About fifty kidney patients have waste products removed three times a week at the UMC Utrecht. This treatment – dialysis – requires specialized nurses. Lotte Duim is largely responsible for their education. She tackles this so energetically that she was recently awarded the title of Nurse of the Year in the education category.
The personal relationship with patients. The operation and possibilities of the dialysis machine. The puzzle with waste products and blood values to always arrive at the best possible treatment. Ask Lotte Duim what makes her work as a dialysis nurse so beautiful and interesting, and the 29-year-old gives one example after another.
Different every day
Laughing: “And to think that five years ago after I left the cardiology department, I had the idea that the care in my new workplace would often come down to the same thing. A misconception, as it soon turned out. Certainly in a university medical center, every day is different in a dialysis ward. We don’t just help relatively stable adults who report at the same times three times a week. For example, we are also there for children or patients who need acute care. Also consider patients for whom plasma filtration is used: a treatment against autoimmune reactions, in which their own plasma is replaced by synthetic plasma or donor plasma.”
Education
Our kidneys clean up the waste products in the blood. For example, an excess of salt or acid. If someone’s kidneys are barely working, dialysis can be a solution. There are two types of these: filtering waste products through the blood (hemodialysis) and through the abdomen (abdominal lavage, or peritoneal dialysis). Children receive only the last treatment. Patients in the UMC Utrecht are assisted by dialysis nurses. Duim: “Nurses can follow the training in our hospital. It lasts fifteen months and will be slightly shorter from November 2022: at least twelve months.” Duim calls itself “the overarching person to steer the training in the right direction”.
Exciting
In 2019 she was appointed as a practical supervisor. “I found that quite exciting, because I myself had only completed the training a year earlier. On the other hand, I saw it as a challenge to help develop the dialysis care of the future and to involve the students in it. As a practical supervisor I am responsible for the practical part of the training. I arrange, among other things, the three internships of the students: in hemodialysis, peritoneal dialysis and the transplant internship in the nephrology nursing ward (diagnosis and treatment of diseases of the kidneys, ed.). Nephrology is relevant, because UMC Utrecht is a transplant center and this is also part of the care we provide. It is also my job to ensure a good and safe learning climate for students and work supervisors.”
Even more students
Seven employees are training to become dialysis nurses at UMC Utrecht. “There are more than ever,” says Duim, who is also active as a dialysis nurse. “I am proud that we have so many students in a period of staff shortages in healthcare. We have succeeded in raising the training to a higher level. That is a joint achievement. Our unit head Marieke Deckers also plays a major role in this. She is fully committed to recruiting new students, for example through social media and job markets. We aim to have as many as nine students able to start working soon.”
More independent
The record number of students is also related to Duim’s initiatives; The Nursing Advisory Council of the UMC Utrecht named her Nurse of the Year in the education category for a reason. “For example, at the end of 2021 we set up a work-study unit for dialysis nurses in training. Normally a student walks with a work supervisor. The student mainly watches and listens and works one-on-one with the work supervisor. Thanks to the learning-work unit, students learn to work much more independently.”
critical thinking
Duim explains: “Two trainees are jointly cared for six patients who are in the hospital for dialysis in the morning. Then they run into questions and help each other to answer them. In this way they learn to think critically about challenges in daily care practice. Their coach monitors that the quality of care and patient safety are optimal, but the basic principle is that the trainees are initially much more responsible for this. The students respond positively to this set-up. We therefore hope to extend the work-study unit to the evenings.”
Best possible care
When is Duim satisfied with her work as a practical supervisor? “When I see that our students are having a good time and that their knowledge and skills are growing. And it is always best when, after fifteen months, students have developed into dialysis nurses who can provide the best possible care to our patients.”
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