Near Death Experiences in Patients on Hemodialysis

Abstract

NEAR DEATH EXPERIENCES IN PATIENTS ON HEMODIALYSIS Sharona Johnson MSN, FNP-BC, Vidant Medical Center Greenville, NC, USA Near Death Experience (NDE) is a phenomenon that occurs when a person loses consciousness and senses a disconnection from the world around them. It is anticipated that patients on hemodialysis can experience multiple NDEs over their lifetime. The co-morbid conditions of patients requiring hemodialysis, routine exposure to hemodialysis machines at least three times a week, and the medical complications of ESRD disproportionately places the patients on hemodialysis at increased risk for NDEs. Patient may decide to miss hemodialysis treatments due to fear and anxiety of future NDEs during hemodialysis. Under IRB approval a qualitative phenomenological research study was employed to explore the lived experiences of patients on hemodialysis following NDE during a hemodialysis treatment. The uncertainty experienced by patients during a hemodialysis treatment after a NDE occurs can lead to physiologic and psychological manifestations. Five major themes were identified: physiologic, psychological, mechanical, muted and nothingness. Study findings may assist clinicians and educators in the care of patients who may experience a NDE during hemodialysis. 5. SURVEY OF DIALYSIS TECHNICIANS: Helen Williams, Fresenius Medical Care, Denver Colorado USA, Peg Garbin, Center for Nursing Education and Testing, Jersey City New Jersey USA This study of dialysis technicians was done in concert with a nephrology nurse survey of the perceived value of certification. Both an on-line survey and paper-pencil surveys were utilized to conduct a convenience sample national survey of dialysis technician practitioners (N=169). The tools used were the Perceived Value of Certification Tool (PVCT) and a demographic survey of the practitioners. Although the PVCT is not yet validated for technicians, the demographic responses received provide interesting insights into their appreciation of certification, their view of their workplace and their future plans. Respondents reflect a diverse ethnicity of workers with 49% Caucasian/white, 21% Black/African American, 12% Asian, and 10% Hispanic. They are also a diverse group in terms of age with 7% in the 20 – 29 age range and 5% in the 60 – 69 age range, with a mean of 45.7 years. This differs from the age of the nursing respondents of whom 68% are in the 50 – 69 age range with a mean of 52.9 years. The majority of technician respondents (62%) report a high school diploma as the highest academic degree they hold. Interestingly 17% also hold baccalaureate degrees, non-nursing, and 14% hold associate degrees, non-nursing. The greatest numbers of respondents (74%) work in an outpatient clinic setting, of which 59% are in freestanding units and 15% are hospital based. 65.7% of respondents indicated they had no plans to make a change in their employment while 16% are looking for another employer in nephrology. 8.9% are planning to leave nephrology for another specialty. Certification of dialysis technicians providing direct patient care is mandated by CMS. The data gathered in this survey can help guide employers and nurse managers to support all levels of nephrology certification. Understanding the demographics of this dominant part of the nephrology workforce should enable employers to improve their recruitment and retention programs. Incentives and initiatives offered to employees can contribute to job satisfaction. They may also enhance and encourage professionalism in this essential group of patient care 6.