Nurse Ruth explains the training required to perform in-home kidney dialysis.
When we start training for in-home dialysis we start with an interview and we interview the patient as well as the partner, and we set out what they can expect.
Some of the expectations are that they will come in five days a week for the training. Their treatment will happen at the same time as they are doing their training.
They start out the first week watching the nurse on the first day, do everything so that it’s a talk through and they can understand what they will be learning.
Then the second day there will be a talk through some more but they will participate with part of it.
And initially it seems overwhelming, however as they go along and they learn more steps, this takes three to four weeks of training and this means that they can go at their own pace because timing is important.
For each individual it’s different and they have periods of time they can ask questions and we walk through, talk through everything that’s done with the machine, with setting up, with diet restrictions, with fluid restrictions, with what is actually happening to their body as this process is going on, toxic waste material, how it’s being removed and how that ties with diet and how their restrictions are by what is going to happen in the machine.
Some other things are there will be testing as they go along to see how they are learning and how they are remembering, because when you are on dialysis you have your up and down days with the amount of toxins that build up in your body between treatments you are understanding changes.
So we talk through that. We talk about a lot of different ideas, things that they can do at home. We also go into their home when they finish their three weeks in-center and we look at where they might place their machine, how they need to set up, what they can expect.
The time difference in setting up at home may be different than setting up in-center. We are setup a little differently.
We also talk about their supplies and where they would store their supplies and how they manage to get their supplies, part of them come from the center, part of them come from the NxStage company that provides the equipment as well as a number of the supplies.
Then we also go through a treatment with them at home or more than one if they need that or want that.
Again, that depends on how well they have learned in-center and their partner, what the expectations of their partner are, and we will review that several times with them.
Ruth Gray, R.N., H.H.D., is a registered nurse affiliated with Southwest Kidney Dialysis in Tempe, Arizona. Ruth works with DaVita Tempe Dialysis in the home hemodialysis department, training patients to perform at-home dialysis.