique because he stopped talking and allowed me to do my work.
I usually talk to my patients and give them some sort of patient education while I do the dialysis, but with him, I just sat there quietly until the end of the treatment. You just know when a patient is too full of himself, it is useless to pour information to him. It will just overflow and spill out. Why waste my energy and saliva. Of course, he did not finish the treatment because he went into seizure after one hour. That was why he was admitted to the hospital. So I stopped his treatment and rescheduled him the next day. Those are the kind of days which leaves me unfulfilled as a dialysis nurse. But I learned my lesson.
The next day, when another patient asked me how long have I been doing dialysis, I merely answered, "Oh, long enough to be bored already." She merely laughed and I started giving her patient education.
Sometimes giving too much "information" can be detrimental to a patient's health and "sanity" because it makes them paranoid. Now, when patients ask me that question again, I look them in the eye and say with all honesty, "Almost a year now." And they leave me in peace to do my work.
When I encounter bossy patients who want to manage their own dialysis treatment and order me around, I merely bombard them with pathophysiologic basis of the treatment that I plan for them. The information overload is usually enough to gain their trust and cooperation. Now I've learned how to use information, i.e. when to give too much and too little according to patient's profile and needs.
I usually talk to my patients and give them some sort of patient education while I do the dialysis, but with him, I just sat there quietly until the end of the treatment. You just know when a patient is too full of himself, it is useless to pour information to him. It will just overflow and spill out. Why waste my energy and saliva. Of course, he did not finish the treatment because he went into seizure after one hour. That was why he was admitted to the hospital. So I stopped his treatment and rescheduled him the next day. Those are the kind of days which leaves me unfulfilled as a dialysis nurse. But I learned my lesson.
The next day, when another patient asked me how long have I been doing dialysis, I merely answered, "Oh, long enough to be bored already." She merely laughed and I started giving her patient education.
Sometimes giving too much "information" can be detrimental to a patient's health and "sanity" because it makes them paranoid. Now, when patients ask me that question again, I look them in the eye and say with all honesty, "Almost a year now." And they leave me in peace to do my work.
When I encounter bossy patients who want to manage their own dialysis treatment and order me around, I merely bombard them with pathophysiologic basis of the treatment that I plan for them. The information overload is usually enough to gain their trust and cooperation. Now I've learned how to use information, i.e. when to give too much and too little according to patient's profile and needs.
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