Today I shadowed Shannon Clark at her Southwest Dialysis location. I got to see what dialysis was like and met some very nice patients. Unfortunately, I was unable to take photos but I have a picture of the basics of kidney dialysis below.
I got to do 2 shifts with Mrs. Clark and got to meet many patients. They were all very positive and very sweet! They told me their stories and Mrs. Clark helped to explain all the different parts of the dialysis machine and what, exactly, it was doing. I was very interested. She also told me a sad and unfortunate story about a patient that had his port covered under a blanket and the needle ended up coming out of the arm. He bled to death very quickly and died. She told me that they now have a rule that makes the patients show their faces and their access ports at all times to avoid this!
The area for dialysis was one big communal area with many chairs, patients, RNs, NPs, and the desk ladies. It was very cold in order to avoid dilation of the veins which is detrimental during dialysis, so the patients had thick blankets.
The dialysis access port was, not going to lie, a little scary. It is installed by vascular method and by surgery. The port is then set up by injecting a needle (preferably one that is 16 gage or 17 gage for starter patients) into the port and setting up the system. The blood then got pumped out and filtered through the artificial kidney and then pumped back into the persons vein. It is all mostly set up using the “graft method” but it can also be set up by going into the veins in the neck (which is uncomfortable and not the “best” option available).
Mrs. Clark also talked about needle sizes with me. She said that because patients are coming in so frequently (3 times a week, either first shift or second shift) the size of the needle plays a significant role in their contentment. Patients generally like smaller needles! Mrs. Clark favors giving smaller needles but going for a longer time, which is not only better for the patient but also better for the heath of their access port!
Overall I had a very fun time today and learned a lot first hand about kidney dialysis and also about sustaining both the patients life-span and happiness. For example, an 85 year old patient may not want to go through dialysis even if it extends their life-span because it is not fun and dying peacefully at home may be better for them!