Professional Certificate Course in Renal Nursing. The Open University of Hong Kong 2011

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1 Professional Certificate Course in Renal Nursing The Open University of Hong Kong 2011

2 Objectives provide students with a specialist training in the knowledge and techniques of essential renal nursing care that are applicable to renal units.

3 Upon completion of the programme, participants should be able to: Appraise the role and responsibilities of renal nurse; Apply knowledge of renal anatomy and physiology in renal nursing; Describe the investigations of different renal disease; Propose therapeutic management for renal patients; Employ the skill and knowledge of renal dialysis in renal nursing; and Demonstrate competence in solving professional problems in renal nursing.

4 Roles and Responsibilities of a Nurse

5 Florence Nightingale RRC (Royal Red Cross) OM ( Order of Merit ) Nurse, writer, statistician Death: London at home 13 Aug 1910 Born: Florence Italy 12 May 1820

6 Merits incorporated education and responsibilities into nursing helped improve hospitals and still influences modern hospital design. helped bring down the death rate for soldiers being treated in the hospitals by making sanitary improvements and establishing standards for clean and safe hospitals such as by increasing ventilation, adding windows, improving drainage, and increasing space.

7 Yearline 1906 written the first textbook, entitled Notes of Nursing. emphasized the importance of patient observation to figure out their symptoms and needs, as to be able to provide the right care. Stressed on sanitary conditions as well as warmth, clean air, light in rooms, and a nutritious diet. opened the first nursing school, which was the beginning of professional education and training in the field, offering the first official training program for nurses. emphasized the importance of patient home care and taught students how to care for the sick at home and the practice of midwifery.

8 Florence Nightingale Founder of Modern Nursing Inventor of Pie chart 1860 For her contribution to Army statistics and comparative hospital statistics in 1860 Florence became the first woman to be elected a fellow of the Statistical Society. Florence established the Nightingale Training School for Nurses at St Thomas Hospital, London. Florence s best known work Notes on Nursing was published this is still available today and has been translated into eleven languages.

9 The Florence Nightingale Pledge Lystra Gretter 1893 I solemnly pledge myself before God and presence of this assembly; to pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession and will hold in confidence all personal matters committed to my keeping and family affairs coming to my knowledge in the practice of my calling. With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care.

10 Renal Nurses Roles and Responsibilities

11 Characteristics of Renal Nurses 1. Understand the nephrology and renal problems in the community; 2. Understand the patho-physiology, etiology of renal diseases; 3. Understand the principles and mechanism of RRT management of patients with acute and chronic renal failure; 4. Know psychology of patients with renal failure; 5. Equip with patient education theories and strategies, models of renal care, the structure and resources for renal care, knowledge of RRT apparatus and the contemporary dialysis nursing practice

12 Characteristics of Renal Nurses With the competency to. 6. Provide effective clinical care, education and counseling to patients with renal impairment and their families; 7. Provides nursing care for patients requiring dialysis; 8. Provide patient teaching and training of patients for dialysis therapy; 9. Enhance patient empowerment and optimal renal rehabilitation; 10. Appreciate and participate in evidence-based practices, clinical and nursing research

13 Nursing Roles Clinician 臨床看護 Counseller 顧問輔導 Educator 教育 Facilitator 組織輔助 Mediator 調停 Monitor 監督

14 Responsibilities Liability to be required to give account, as of one's actions or of the discharge of a duty or trust. Involving personal accountability or ability to act without guidance or superior authority: a responsible position within the community Being a source for information. Able to make moral or rational decisions on one's own and therefore answerable for one's behavior. Able to be trusted and be reliable. Based on or characterized by good judgment or sound thinking: responsible nursing practices. Having the means to fulfill obligations. Required to render account; answerable: The cabinet is responsible to the parliament. The renal nurses are responsible to..

15 Responsibilities operating dialysis related equipment, making sure that the equipment used for dialysis is working properly and any repairs that are needed are reported to the management in time. general care of the patient, educating patients and performing some routine procedures. patients may be in very serious conditions such that the dialysis nurses have to follow the medical protocol strictly meanwhile with the sensitivity and sensibility to make sure patients are comfortable and safe.

16 Responsibilities Focus on assisting patients with kidney conditions despite job responsibilities of the nephrology nurse may vary a/c individual facility Psychological support is an important responsibility for the dialysis nurse, as patients have an incurable condition. Dialysis is at the core of nephrology, though not all patients are at the state where dialysis is necessary. Patient condition is monitored regularly by the nephrology nurse, to assure maintenance of patient health. Everything from diet to sugar intake to exercise regime must be watched closely. Other nephrology specialists and specializing physicians often work in collaboration with the nurse to achieve the best treatment outcome possible.

17 Common Challenges Patient loads are increasing There is a growing staffing shortage within the dialysis specialization leading to overworked nurses in many institutions, with no sign of easing. The labor deficit translates to more work for the nurses. What can be done?

18 Lady with the Lamp I think one's feelings waste themselves in words; they ought all to be distilled into actions which bring results.

19 Lady with the Lamp Apprehension, uncertainty, waiting, expectation, fear of surprise, do a patient more harm than any exertion

20 What can be done? Reduce patient increase? Reduce workloads? Reduce risks? Reduce stresses?

21 Integrative Model Empowerment Partnership Autonomy Authority

22 Principles of Biomedical Ethics (in descending order of Priority) Autonomy - follow the policy of individual units Nonmaleficence avoid doing harm eg taking thorough history to prevent potentially harmful interaction Beneficence do the good to help eg massage to relieve cramps Justice fairness of access Nash 1999

23 Principles of Professional Practice The client is a total human being needs to be seen and responded to as an individual with inseparable aspects The client is a unique individual the individual needs to be assessed and encountered The client has the ability to structure his or her own life practitioners provide diagnosis and care Bolletino 1998

24 Devising Care Plan Observe, Assess, Record of physiological, behavioral, emotional, intellectual, psychological and social signs and symptoms of health, disease and injury, including tests / intervention with evaluation results

25 Devising Care Plan Provide family assessment, discharge planning, Enhance therapeutic care and service such as dialysis in renal units; preventive care and service such as promoting appropriate fluid control restorative care and service such as encourage renal rehabilitation

26 Nursing Achievements Ensure safe and quality care Allow effective utilization of resources Enhance platform for self development, personal growth Participate in staff education and research Escalate through the gaps from good practices to best practices

27 Reducing stresses Exercise: running, trekking, swimming Getting a hobby : reading novels, photography, bird-watching, collecting Spend time in nature Spend time with pets Spend time with family Spend time with friends

28 Communication Media Renal Patients Healthcare providers Renal staff allied staff Organization Relatives Community

29 Quotes from Florence Nightingale "The very first requirement in a hospital is that it should do the sick no harm." -

30 Quotes from Florence Nightingale To understand God's thoughts we must study statistics, for these are the measure of His purpose Ananalysis Researches Statistics

31 Quotes from Florence Nightingale "So never lose an opportunity of urging a practical beginning, however small, for it is wonderful how often in such matters the mustard-seed germinates and roots itself."

Introduction. ata_kard@ukr.net

Introduction. ata_kard@ukr.net Introduction ata_kard@ukr.net 2014 Зміст 3 Зміст Зміст 4 The Nightingale Pledge, named in honour of Florence Nightingale, is a modified version of the Hippocratic Oath. Lystra Gretter and a Committee