Real-Life Decision Making
As a dialysis technician, you work as part of a team. A nephrologist --
an MD -- prescribes dialysis treatment for patients and a registered nurse
(RN) oversees the treatment itself. As the technician, you are most likely
to notice problems with the patient's treatment, however, and are expected
to report anything unusual to your supervisors immediately.
As a technician who gives in-home dialysis, your role as the observer is
even more important. The RN who oversees your work only visits the home once
a month, while you arrive three days a week to administer treatment.
This morning, you arrive at the home of one of your patients only to find
his wife greeting you at the door. She is concerned about how her husband
is feeling, and she's worried that the treatments need to be increased.
You listen to her concerns and say you'll speak to the doctor and RN about
them. However, during the treatment, the patient tells you that while he feels
better immediately after his dialysis treatments, he doesn't feel he needs
more.
Only after talking to him for a long time do you find out that his insurance
policy only covers three treatments per week and he cannot afford any more.
As you prepare to leave after the treatment, your patient begs you not
to say anything to the doctor about increasing his treatments. As you head
back to the clinic, you wonder what you should do.
What do you decide?