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A heartfelt commitment to the kidney

Rebekka Walli

Rebekka Walli

May 8, 2024

reading time

5 min

The journey to the dialysis centre is one that patients with chronic kidney failure make several times a week, usually for the rest of their lives. At Zollikerberg Hospital, they are accompanied by Esther Karlen, who has been working as a qualified nurse on the dialysis ward since 2015. In this article, she explains how she supports the patients on the ward not only from a professional but also from an emotional perspective.

Patients come to Esther Karlen and the dialysis team when their kidneys are not working properly. The diagnosis is usually chronic renal insufficiency. From then on, dialysis therapy three times a week will be their constant companion.

Dialysis at Zollikerberg Hospital

The dialysis procedure is the same every time: patients come for dialysis at set times. When they arrive in the dialysis department, they are greeted by a nursing assistant if they need help and accompanied to the scales. The scales are visited before and after dialysis to measure the dehydration caused by the blood washing. The patients then lie down on a couch. They can make themselves comfortable there before a qualified nurse begins the preparations to start the dialysis. "We work with software that loads the settings directly onto the dialysis machine and calculates the water removal based on the patient's weight. Patients are asked about their well-being before and during dialysis and their vital signs are constantly monitored," explains Esther Karlen. The therapy is then started. Depending on the person, dialysis therapy takes place via a catheter or a shunt. It is carried out in the form of haemodialysis (blood washing). The average duration of treatment is four hours, but the stay on the dialysis ward can take a little longer with the preparation and follow-up of the patients. "Our nephrologists draw up an individual treatment prescription for each patient. This includes the time, form of therapy and medication. They are regularly adjusted and adapted during the ward round," says Esther Karlen. Another form would be peritoneal dialysis, which is carried out independently at home. All patients also have the opportunity to draw, watch television and some even work on the computer during dialysis at the hospital. There are also other offers such as aromatherapy care or personal conversations with a carer.

Emotional support through carer support

"Here at the dialysis centre, we work with caregivers. Every patient is assigned a carer who talks to them at regular intervals," explains Esther Karlen. This continuous in-depth exchange facilitates the nursing history, which is compiled at the start of dialysis and then adjusted in a regular cycle or in the event of individual changes. This is because thorough nursing diagnoses allow changes to be recognised, recorded, documented and evaluated at an early stage. "In my work, I always try to do justice to every patient and provide the support they need," explains Esther Karlen.

Dialysis centre

The reference care concept

The reference nursing concept means that a qualified nurse always cares for the same patients within a week. This allows them to respond well to the physical, emotional and psychological changes that occur during the course of dialysis and provide the best possible support for patients.

"I usually find that people who are new to dialysis often have to deal with fears and worries. The fear of not knowing what to expect can be very intense," reports Esther Karlen. The qualified nurses on the dialysis ward are able to counteract these fears in the best possible way thanks to the reference care. "We are there and trained for such situations. And we also hold regular case discussions and supervisions in the team on the ward. We can also discuss challenging situations, so we are always learning," says Esther Karlen.
In addition to the carer concept, patients are also offered psychological and pastoral support.

Heartfelt support over the years

Recovery options for kidney failure are few and far between, but they do exist: "Particularly in cases of acute kidney failure, we repeatedly have cases where the kidneys recover and patients no longer need dialysis. A kidney transplant can also lead to a kind of recovery," says Esther Karlen. In most cases, however, patients need dialysis therapy until the end of their lives. There are patients who have been coming to Zollikerberg Hospital for dialysis for 20 years. And others come as guests, such as holiday patients. It can happen that patients no longer come for dialysis because their suffering has become too great or their state of health has deteriorated. In some cases, patients are also transferred to the specialised palliative care ward at Zollikerberg Hospital, where they are accompanied towards the end of their lives by competent and caring staff. How a qualified nurse on the dialysis ward deals with patients who no longer turn up for treatment is very individual. "We have the opportunity to deal with such cases together as a team or with targeted supervision. Sometimes we also attend the funerals of our deceased patients or write a card to their relatives," recalls Esther Karlen.

From her first trip to the dialysis centre's scales to the final farewell, Esther Karlen and the other qualified nurses on the ward are there to support their patients reliably and with a lot of heart.

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Rebekka Walli

Junior Specialist Marketing and Communication, Management

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