The Traveled Road of Dialysis Opinion: Do we give credit to those nursing staff that care and provide quality care? Are these staff caught in the negative part of the ever-changing health care environment? Trying to do what they always did ----deliver good patient care? We should not forget that it is not easy to provide quality, let alone, appropriate patient care when there is, for example, a shortage of nurses. This is just one factor that intrudes into the realm of delivery of care. It is documented, as well as, researched, the direct correlation between medical errors and the present nursing crisis. The shortage of nurses has placed a different type of stress onto the nursing staff?s shoulders. Consequently, we can ask, ?What do these nurses do when faced with external factors impeding the provision of quality patient care?? We, as consumers, can thank those who continue to be dedicated, caring professionals, in spite of the obstacles they face on a daily basis. Dialysis units are facing the same problems as hospitals. PREFACE After speaking with several nurses, physicians and administrative staff in the dialysis environment, there seems to be an overall consensus that due to the nursing shortage, more individuals are being trained to be dialysis technicians. As all nurses (Registered Nurses, Licensed Vocational/Practical Nurses) are required to be licensed, unfortunately, dialysis technicians, depending on the State, might not need to be licensed, or certified. Their training may vary from state to state. Therefore, we can only hope that they have been trained appropriately, and, in fact, have good educators who are well versed and seasoned in the dialysis treatment environment. Naturally, this holds true for others who work in the dialysis environment, as well. Many individuals do not realize that this speciality keeps many patients alive. If it were not for the availability of dialysis machines, many would suffer and die. We hope that, those providing education and training to individuals who want to work in the dialysis field, have the expertise in this very specialized area - dialysis and End Stage Renal Disease. Furthermore, we hope that those learning this very specialized field will have an honest and sincere interest in their new profession, and, not view it as ?just a job.? Even though machines are programmed, the human factor still needs to be addressed. The dialysis staff must be able to--------------------- understand how the machine works, understand patient reactions to the machine, and know what each reaction indicates, understand patient physiology, understand emotional aspects the patient is encountering, understand what the patient experiences physically during treatment understand how to identify problems that can, and will, impede the dialysis process, understand the importance of educating the patient/family, understand the patient plays a vital part in the treatment team, understands the essential nature of being sincere and honest with the patient, understands the patient has a need to ask questions, as well as question what is being done to their body, understands the patient as a whole not a part understands how to deliver ?safe? patient care -----------------------------------AND, Let us not forget, the patient plays a role in this dialysis journey. The patient is a critical part of the team. Being able to discuss concerns, ask questions, question what is being done and requesting education is imperative in the dialysis team relationship. The patient must be at ease in the relationship and feel comfortable interacting with the dialysis staff. Dialysis is a life long journey. A good patient-staff relationship is necessary. For, without this relationship, there is no team. And, remember, the team is the patient and dialysis staff. Entering a dialysis unit can, and, is a difficult experience. A life long road to be traveled, with, perhaps, curves and bumps. Learning how to drive this car, on this long traveled road, will be a joint venture. A relationship between the patient/family and the dialysis staff is needed in order to ensure appropriate delivery of patient care. We, as consumers, hear, over and over, about the horrible dialysis units and poor, or lack of appropriate care. We hear about patients who are retaliated against due to various situations. We hear about those patients who are ?dumped,? made to leave the dialysis unit, with no other unit to go to for their treatments. In all due respect, on the other side of the road, there are wonderful good dialysis units with marvelous caring devoted nursing staff. Thus, we are appreciative for these dialysis staff. These are the people who set the standards for good and safe delivery of patient care. Nevertheless, knowing what good care involves can only increase one?s awareness. Having this increased awareness will render a foundation in order to determine if the care one is receiving is adequate, and, hopefully, good. Asking questions, as a new dialysis patient, is okay. Remembering, your body, your treatment. THE PATIENT The patient can ask a question, when the dialysis staff approach, to perform a task, ?what are you doing, and why?? The patient, can question a staff (and, feel comfortable, in doing so) if there is belief that something is not right with treatment. The patient has a responsibility to share concerns with staff. The patient has a responsibility to provide needed information, on how they feel, physically and emotionally, to staff, in order to have staff deliver quality patient care. Remember, the patient and the dialysis team are in this long journey together. Both the dialysis staff and patient are human and all have feelings. Mutual respect is needed for everyone involved, for without this, there is no team. We, as consumers hope that dialysis staff will provide care to the patient as they would want care provided to their family, or themself