UMC Utrecht is like a clock: activities run around the clock and this is only possible when the parts of the cogwheel mesh exactly together. We will highlight some of them in a summer series. This time: dialysis nurse Mark Jordaans. “The beauty of this profession is the special combination of tasks: clinical reasoning, moving machines and building a bond with the patient.”
New, but tried and tested. Specialized, but ambitious to mean a lot in other sectors as well. These characteristics apply to Mark Jordaans. It is relative new in our organization, because he passed through the UMC in Amsterdam four months ago. The 27-year-old is expert in specialized, given the two years she worked as a dialysis nurse. And ambitious in other areas Finally, Mark is due to his involvement in introducing a new therapy for patients with sickle cell disease.
Flexible
“An important reason for joining UMC Utrecht is that I can not only be a dialysis nurse here, but also be a daytime coordinator once a week,” says Mark. “This is an interesting new challenge. In short, it means that I then have to make sure things run smoothly in the dialysis ward. “
Keeping track
He explains: “That day I am responsible for patient planning and division of duties within the dialysis nurse team. A lot can happen in the department; for example, a patient develops complications or someone is brought in who needs urgent dialysis. So it is important to keep an overview. On behalf of the department, the day coordinator is also the first interlocutor, for example, of doctors. For example, discuss all the details of the patients who have been hospitalized together. “
Filter the waste
Patients whose kidneys are not functioning properly go to the dialysis unit. A dialysis machine – an artificial kidney – takes over the function of these organs as much as possible. Healthy kidneys filter waste products from the blood. They also regulate the amount of water and salts in the body and the excretion of excess substances. Plus minus 45 fifty hemodialysis patients, for whom waste products are filtered through the blood, receive treatment at UMC Utrecht three times a week, each time for an average of three to four hours.
Connection with patients
“As a dialysis nurse, you see the same patient regularly,” says Mark. “This often creates a bond, and this is one of the attractive aspects of the profession for me. I remember a man who was about my age. Since we were more or less the same age, I was able to put myself in his place very well and I sympathized a lot. He was in the middle of life and career when he was told that his kidneys were not working properly and that he needed dialysis several times a week. A donor kidney was subsequently transplanted, after which dialysis was no longer necessary. During the checks in the hospital, he always came to see me to catch up. “
Lemon slice
A dialysis nurse also instructs patients. Mark: “An important rule for a kidney sufferer to maintain optimal health is not to drink too much. Otherwise, the excess fluid cannot be extracted from the body and the blood pressure becomes too high and a person can run out of breath. I tell the patient how to cope with thirst. For example, he sucks an ice cube. Or put a slice of lemon in your mouth or in a little water, because citric acid stimulates the production of saliva ».
Monitor blood pressure and blood flow
In addition to contact with the patient, Marco likes the technique and clinical reasoning. Speaking of technology, he says: “We not only work with a dialysis machine, but also with a shunt flow meter to monitor blood flow in the shunt. A shunt is a subcutaneous connection between an artery and a vein in the arm. This connection is necessary to get enough blood to and from the dialysis machine. The shunt must be punctured prior to dialysis. We can use an ultrasound machine to help with this. On a screen you can see the path of the blood vessel and you can find suitable places to puncture the shunt. A vascular surgeon applies the shunt.
Prevent cramps
Clinical reasoning means that the healthcare professional observes the patient, interprets his observations and links all of this to his medical knowledge. Mark: “What are the patient’s blood values? And does he or she have any complaints? You constantly observe and consider if you need to act on something. If too much fluid is withdrawn from the body during dialysis, the patient may develop low blood pressure and cramps, for example, in a foot, leg or arm. So we stop extracting the moisture. If the complaint is more serious, we can administer fluids. “
Life quality
A dialysis nurse takes care of one to three patients during the shift. Mark: “My goal is for dialysis to ensure that the treatment contributes to their quality of life. What is quality of life? Which differs per person. One is happy if she can continue to pursue her hobby, the other if she can walk with her grandchildren. “
New treatment
Part of the day a week, Mark focuses on a new challenge. UMC Utrecht wants to add treatment to care for people with sickle cell disease. This is a hereditary and severe form of chronic anemia. Mark has a coordinating role in treatment setting and sees plans through a nursing lens.
Nursing training
He says: “This treatment is called erythrophesis. A machine replaces the abnormal blood cells with donor blood cells. Erythrophesis and plasma filtration techniques are not renal replacement treatments. Yet they are performed in the dialysis ward. This has to do with the nature of the treatment: the blood flowing out of the body is treated and returns to the patient. For this project I work closely with the internist-nephrologist Sabine Meijvis. We are in the middle of the preparatory phase. For example, it is important that nurses are properly trained to work with the machine, so that they can start treatment safely and responsibly ”.
