The grace of empowerment

Mr Matthew Harvey, Dr Louis  Huang, Mrs  Peta McLean, Mrs Dong Wang, Mr Lionel Holt

1Eastern Health, Box Hill, Australia

Introduction

Mr H is a 73 year old who has been on satellite haemodialysis for 5 years. The physical limitations of osteoarthritis affecting his mobility, ability to drive and manage his rural property, combined with the scrutiny of diet, fluid consumption, weight gain, monthly pathology and medications that is standard satellite management contributed to an ever increasing tension between Mr H and dialysis staff. The situation became untenable.

Method

In response to increasing verbal aggression from Mr H, the resultant unplanned leave for staff and patient complaints of dissatisfaction with their dialysis experience a multi-disciplinary approach was taken to initially de-escalate, find the root cause and create a plan to improve Mr H’s overall health, dialysis regimen and quality of life. Regular consultation over several months uncovered contributing factors to rising frustrations and identified his desire to attempt haemodialysis at home.

Results

Despite many barriers to dialysing at home including limited mobility, isolation in a high-risk bushfire zone, a non-English speaking partner and regular power outages, Mr H and the EH Home Dialysis Team pushed on with training and after 3 months Mr H had his first independent run at home.

Conclusion

Mr H has been dialysing independently at home for 7 months and with control over his diet/fluid intake, weight gain and dialysis hours he is experiencing a greater sense of purpose, increased time at home with his wife, improved level of trust in healthcare professionals and a greater quality of life.


Biography:

Matt has been nursing for 25 years predominantly in the Medical Specialties of Renal, Neurology, Stroke and Endocrine. After completing a Nursing Graduate Program at Alfred Health in 1995, he held positions as Associate Unit Manager and Clinical Support & Development Nurse, before taking up a position as Nurse Educator at Eastern Health soon after the opening of the new Eastern Health Integrated Renal Service in 2009. For the past 8 years, Matt has worked as a Nurse Unit Manager currently leading the Home Dialysis Service at Eastern Health and has a passion for great patient outcomes.

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