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Pennsylvania — “I love nursing — it’s my bag,” says Liz, a DaVita nurse, who helped start the nocturnal program at at a DaVita Pennyslvania center in March 2007. Liz's Facility Administrator, Lucy, initiated the in-center nocturnal program to offer patients more dialysis choices. Three patients immediately moved from days to the overnight shift. Recently, a fourth patient has opted for nocturnal dialysis. “This patient moved from another area and chose DaVita because he heard DaVita was offering nocturnal,” Liz reports.
Liz began working in dialysis in 1973 as an LPN (licensed practical nurse). But a few years later that nursing degree wasn’t recognized in the dialysis center so she took the role of a technician. Because Liz had previously done the work of a nurse, she decided to go back to nursing school to become a registered nurse (RN) in 1983. Liz had started working the nightshift to have a schedule similar to her late husbands’. Now she simply enjoys working the overnight schedule and in dialysis. According to Liz, “Dialysis is in my blood,” and it was passed down a generation; one of Liz’s daughters has been a DaVita dialysis nurse for 10 years.
Regarding nocturnal dialysis, Liz says, “Patients love it.” Liz believes that her patients are enjoying lifestyle and clinical benefits from this longer treatment time. “I think it’s both the treatment and the schedule that helps patients,” she says.
Each patient has a personal reason for choosing nocturnal dialysis; whether it’s to be home to take care of a child, help out around the house or be active in the community. Liz shares the stories of the people in her nocturnal program:
“One lady is a proofreader for a book company and she works in the evening. She used to complain about having to get up so early in the morning to come to dialysis. Now she comes to dialysis straight from work at night and gets home in the morning in time to take her daughter to school.”
“We have a gentleman that was a failed transplant candidate who wanted to be home during the days. He was an electrician by trade and his wife works now; if he has his days free, he can help out.”
“Superman, that’s what we call him, is a retired cop. He loves nocturnal because he’s very active teaching Bible school, coaching Little League and soccer. He does a lot for the children in the community and needs his days free.”
Three nights per week these patients come into the dialysis center for the approximately eight hours of dialysis treatment. After four months, Liz says her patients are still telling her, “This is the best thing that’s ever happened to me — I feel so good now.”
Liz and her patients have seen clinical results improve from nocturnal dialysis, too. “Patients report they no longer feel washed out after their treatment is over,” she says. Liz attributes this to the longer dialysis run time and says patients feel better after treatment “because they don’t run so hard.”
Patients also report they have better appetites. Liz has worked with her female patient to get her protein up. “She had a poor appetite before nocturnal; we’ve seen her albumin go from 2.2 to 3 in a couple of months.”
“The man who moved here; he now walks six miles a day and his potassium and phosphorus are improving. He’s on the list to get a transplant,” states Liz.
Having more energy is another benefit for nocturnal patients. This is also measured in the hemoglobin levels. Right now Liz’s patients have been cutting back on the amount of anemia drug they are receiving because their hemoglobin levels have been rising.
Liz creates a relaxed and homey atmosphere at the dialysis clinic each night. “I bring in my movies and we watch them, and the patients like participating and bring in their favorite movies, too.” Because the nocturnal dialysis sessions are over a longer period, Liz brings in frozen freezer pop treats to help replace the fluid the patients lose through the treatment and crackers for snacks. “One treat the patients really enjoy is when I bring in frozen grapes. They are a refreshing treat and also help with thirst control.” She also has breakfast bars available in the morning.
Taking care of people comes naturally to Liz who has received recognition over the years for her outstanding work. “Patients have to trust you, because they are putting their lives in your hands, especially with nocturnal. My patients know they can fall asleep because I’m watching them,” says Liz.
Liz looks forward to more dialysis patients joining the nightshift; because as she puts it, “This nocturnal really works!”
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