The Tallahassee center offers dialysis in three shifts, 6 am, 11 am, and 5 pm. They are the only one around that offers 5 pm dialysis which is great for those persons still working and cannot come during the middle of the day. This center has 24 chairs total.
The first day I met with the RD and learned about the dialysis machine and the 'fake kidney'.
The second day of this rotation I was in Perry, Florida (about an hour drive) at another DaVita dialysis location. It was a much smaller clinic with only 12 chairs and two shifts.
The dietitian talked about the effects of cancer and dialysis and she showed me their charting program. We charted on some patients together. They use a point of care note, not nutrition care process so there's no PES (problem, etiology, signs/symptoms) statements. Their charting covers why the patient was seen, what education was given and what was spoken, as well as if goals were set, met, or not met. It's mostly a lot of box clicking with minimal writing. The RD does suggest putting in comments that will make you remember the patient at a later point in time if needed.
At dialysis, the lab values of concern are Albumin, PO4, K, Ca.
The first Friday was very interesting. I was back at the Tallahassee DaVita clinic, and saw some of the same patients from Monday. I was able to sit down with two of the patients and hear their story about dialysis and how they live with it and what it's like to be in kidney failure. These patients shared their stories and experiences.
It was interesting to know that if any DaVita patients travel, DaVita's are world wide- they can set up appointments while traveling and DaVita sets the appointments. DaVita can even schedule dialysis appointments around the world even if it's not a DaVita clinic.
The following Monday I was back in Perry, FL . It was kind of a crazy morning, the doctor was there for rounds on the patients. The interaction between the patients and the doctor was pretty neat. He checked almost every patient for fluid retention in their legs/abdomen. After rounds we met with the doctor to discuss bone mineral disease and see if the medications are enough or too much for the patients related to their calcium levels.
In Perry I made this lovely bulletin board (below)
Wednesday I was not at the rotation, I was at RD Legislature Day. (I have a separate post about this)
Friday I was back in Tallahassee and gave the patients reminders that 'big labs' were on Monday. Big Labs are when monthly labs are taken. I had to remind them to watch what they ate on Easter and to take extra binders if needed.
I went back to DaVita for my final day on Wednesday April 3rd as a make up day because I missed a day due to the Legislature Day. I went around to the patients and gave them their 'report card' for their monthly labs. Many people had high phosphorus lab values so I had to educate them on proper foods and to take binders.
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