Finding out that you have renal failure can be a devastating prognosis that changes a person’s life in an instantaneous and dramatic way. Your routine and daily life takes a backseat to the dialysis treatments that you will need several times a week to stay alive.
So many of the freedoms that patients once enjoyed are curtailed but with the increased availability of home dialysis, and through the work of home dialysis nurses from Northwest Indiana Nephrology, dialysis patients are getting some of their freedom and their life back.
Home dialysis nurse, Shawn Kroft, originally worked as a nurse in a hospital before joining NWI Nephrology, but she wasn’t satisfied with the level of care that she was able to provide the high number of patients that she was treating every day.
“I wanted to take care of people and provide the best care possible but with nine patients a night, who don’t all sleep, you’re trying to juggle too many things at once,” said Kroft. “A friend of mine said, ‘why don’t you try dialysis?’ I felt like I needed more time in the hospital but the longer that I did it I realized that it wasn’t for me.”
Kroft first went into acute dialysis nursing which involves providing hemodialysis to patients in the hospital who are ill. She usually provided care to one person at a time which was more suited to Kroft’s desire to administer the best, most focused care possible. The only drawback that she noticed, however, was the scheduling. The shift was lengthy with 12-16 hour shifts and one day on call for 24 hours.
“I decided that it was way too much,” Kroft said. “I missed my family as the schedule was very hard of family-life so my boss told me to look into ‘PD’ which is the peritoneal dialysis. He said, ‘you teach them to do it at home and since you love education, you know you’re going to love it.”
“I wasn’t real sure about it and I didn’t know much about the home visits or PD. When I started looking into it I felt like it was right up my alley because one of my favorite parts about nursing is the education side of learning new things and teaching people to take care for themselves.”
Kroft fell in love with the position immediately and has been working with patients on home dialysis for nearly four years now.
“I fell in love with my patients and the idea that you provide total care to the patient, not just renal care,” Kroft said. “For home dialysis, you’re the link between the doctor and the patient. You’re just managing the whole patient.”
“It’s a shock to be told that, ‘now for the rest of your life you’re going to have to do this or you’re going to die,” Kroft said when patients learn the details of their condition and what lies ahead. “They go through a whole grieving process and it’s a normal feeling. You’re losing a lot. Some lose the ability to drive and a lot of their freedom is gone.”
Patients not on home dialysis will normally go to ‘in-centers’ three days a week which basically turns into a part-time job. When the patient gets a chance to transition to home dialysis it can have a profound impact on their quality of life. It gives them their life back in many cases and the freedom that they had lost by having to go to doctor appointments throughout the week is restored.
“It gives them that freedom that they had lost,” Kroft said of patients who transition from in-center to home dialysis. “If they want to work they work. If they want to golf then they can do their dialysis on a different day. They gain some control back and to see their personalities come back out as the people they are is really, really exciting and cool.”
Along with the time and freedom that comes with home dialysis, generally patients feel better and their overall health increases after transitioning from in-center to home dialysis.
“Physically, patients feel about as well as they are ever going to feel having renal failure,” said Kroft. “Usually the patients that go from in-center to home can’t believe the transition. The research out there shows that if we can start them, or keep them, on home dialysis, their percentage of longevity of life goes up quite significantly. I can’t remember the numbers exactly but it’s around 20-30%.”
Your kidney works 24 hours a day so when a patient is getting more dialysis, which they get when they can use their dialysis machine at home, they are essentially removing more of the toxins that would have otherwise built up in their body between in-center visits.
“It goes in cycles and there was a push for in-center but now there’s more of a push for home dialysis,” Kroft said. “They’re realizing that patients do feel much better on home dialysis and the research is there that shows it. More dialysis is better so if you can get more by being at home it only makes sense.”
“I think people feel better and more comfortable being at home too. When it’s 30 below zero outside or a blizzard you’re not going to want to go into the center. I tell patients that if you cut it short by just one treatment a week you’re still, down the road, cutting years off of your life essentially. You’re shortening your life over time so by being able to get more treatment it gives them a greater chance to live a normal life and feel good.”
Making patients comfortable and giving them the ability to lead as normal a life as possible while on dialysis is the mission that Kroft and Northwest Indiana Nephrology work towards.