What You Should Know About Social Media
A new phenomena has reached our industry and healthcare professionals should be aware of the possible ramifications. Facebook, and Instagram are the most prominent outlets for social media today. With widespread use of iPhones, Tablets and Notebooks, people are documenting everything, absolutely everywhere, all the time.
As I see it, there are two primary issues with this sharing of social media, first what is being shared, and second who may view it. There are no gatekeepers as to what is being shared, and there arepotential consequences for what a person does or says in their private life, and its potential effect on their professional life are very real.
My point is this, social media is a public forum, people are very open, they say and share virtually everything, in real time, and once it is out there, it is permanent and accessible. Employers, and even more importantly potential employers may check you out on social media. I became aware of this when a colleague of mine told me that she was concerned about a staff member because of what she saw on her Facebook page, she also shared that she friends all her subordinates. Perhaps it is time for us all to take a step back and reconsider what we share on our social media!
Hemodialysis is the most common form of life sustaining treatment for kidney failure worldwide. Most people receiving hemodialysis go to out-patient dialysis centers for treatment (3) times each week, or approximately every other day. During hemodialysis approximately twelve ounces of blood is pumped through a special filter that removes excess fluid and waste from the blood. Treatment times vary but are generally between 3 to 5 hours in duration, at which time the patient goes home.
Hemodialysis treatments performed in dialysis centers are routinely performed by dialysis trained RN’s and Certified Hemodialysis Technicians. The patient may choose home hemodialysis treatment because of its increased flexibility in scheduling with a trained partner. The days and hours of treatment may be as frequently as short daily treatments of 2 to 3 hours, or long nocturnal treatments run overnight (3) times each week for 6 to 8 hours.
Diabetes is a chronic condition associated with carbohydrate intolerance. Characterized by high blood sugar levels, diabetes affects 29.1 million people according to the National Diabetes Statistics Report, 2014. That equates to 9% of the U.S. population. Worse yet, 28% are undiagnosed. One study estimates that the number of people living with diabetes in 2025 will increase by 64% to 53 million.
Type two, or adult onset diabetes can be managed with weight control, a healthy diet, regular physical activity and, or medication. People with diabetes are at increased risk of serious health issues. Risks associated with poor blood sugar control from undiagnosed or uncontrolled diabetes include retinopathy and may lead to blindness, and micro-vascular disease leading to heart disease, stroke, chronic kidney disease, amputations of toes, feet and, or legs, and premature death.
So . . . What does diabetes have to do with dialysis? Diabetes Mellitus is the number one cause of kidney failure in the United States today. In 2011 Diabetic Nephropathy was listed as the primary cause of kidney failure in 44% of all new dialysis starts. Some 300,000 diabetic Americans are living with chronic kidney failure today and unless something changes, that number will likely increase!
For many years the accepted method of cannulating an AV fistulas for hemodialysis has been the “site rotation or rope ladder” technique. Rotating needle sites was thought to prolong the life of the fistula and minimize aneurism formation.
In the last few years the “buttonhole or single site” cannulation technique has gained popularity. Once healed the buttonhole is similar to the tunnel created in a pierced ear. Less pain with needle insertion, ease of use to promote self cannulation for home dialysis, and use in patients with short fistula lengths are the intended benefits of this technique.
As use of the buttonhole method spreads, the benefits and risks are becoming all too apparent. Historically, AV fistulas were known to have very, very low incidence of infection and as more facilities adopt the buttonhole technique, fistula infections and serious septic infections related to AV fistulas are on the rise.
Okay, here’s the deal, I don’t know which technique is better! There are proponents on both sides of the isle with very strong opinions about this subject. All I do know is that having dealt with several septic infections caused by infected buttonholed fistulas is, I think we need to rethink this method. Perhaps new and improved is not always better. So . . . buyer beware!
With hospital space at a premium, more and more dialysis centers are being built as out patient facilities in strip malls, professional buildings near local hospitals, and even an occasional old bank building, gone are the days of basement dialysis centers, down the hall from the hospital morgue. In California, the majority of dialysis nurses and technicians work three, twelve hour shifts each week, for example Monday, Wednesday, Friday or Tuesday, Thursday, Saturday.
During a shift, each technician will care for 4-6 patients at a time, with three shifts of patients each workday. Patient shift turnovers last 1.5-2 hours and are busy times in the facility. Once all the patients treatments have started, the staff monitor their vital signs, and equipment until it is time to return the patients blood and begin again with the next shift of patients. Nurses on the other hand spend their day assessing patients, administering medications, coordinating care, communicating with physicians, and monitoring the technicians work. Each nurse will supervise 2-3 technicians providing care to 10-12 patients each patient shift.
The work is rewarding, long term relationships exist between dialysis patients and the staff who provide care for them in the dialysis center. Over time, the dialysis staff help patients and their families understand their disease process, the renal diet and routine medication requirements. We celebrate their success and help them cope with losses. I have to say there have been many memorable days for me as a working dialysis nurse over the years, but hands down the best days were the ones when we “got the call” that one of our patients had been transplanted. When I look back, all those years ago, when I was a young nurse receiving my first pay check, my first thought was, wow! I can’t believe they are going to pay me to do such rewarding work. If I hadn’t been so poor, I probably would have framed that first check. I believe there is a common thread between healthcare workers, we are caretakers by nature and have a real need to care for others. Isn’t it marvelous to be rewarded in so many ways for doing something that makes us feel good inside.